Background: The recent change in pharmaceutical education system following the paradigm shift to patient-oriented pharmacy service requires an in-depth discussion to reorganize a future direction and establish a basis for maximizing social values of community pharmacy service. Objective: This study was conducted to review the current status of community pharmacy service provision in Korea based on published literatures. Methods: The electronic databases of National Digital Science Library and Electronic National Assembly Library were used to search the journal articles and dissertation papers. A search term "community pharmacy" was used and the published period was limited to papers published after year 2001, when the legal separation of prescribing and dispensing was implemented. Relevant study reports were also searched manually. Information about pharmacy service provision and study outcomes were retrieved from the selected papers, and classified by predefined individual service scope. Results: A total 33 papers reporting services provided by community pharmacies were selected (journal article 11, dissertation paper 17, and study report 5). Pharmacy services identified in these papers could be classified into prescription dispensing service, pharmaceutical care service, self medication service, other products service, and health promotion service. Twenty papers reported prescription dispensing services, three papers reported pharmaceutical care service, and only two papers reported health promotion service. Current community pharmacy services are highly dependent on prescription drugs while expanded services such as pharmaceutical care and health promotion are peripheral. Most prevalent research topic was medication counseling service (18 papers), reflecting that community pharmacists generally consider it to be the most important and fundamental service. Overall, current pharmacy services are very limited and focus on prescription dispensing service. Conclusion: At this point of time requiring expansion and quality improvement of community pharmacy services, we suggest further lively discussion to strengthen pharmacist's functional identity and set conditions for providing socially expected services.
Background: In order to achieve the goals of community pharmacy practice, its legal, labour-related, and economic barriers need to be identified. This study examined pharmacists' perceptions of constraints on providing optimal pharmacy services in order to identify underlying factors and analyse the associations between barriers and pharmaceutical services in community pharmacies. Methods: A survey targeting pharmacy owners was conducted from May to June 2012 using a structured questionnaire including nine pharmaceutical service items. According to the service provision level, we classified pharmacists as inactive (fewer than 5 items among the listed 9 service items) and active providers (5 or more items). Principal component analysis was used to group significant factors for barriers into four thematic components. Associations between the participants' demographics and pharmacy characteristics and the services provided were explored by logistic regression analyses. Results: Participants were 402 pharmacists. Over 60% provided disease management services for hypertension, diabetes, and hyperlipidaemia. Variables that affected pharmaceutical services included the lack of separate areas for patient counselling (OR: 2.12, 95% CI: 1.18-3.80), and clinical knowledge and information-related barriers (OR: 0.59, 95% CI: 0.36-0.97). Conclusion: Strategies for improving clinical knowledge and providing expeditious information are necessary in order to improve community pharmacy services.
The purpose of the study was to compare patient's satisfaction on the pharmacy services after introducing the new system of separation of dispensing from prescribing medicines, between those filling their prescriptions from the pharmacy nearby hospitals and those from the pharmacy in their resident areas. To measure patient's satisfaction, a questionnaire survey was conducted with 354 outpatients who received prescriptions from any of the three university hospitals located in In-Cheon city. Study results showed that geographic accessibility to pharmacy was a main attribute to select pharmacy. Size of the pharmacy and availability of prescription drugs are the second major reasons for pharmacy selection for the patients from the pharmacy nearby hospital, whereas patronage is the second major reason for those from the pharmacy in resident areas. Overall satisfaction was higher among the patients from the pharmacy in resident areas than those from the pharmacy nearby hospitals, mainly due to better facilities(waiting area, public telephone, etc), kindness, cleanliness, shorter waiting time, and pharmacist's concern about patient's health. On the other hand, the patients of the pharmacy nearby hospitals showed low satisfaction because of long waiting time and the lack of pharmacist's knowledge and information about patients' health status and medication history. Patients visiting the hospital that has pharmacy-hospital cooperation system showed higher satisfaction as compared to those visiting the hospital without such system. This study provided an empirical evidence that it would be more advantageous for patients to receive pharmacy services from pharmacies located in their living areas than from pharmacies nearby hospitals. This implies that there is a strong need for adequate strategies to enhance the role of pharmacies in resident areas under the new system of separation of dispensing from prescribing medications.
