• Korean Journal of Clinical Pharmacy
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• v.33 no.2
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• pp.135-142
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• 2023

Background: Pharmacists communicate with a variety of healthcare experts to prevent medication errors. Situation-Background-Assessment-Recommendation (SBAR) is a tool used for concise and accurate communication. In 2018, we developed the pharmacy-SBAR (P-SBAR) to deliver pharmacists intervention more quickly and effectively through quality improvement activities. Objectives: This study evaluates the efficacy of P-SBAR on pharmacists' intervention activities before and after the implementation of P-SBAR applications. We assessed the impact of P-SBAR on reducing the burden of intervention work, promoting pharmacists' participation, and enhancing the acceptance rate. Methods: This is a retrospective study of the two groups before and after P-SBAR implementation. All pharmacists' intervention records during two periods (2016-2017 and 2019-2020) were extracted from the data warehouse system at Kyunghee University Hospital at Gangdong, Seoul. The outcome was the number of inpatients and pharmacists who participated in the prescription monitoring activity, the number of interventions, and the physicians' acceptance rate. Results: Although the total number of inpatients decreased (364,753 vs. 348,229), the number of pharmacists who participated in intervention activity increased (monthly mean: 15.8 vs. 18.0, p=0.001). The total number of interventions (2,767 vs. 4,389), the frequency of full acceptance (2,018 vs. 3,710), and the monthly acceptance rate increased significantly (73.8% vs. 83.8%, p<0.001). Conclusion: P-SBAR improved accessibility and convenience by digitalizing the intervention activities performed in an offline environment. Improvement in work burden and acceptance rate using P-SBAR is expected to contribute toward reducing medication errors.

• Korean Journal of Clinical Pharmacy
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• v.20 no.2
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• pp.120-127
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• 2010

Objective: The purpose of this study was to identify the type and frequency of chemotherapy-related prescribing errors and assess the pharmacist intervention in preventing potential harm. Methods: This study was performed in satellite pharmacy of oncology/hematology unit in tertiary teaching hospital from April to September, 2009. All chemotherapy prescribing errors detected by pharmacists were recorded. Frequency and characteristics of prescribing errors were analyzed. Pharmacists reviewed 28, 495 chemotherapy orders from 12,719 patients during 6-month periods. Results: A total of 835 prescription errors (2.93%) in 734 patients (5.77%) were detected by pharmacists. Alkylating agents (37.6%) followed by antimetabolite (23.35%), and mitotic inhibitors (21.44%) were the most prevalent classes in which errors occurs. The most common types of error detected were incorrect dose (34%), incorrect solution (33%), incorrect route (9%) and omission errors (8%). Changes in chemotherapy order due to pharmacists' intervention occurred in all error cases. Conclusion: Pharmacists' intervention in reviewing chemotherapy and drug orders intercepted potential harm due to prescribing errors. The current study provided strategies for reduction of medication errors.

• Korean Journal of Clinical Pharmacy
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• v.34 no.1
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• pp.62-70
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• 2024

Background: Drug-related problems have the potential to threaten patient health, and pharmacists are in a position to prevent such problems through prescription reviews and patient counseling, actively engaging in pharmaceutical care activities. This study aims to categorize and analyze the intervention activities of pharmacists in community pharmacies concerning drug-related problems, following international criteria. Methods: Over a six-month period, prescription interventions completed in a community pharmacy in Seoul were selected as the research subjects. The causes of interventions were classified according to the Pharmaceutical Care Network Europe (PCNE) drug-related problems (DRPs) classification system and the types and frequencies of DRPs were identified. Results: Among a total of 49,334 prescriptions, 527 interventions were completed, constituting approximately 1.07% of the daily average filled prescriptions. Individuals over 60 years of age represented more than 50%. The primary cause of DRPs was prescribing and drug selection issues, comprising 256 cases (48.58%), with specific subcategories including 109 cases of drug selection, 79 cases of treatment duration errors, 47 cases of dose selection, and 21 cases of inappropriate dosage form selection. Patient-related issues accounted for 204 cases (38.71%). Conclusion: The study demonstrated that the pharmacists' intervention in community pharmacies contributes to the safe use of medication by patients.

