• Korean Journal of Clinical Pharmacy
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• v.28 no.2
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• pp.154-157
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• 2018

Levosulpiride is one of the most frequently prescribed medicines in Korea. An adverse drug reaction (ADR) after taking levosulpiride was reported at a community pharmacy in Korea. A 31-year-old woman reported the symptoms of lactation and amenorrhea after taking levosulpiride; an evaluation of whether these symptoms were caused by the medication was therefore necessary. Several tools can be used to determine if the ADR resulted from the administered drug or other factors, including the World Health Organization-Uppsala Monitoring Centre (WHO-UMC) criteria, the Naranjo scale, and the Korean causality assessment algorithm (Ver. 2). The causality was evaluated as "possible" by the WHO-UMC and Naranjo scales, but as "probable" by the Korean causality assessment algorithm (Ver. 2). In conclusion, the information provided did not indicate definite causality and there were slight differences in the results obtained from each assessment method.

• Korean Journal of Clinical Pharmacy
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• v.19 no.2
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• pp.159-166
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• 2009

The purpose of this study was to evaluate the attitude and knowledge of community pharmacists to spontaneous adverse drug reaction (ADR) reporting. A survey was conducted in 103 community pharmacists in Seoul and Kyung-Gi Province from September to October, 2009. Almost half (53, 51.5%) and three-fourths (79, 76.7%) of respondents knew they could participate in ADR reporting in the Regional Pharmacovigilance Center (RPC) or Korean Food and Drug Administration (KFDA). However, only three of them have reported an ADR to the RPC and none of them have reported to KFDA. A majority of the respondents (96, 93.2%) felt that ADR reporting was a professional obligation for pharmacists. The purpose of an ADR reporting was incorrectly identified by most pharmacists. ADR reporting was encouraged if the reaction was serious and a new product. The most frequently mentioned barriers to reporting were: uncertainty concerning the causal relationship (86.3%) and not knowing how to report an ADR (83.2%). Only 19 (18.4%) respondents had received education on how to report ADR. Education was the most recognized method of improving ADR reporting. This study showed the knowledge of ADR reporting among community pharmacists is inadequate. Education and training should be reinforced in order to improve ADR reporting by community pharmacists.

• YAKHAK HOEJI
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• v.58 no.6
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• pp.378-386
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• 2014

Topical agents including of steroids are easily exposed to Korean patients in community setting. Those topical agents must be use cautiously because can cause adverse drug reaction unlike other oral medication. We evaluate the using pattern topical agents of Korean in community setting. We performed a questionnaire survey in three different pharmacies (general community pharmacy, dermatology clinic oriented pharmacy, general hospital oriented pharmacy) and in three university town. The survey asked necessity of topical agents, the number of applications per day, application period, site, and exist of steroids ingredient, etc. Total 330 people was participated in the survey from May 1st to July 31st, 2014. We analysed the survey by the frequency of each question and cross-analysis of the compliance between general public and pharmacy groups. In results, Korean people used topical agents for sudden skin diseases (66.9%), was gotten by dermatologist's prescription (89.1%), and did not know their diagnosis (39.2%). The people applied topical agents on face (22.3%), less one half FTU (finger tip unit) per application (61.9%), less than one week (62.9%). Though they was received drug education from pharmacist (52.2%), did not heard about adverse effects (78.4%). And compliance of applied times in pharmacy group was higher than in-non-pharmacy group (56% vs 38%, p=0.002). The highest compliance between 3 pharmacy subgroup was general community pharmacy (76.3% vs 61.6%, 61.2%, p=0.039). Compliance of applied duration was no difference between groups. Majority of respondents did not know diversity of ingredients, potency, application area of topical steroids, and replied to feel some vague reluctance and to think so dangerous about topical steroids. In conclusion, Korean people in community use topical agents well but still some exposed to risk from topical agents.

• Korean Journal of Clinical Pharmacy
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• v.23 no.1
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• pp.49-56
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• 2013

Objective: The purpose of this study was to evaluate the patterns of Over-the-Counter (OTC) drugs and their interactions with prescription drugs in adults visiting a community pharmacy. Method: The subjects were 151 adults aged over 20 years visiting a community pharmacy in Asan-si from December 16th 2011 to February 1st 2012. We used a survey questionnaire. The survey inquired about the prevalence and the details of any OTC drug use and the characteristics of the study subjects. The drug interaction classification system from Lexicomp's Lexi-interact data fields was used to identify OTC drugs likely to have clinically significant interactions with prescription drugs. Results: The patterns of OTC drug use were related to thirties (from 30 to 40 years old), female gender, higher education, non-smoking, sometimes use of alcohol, and self-perceived normal health status. The most commonly used OTC drug category was antipyretic-analgesics (n=104, 53.3%), and the most commonly used ingredient was acetaminophen (n=67, 64.4%). The biggest motivation for taking OTC drugs was suggestion by pharmacists, reported by 55.6%. After reviewing each patient's prescription drugs and OTC drugs, 14 patients (36.8%) of 38 patients using prescription drugs were taking drug combinations with potential for clinically significant interactions. The concomitant use of OTC drugs with prescription drugs may lead to increased potentially harmful interactions. Conclusion: It is suggested that health-care professionals should be more aware of the potential and possible interactions and take into better account their patients' OTC drug use.