Objective: Community pharmacists are frontline health care providers, but have been considered as underutilized professionals on a daily basis. The purpose of this scoping review was to identify information about the impact of the COVID-19 pandemic on community pharmacy services and to evaluate new services that could be applicable. Methods: We searched MEDLINE and EMBASE for studies published up to January 10, 2020. Search terms consisted of keywords relevant to this review, including "COVID-19", "community pharmacy", and "community pharmacist". This review targeted studies of pharmacist services provided by community pharmacies in OECD member countries during the COVID-19 pandemic period. Results: Twenty-seven studies were included in this review. Changes in community pharmacist services due to the COVID-19 pandemic were broadly classified into four categories. First, as the face-to-face services became challenging, various non-face-to-face services were being tried. Second, community pharmacists directly participated in the services to prevent the spread of COVID-19. Third, community pharmacists made efforts to support continuity of care for patients who experienced difficulties due to the reduced professional care as health and medical resources are concentrated in response to COVID-19. Fourth, community pharmacist services were emerging, targeting patients suffering from greater health inequality during the pandemic. Patients expressed high demand and satisfaction for the service of the community pharmacist, and pharmacists reported self-efficacy and professional pride. Conclusion: This study demonstrated that in the era of the COVID-19 pandemic, various community pharmacist services have been tried and received positive evaluations from patients in several OECD countries.
Since the national health insurance was introduced in 1978, the increased utilization of hospitals and the growing importance of pharmaceutical services to hospital patients have made the administration of these services a very complex and specialized responsibility. The pharmaceutical services has always been an essential component of comtemporary hospital care. In the hospital, the pharmaceutical services is the professional department which concerns itself with the evaluation, selection, control and utilization of drugs. The director of this service must be a versatile professional person who can work effectively in a heterogenous society of educated persons. However, graduate education in hospital pharmacy has not been introduced yet in Korea. The necessity of graduate education hospital pharmacy has been discussed in this research. Graduate education in hospital pharmacy emphasizes preparation for assumption of responsibility as the senior hospital pharmacist or the director of pharmaceutical services. Graduates should also be prepared as administrators of a department that must operate with great efficiency. They should be prepared serve as a consultant on drugs for the medical and allied health professional staff, organizing and disseminating a large and dynamic body of information in their interest and to establish professional roles that emphasize procurement, storage, manufacturing, packaging, distribution, control and evaluation of drugs. Senior hospital pharmacist is a teacher charged with responsibility fer formal and informal instruction of other hospital personnel in pharmaceutical sciences. In addition, the graduates have the opportunity to be a researcher dealing with aspect of hospital care and are intensively educated in the professional aspects of hospital pharmacy practices. The curriculum of graduate education in hospital pharmacy should be established detailly and carefully to fit the educational objective.
Objective: This study aimed to investigate pharmaceutical care for critically ill neonates and suggest targeted strategies compatible with the Korean health-system pharmacy. Methods: Articles that reported pharmacy practices for critically ill neonates were reviewed. Pharmaceutical care practices and roles of neonatal pharmacists were identified, and criteria were developed for neonates in need of specialized care by clinical pharmacists. Results: Neonatal pharmacists play many roles in the overall medication management pathway. For clinical decision support, multidisciplinary ward rounds, clinical pharmacokinetic services, and consultation for pharmacotherapy and nutrition support were conducted. Prevention and resolution of drug-related problems through review of medication charts contributed to medication safety. Pharmaceutical optimization of intravenous medication played an important role in safe and effective therapy. Information on the use of off-label medicine, recommended dosage and dosing schedules, and stability of intravenous medicine was provided to other health professionals. Most clinical practices for neonates in Korea included therapeutic drug monitoring and nutrition support services. Reduction in medication errors and adverse drug reactions, shortening the duration of weaning medicines, decreasing the use and cost of antimicrobials, and improvement in nutrition status were reported as the outcomes of pharmacist-led interventions. The essential criteria of pharmaceutical care, including for patients with potential high-risk factors for drug-related problems, was developed. Conclusion: Pharmaceutical care for critically ill neonates varies widely. Development and provision of standardized pharmaceutical care for Korean neonates and a stepwise strategy for the expansion of clinical pharmacy services are required.