• Journal of Neurocritical Care
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• v.11 no.2
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• pp.110-118
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• 2018

Background: The role of clinical pharmacists in medication therapy to improve clinical and economic outcomes has been reported in the literature. This study was conducted to analyze the changes in details of medication interventions before and after the introduction of clinical pharmacists into the care of neurocritical care unit (NCU) patients, and to evaluate the economic effects of clinical pharmacists by calculating the avoidance cost. Methods: A retrospective study was conducted reviewing the electronic medical records from June 2013 to May 2014 (before), and from June 2016 to May 2017 (after). We calculated the number and rates of intervention, the acceptance rates of it, and also reviewed the list of interventions. We calculated avoidance cost if there was no intervention. Results: The monthly mean number of interventions increased from 8.0 (${\pm}5.7$) to 31.7 (${\pm}12.8$) (P<0.001) and the frequency of intervention also increased from 0.8% to 1.6% (P=0.003). The most frequently provided pharmacist intervention was nutritional support before introduction of clinical pharmacists and discussions on the medication plan after. The number of classified interventions was 14 before introduction of clinical pharmacist services and 33 after. The calculated cost avoidance associated with a clinical pharmacists' integration was 77,990,615 won per year. Conclusion: Introduction of clinicals pharmacist into the NCU was associated with increased intervention rates and expanded types of clinical interventions. The cost avoidance achieved by the pharmacists' interventions can be further explored to evaluate if similar expansions of pharmacists' services achieve similar results in other settings.

• Journal of Preventive Medicine and Public Health
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• v.57 no.3
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• pp.212-222
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• 2024

Objectives: Epilepsy is a chronic disease that requires long-term treatment and intervention from health workers. Medication adherence is a factor that influences the success of therapy for patients with epilepsy. Therefore, this study aimed to analyze the role of pharmacists in improving the clinical outcomes of epilepsy patients, focusing on medication adherence. Methods: A scoping literature search was conducted through the ScienceDirect, PubMed, and Google Scholar databases. The literature search included all original articles published in English until August 2023 for which the full text was available. This scoping review was carried out by a team consisting of pharmacists and neurologists following the Preferred Reporting Items for Systematic reviews and Meta-Analyses (PRISMA) Extension for Scoping Reviews and the Joanna Briggs Institute guidelines, including 5 steps: identifying research questions, finding relevant articles, selecting articles, presenting data, and compiling the results. Results: The literature search yielded 10 studies that discussed pharmacist interventions for patients with epilepsy. Five articles described educational interventions involving drug-related counseling with pharmacists. Two articles focused on similar pharmacist interventions through patient education, both verbal and written. Three articles discussed an epilepsy review service, a multidisciplinary intervention program involving pharmacists and other health workers, and a mixed intervention combining education and training with therapy-based behavioral interventions. Conclusions: Pharmacist interventions have been shown to be effective in improving medication adherence in patients with epilepsy. Furthermore, these interventions play a crucial role in improving other therapeutic outcomes, including patients' knowledge of self-management, perceptions of illness, the efficacy of antiepileptic drugs in controlling seizures, and overall quality of life.

• Korean Journal of Clinical Pharmacy
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• v.32 no.1
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• pp.20-26
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• 2022

Background and objective: The Seoul National University Bundang Hospital (SNUBH) implemented ward-based clinical pharmacy system with designated pharmacists in 10 general wards. Designated pharmacists conduct inpatient medication review, medication intervention, and medication consultation, and provide drug information for health care providers. This study aimed to evaluate the clinical pharmacy services and to examine the perception and expectations of health care providers on the services provided by the designated pharmacists in general wards. Methods: A survey was constructed to include questions on the health care providers' recognition, satisfaction, and perceived needs of designated pharmacists. We determined the frequency and type of interventions of ward pharmacist and their acceptance rate through a retrospective observational study using electronic medical records. Results: A total of 59 health care providers responded the questionnaire and 79.7% of the respondents reported moderate to high levels of satisfaction. Satisfaction with the services was positively associated with clinical interventions and nutrition support team (81.4%). Of 59 respondents, 88.1% agreed that preventing drug-related problems by designated pharmacists' activities were effective. The most common interventions included inadequate dosage (27.4%), omission and additional prescription (14.6%) and inadequate drug form (9.6%). The acceptance rate of intervention was 91.5%, and 151 potentially serious risks and 523 significant risks were prevented by the intervention. Conclusion: Positive results were confirmed in the awareness, satisfaction, and perceived needs of the health care providers for designated pharmacists. Expansion of the ward-based clinical pharmacy system with designated pharmacists to other wards may be considered.

• Korean Journal of Clinical Pharmacy
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• v.26 no.3
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• pp.245-253
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• 2016

Objective: This study was conducted to evaluate payer-driven medication adherence intervention program from the patient's and counselor's perspectives. Methods: Target patients for intervention were selected by retrospective adherence measures based on national health insurance claims data for hypertension, diabetes and hyperlipidemia. As a serial intervention for higher risk groups of medication non-adherence, initial direct mailing, the first direct telephone call and the second direct call or a home visit were followed. Interview approach to qualitative inquiry was used to evaluate intervention results. Results: Participants including 4 patients received telephone calls, and 4 National Health Insurance Service staff and 4 pharmacists participated as counselors were interviewed regarding their impression of the intervention program. Three major themes arose: overall perception; necessities; and suggestions for success, of the intervention. Despite short period of intervention, educational intervention by telephone counseling involving pharmacists shows potential to improve self-management of chronic disease, and pharmacist-involvement. But more sophisticated selection of target patients requiring the intervention and complementation of electronic database system would be necessary. In addition, personal disposition of counselor was revealed to be an important factor for achieving successful outcome of intervention. Conclusion: The findings suggest that the individualized counseling intervention would be an efficient option for improved medication adherence. Further researches should include longer periods of interventions, a quantitative analysis using adherence measures based on claims data and consideration of clinical benefits associated with the intervention.