• Asian Pacific Journal of Cancer Prevention
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• v.13 no.9
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• pp.4427-4430
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• 2012

Breast cancer is the most common cancer and the leading cause of cancer death among women in Malaysia. Despite the campaigns undertaken to raise the awareness of the public regarding breast cancer, breast cancer screening rates are still low in the country. The community pharmacist, as one of the most accessible healthcare practitioners, could play a role in the provision of breast cancer health promotion services to the community. However, there are no documented data regarding the community pharmacists' involvement in breast cancer related health promotion activities. Hence, this study was conducted to examine self-reported knowledge, practice and perception of community pharmacists on provision of breast cancer health promotion services and to investigate the barriers that limit their involvement. This cross-sectional survey conducted between May to September 2010, included a sample of 35 community pharmacists working in the districts of Hulu Langat and Sepang in state of Selangor. A 22-item validated questionnaire that included both closed and Lickert scale questions was used to interview those pharmacists who gave their informed consent to participate in the study. The data was analysed using SPSS. Only 11.3% of the community pharmacists answered all the questions on the knowledge section correctly. The mean overall knowledge of the community pharmacists on risk factors of breast cancer and screening recommendations is 56%. None of the respondents was currently involved in breast cancer health promotion activities. Lack of time (80%), lack of breast cancer educational materials (77.1%) and lack of training (62.9%) were the top three mentioned barriers. Despite these barriers, 94.3% (33) of the community pharmacists agreed that they should be involved in breast cancer health promotion activities. Hence, there is need to equip community pharmacists with necessary training and knowledge to enable them to contribute their share towards prevention and screening of breast cancer.

• Korean Journal of Clinical Pharmacy
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• v.27 no.2
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• pp.69-76
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• 2017

Objective: This study was conducted to assess the current status of experiential education, by analyzing pharmacy students' satisfaction and evaluation for practice sites and preceptors for 3 years from 2014 through 2016. Methods: Students evaluated the practice sites and preceptors using a 5-point and a 4-point Likert scale, respectively. Analysis was performed based on the types of curriculums and practice sites. In addition, sub-analysis was conducted based on the types of health-system pharmacy and the community pharmacy. Results: Total 203 students responded to the survey questionnaires. The 3-year average score of students' satisfaction with practice sites was 4.25. In the sub-analysis conducted based on the types of health-system pharmacy, the score was higher in the tertiary hospital pharmacies than that of the general hospital pharmacies (4.49 vs. 4.06, P<0.001). For community pharmacy, the difference in the score of the 3-year analysis was not significant, depending on the types (4.51 vs. 4.33, P=0.054). The average score of students' evaluation on the preceptors was 3.37 in the 3-year analysis. The score was significantly higher for the preceptors of tertiary hospital pharmacies than those of general hospital pharmacies (3.61 vs. 3.25, P<0.001). For community pharmacy, no significant differences were found, depending on the types of pharmacy (3.53 vs. 3.43, P=0.309). Conclusion: The students' satisfaction with practice sites and preceptors in pharmacy experiential education was high. However, it varied greatly depending on the types of educational institutions. Mutual effort between university and educational institutions is required, to narrow the gap in the degree of students' satisfaction.

• YAKHAK HOEJI
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• v.57 no.1
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• pp.63-69
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• 2013

The objectives of the study are to investigate pharmacy remuneration levels stratified by the number of prescriptions dispensing and the type of nearby medical facilities using the Korean National Health Insurance (NHI) database, and to classify community pharmacies based on the characteristics. Claims data of all community pharmacies were extracted from the Korean NHI database from January 1 to June 30, 2010. A total of 14,985 pharmacies were included for the analysis. The remuneration amounts per pharmacist were directly associated with the number of prescription dispensing, and varied by the type of nearby medical facilities where more than 90% of prescriptions dispensed at the pharmacy are issued from. We classified pharmacies to six groups according to the number of prescription dispensing and the type of nearby medical facilities; (1) pharmacies with equal to or less than 200 prescriptions per month per pharmacist, (2) pharmacies near a general hospital, (3) pharmacies near a regular hospital, (4) pharmacies near a clinic, (5) pharmacies near multi clinics, and (6) pharmacies that do not belong to the above types. Compared to pharmacies near a clinic or multi clinics, pharmacies near a general hospital showed a lower number of prescription dispensing per pharmacist, but the income from dispensing fees was higher (p<0.05). The new taxonomy of community pharmacies can be a useful basis for further policy development in pharmacy remuneration system.