The need for and components of a contemporary community pharmacy externship for pharmacy students have not been clearly identified in Korea. Mail survey was performed among 20 college of pharmacy deans and 800 community pharmacists to analyze the current status and develop a consensus regarding major focus area and criteria of community pharmacy externship to be implemented under the separation of dispensary from medical practice in year 2000. Mail survey yielded $80\%\;and\;23.5\%$ response rate for pharmacy school deans and community pharmacists, respectively. Of the 16 pharmacy schools that responded 14 said they have externship program in hospital pharmacy, and only 8 pharmacy schools responded of having externship program for community pharmacy. However, these community pharmacy programs lacked criteria and standard guideline for the externship. The results of survey revealed that community pharmacy externship program for students should be organized and directed toward developing expert knowledge and skills in pharmacy practice activities, clinical services, communications, pharmacy management, and professionalism. Pharmacy practice components should include competencies and skills in computer application, prescription processing, dispensing, pharmaceutical compounding, Narcotics Control Law application, maintenance and provision of drug information, and laws and regulations. Clinical service components should include the ability to identify patient's drug-related problems, provide long-term patient care and appreciate drug therapy services. Communication skills should be taught to effectively express his/her professional opinion, deduce the needs of others, utilize appropriate techniques and media to communicate ideas and conduct a patient interview and to obtain patient drug history. Pharmacy management skills should be taught to be efficient in medical insurance and drug control process. It was found that professionalism, morality, pharmacy practice experience, ability to provide clinical services, collect and provide drug information and regality are important criteria of preceptors. Externship sites should possess the ability to stock various drugs, access and provide diverse pharmacy services and should have private patient counseling area. Most pharmacists agreed that top 200 drugs' generic and brand name, indications, dosage, side effects, and contraindication should be instructed during the externship. It was also found that student and preceptor should be evaluated for their performances during the externship. This information will be incorporated into teaming objectives for students and to develop Academic Extemship Program Guidelines.
Kim, Jeongun;Baek, Sijin;Choi, Nayae;Jeon, Sujeong;Namgung, Hyung Wook;Lee, Junghwa;Lee, Euni;Lee, Ju-Yeun
Korean Journal of Clinical Pharmacy
/
v.32
no.1
/
pp.20-26
/
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.
Objective: We conducted a survey to understand the current state of pharmacy services and pharmacists' thoughts in the future of the community pharmacy setting. Methods: A questionnaire was distributed to 229 pharmacists and gathered from 95 respondents. Results: We asked to pharmacists about what the ideal pharmacy duty should be in the next 10 years at the community pharmacy setting in Korea. For this question, the respondents said drug counselling (19.4%), dispensing (13.8%), long-term care of chronic disease and healthcare education (12.8%), and OTC counselling (11.5%). When asked about how much time they were spending doing certain tasks in the pharmacy, the main tasks were dispensing (23.5%), counselling (17.1%), prescription review (10.1%), and OTC counselling (5.5%). When asked about what the most important duty of a pharmacist was, medication counselling (45.4%) was the most important task that they identified and the reasons for not being able to fulfill this role properly was time shortage (78.9%) followed by the lack of counselling spaces, up-to-date knowledges, and focus on financial gains over patient counselling. Conclusion: Korean pharmacists are mainly focusing on dispensing in their daily work. Their basic responsibilities can be easily mechanized over the next few years, but the social expectations of disease-prevention and public health promotion both in current and future can not be replaced by such mechanical measures. Therefore, pharmaceutical services in Korea should be developed in more diverse and professional ways.
Background: South Korea is rapidly being an aging-society and the demand of long-term care insurance services for elderly patients is rising. In addition, because the elderly taking multiple medicines, the adherence is lowered and the adverse events are easily occurred. Therefore, many are interested in introducing the geriatric pharmacy specialist to manage this situation. Purpose: By applying a similar program such as the geriatric pharmacy specialist working in nursing home, we conducted this study to evaluate the potential contribution to both the health insurance services and financial savings for the elderly patients. Methods: We conducted a trial in an elderly nursing home to collaborate between doctor and pharmacist making a checklist for improving medication adherence and establish a consultation system. Also we applied a smart phone application in the pharmaceutical care processes. Results: Thereby completing the drug therapy related checklist apply to nursing facilities in South Korea. And we got a performance that improves medication adherence when used in the clinical practice settings. Conclusion: By introducing a training program of pharmacy care managers and geriatric professionals such as the United States and Japan, we revealed the elderly nursing home residents and vulnerable elderly people living alone were improved the medication adherence and it will contributed to the health and quality of life of the patients.
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