• YAKHAK HOEJI
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• v.53 no.6
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• pp.368-376
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• 2009

DUR (Drug Utilization Review) originally referred to the evaluation of drug usage details: however DUR refers to the system used to support the services of prescribing and dispensing through linking from Health Insurance Review and Assessment (HIRA) Service in Korea. HIRA is going to begin the DUR enforcement for extending to nationwide coverage after pilot test. Objectives: The aims for this study were to evaluate and clarify the current opinions of the pharmacists for the recognition and acceptance rates before nationwide coverage concerning DUR system. Methods: A 16-question-questionnaire was developed and pilot tested. For 40 days of survey by both on-line and fax paper, it was carried out on 80 pharmacists working at community pharmacy in Goyang-si, Gyeonggi-do. Results: Most of answers were broadly positive and interested in begining the DUR system and kept in mind that the goal of DUR is safety guarantee for people. On the other hand, most of answerers worry that delay of patient waiting time and inharmonious communication with doctors in DUR processing can be a major obstacle to begin the DUR system. Conclusion: To solve several problems, the most important things are to make good reciprocal relationships between doctors and pharmacists, investigate intervention tool to shorten patient waiting time, and activate educational program of inspecting items for the pharmacists.

• Asian Pacific Journal of Cancer Prevention
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• v.16 no.8
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• pp.3319-3323
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• 2015

Background: Community pharmacists play an important role in tobacco control and adequate training on smoking cessation is essential. Materials and Methods: A quasi-experimental pre-test/post-test design was used. A one-day workshop on smoking cessation organized by Indonesian Pharmacists Association as part of PCE program was offered to 133 community pharmacists. The workshop consisted of a 3-hour lecture and a 3-hour role-play session. Pre-training and post-training surveys assessed the impact of training on parameters including knowledge, perceived role and self-efficacy with respect to smoking cessation counseling practices. Intention and ability to perform counseling using the 5A framework was assessed after training only. Results: After PCE, knowledge score significantly increased from $24.9{\pm}2.58$ to $35.7{\pm}3.54$ (p<0.001). Perceived role and self-efficacy in smoking cessation counseling also significantly increased from $25.8{\pm}2.73$ to $28.7{\pm}2.24$, and $27.6{\pm}4.44$ to $32.6{\pm}3.63$, respectively (p<0.001). After the workshop, most participants were willing to ask, advise, and assess patients who ready to quit, but were still less likely to assist in quitting plans and arranging follow up counseling. More than 75% pharmacists were able to perform cessation counseling and 65% of them can completely perform a 5A brief intervention. Conclusions: PCE can enhance pharmacists' knowledge, perceived role, self-efficacy in cessation counseling practices, and create willingness and ability to perform cessation counseling. Future training is recommended to improve skills in assisting quitting plans and arranging follow up.

• Korean Journal of Clinical Pharmacy
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• v.29 no.3
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• pp.193-201
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• 2019

Background and Objective: Since the introduction of hospital pharmacy residency programs in 1983, hospital pharmacists in South Korea have been expected to expand their roles. However, their services and the outcomes have not been fully understood. In this study, we conducted a systematic review of Korean hospital pharmacist-provided interventions with regard to intervention type, intervention consequences, and target patient groups. Methods: A literature search of the following databases was performed: Embase, PubMed, Medline, KoreaMed, RISS, KMbase, KISS, NDSL, and KISTI. The search words were "hospital pharmacist", "clinical pharmacist", and "Korea". Articles reporting clinical or economic outcome measures that resulted from hospital pharmacist interventions were considered. Numeric measures for the acceptance rate of pharmacist recommendations were subjected to meta-analysis. Results: Of the 1,683 articles searched, 44 met the inclusion selection criteria. Most articles were published after 2000 (81.8%) and focused on clinical outcomes. Economic outcomes had been published since 2011. The interventions were classified as patient education, multidisciplinary team work, medication assessment, and guideline development. The outcome measures were physicians' prescription changes, clinical outcomes, patient adherence, economic outcomes, and quality of life. The acceptance rate was 80.5% (p < 0.005). Conclusion: Studies on pharmacist interventions have increased and showed increased patient health benefits and reduced medical costs at Korean hospital sites. Because pharmacists' professional competency would be recognized if the economic outcomes of their work were confirmed and justified, studies on their clinical performance should also include their economic impact.