• Korean Journal of Clinical Pharmacy
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• v.31 no.1
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• pp.61-78
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• 2021

Background and Objective: The use of potentially inappropriate medications (PIMs) increases the risk of negative health outcomes, including drug-related admissions. Tools for structured medication review have been developed to ensure optimal medication use and safety. Here, we aimed to evaluate medication use review (MUR) tools for community-dwelling older patients. Methods: We performed a systematic review of the literature according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses Statement (PRISMA). We searched PubMed, Embase, and the Cochrane Library from 1991 to 2020, excluding tools that are specifically applied to hospitalized patients or nursing home residents. We identified the most common inappropriate medications, drug-disease interactions, drug-drug interactions and prescribing omissions presented among tools. Results: From among 9,788 identified reports screened, 60 met our inclusion criteria; finally, 27 were eligible for data analysis considering originality and up-to-dateness. Most tools presented explicit criteria (93%), and only one was specific to community-dwelling elderly. The most common PIM was tricyclic antidepressants. Use of diltiazem and verapamil in patients with heart failure and the combination of nonsteroidal anti-inflammatory analgesics and warfarin were the most frequent disease-specific PIM and drug-interaction, respectively. Conclusions: Although several medication review tools have been developed for older adults, specific guidelines for community-dwelling populations remain limited. Furthermore, the list of PIMs differed among available tools. In future, specific but integrating MUR tools need to be developed for clinical practice considering this population.

• Korean Journal of Clinical Pharmacy
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• v.32 no.1
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• pp.27-36
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• 2022

Background: Medication-related problems (MRPs) frequently occur during the discharge period. Elderly patients, particularly, are at high risk for these problems due to polypharmacy and the use of potentially inappropriate medications. The purpose of this study was to build and implement collaboration between general hospital and community pharmacies to address MRPs among high-risk elderly patients before/after discharge. Methods: This retrospective study was conducted between June and December of 2020. The inclusion criteria were patients with aged ≥65 years; residents of Jeonju; discharged from Jeonbuk National University hospital; either on medication of exceeding 10 medications (or high-risk medications) after hospitalization through the emergency room, or having severe illness. Patients received medication reconciliation and counselling by hospital pharmacists before discharge and home-visit pharmaceutical care as follow-up by community pharmacists after discharge. Results: Twenty-two patients agreed to home-visit pharmaceutical services. Fifteen and 11 patients completed the first and second home-visit pharmaceutical care service, respectively. Forty-two MRPs were identified in 15 patients. The types of high-frequency MRPs were incorrect administration of drug, adverse drug reactions, medication non-compliance, drug-drug interactions, lifestyle modifications, and expired medication disposal. After consultation with the pharmacist, 34 out of 42 MRPs were resolved. Conclusions: Transitional care for high-risk elderly patients before and after discharge was successfully built and implemented through a collaboration between general hospital and community pharmacies. This study suggests that home-visit pharmaceutical services may have positive effects on the safe use of drugs during the transition period; however, additional research is needed to expand on these findings.

• Korean Journal of Clinical Pharmacy
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• v.25 no.2
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• pp.68-73
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• 2015

With the changes in the pharmacy curriculum from a 4 year program to a 6 year program in 2009, a new subject called Pharmacy Practice Experience (PPE) has been launched into the curriculum. The purpose of introducing this subject is to increase the competency of new pharmacy graduates in providing quality healthcare to the community. This study has been done, via comparison among different pharmacy schools in Canada and Korea, to ensure that the competency of future Korean pharmacists can be increased with the introduction of this subject. In general, the Introductory Pharmacy Practice Experience (IPPE) in Korea consists of 60 hours while Canada consists of 320 hours (minimum). Furthermore, the Advanced Pharmacy Practice Experience (APPE) required in Korea is 1340 hours while Canada requires minimum of 960 hours. Specifically, comparing the Korean PPE curriculum to the PPE curriculums of University of Toronto (UT) and University of Waterloo (UW), UT and UW required a minimum of 75% and 89% direct clinical patient care experience respectively, either in hospital or community setting, compared to 45% in Korea; the remaining percentage in any of the universities can be fulfilled by taking other electives that may not require direct patient care experience. Observing these differences, it seems clear that the current PPE experience in Canada takes more of a patient focused approach than in Korea. Thus, with the recent movement in the Korean pharmacy community towards a more patient focused approach rather than a product focused approach, it would be beneficial to learn the differences between the PPE curriculums in Korea and Canada and apply any new understandings to the relatively newly introduced PPE program in Korea to further enhance the value of the new curriculum in helping to deliver quality patient care.