• Korean Journal of Clinical Pharmacy
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• v.24 no.4
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• pp.272-281
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• 2014

Objective: The provision of pharmaceutical care service in compliance with good pharmacy practice (GPP) standards is important, but there is lack of studies to investigate the barriers that significantly hinder community pharmacies in Korea from adhering to the standards. This study was aimed to identify the major barriers to provision of pharmaceutical care service in compliance with the proposed pharmacy practice standards which have been developed based on the GPP standards recommended jointly by WHO and FIP. Methods: Questionnaires reviewed by the expert committee were posted for 32 days on the website which is most frequently accessed by community pharmacists. The respondents completed them by checking the scores (Max=5, Min=1) for major barriers to provision of pharmaceutical care service focusing on patient information management and drug use review process in prescription fillings. The answered scores were automatically collected using online data processing. Mean differences between scored data were assessed by ANOVA. Results: Total 321 pharmacists participated in the survey. Results indicated that 'difficulty of diagnosis identification' (m=3.92, SD=1.21), 'lack of time' (m=3.48, SD=1.22) and 'lack of updated clinical information' (m=3.17, SD=1.10) were the major barriers to provision of pharmaceutical care service in patient information management. The main barriers to drug utilization review were 'lack of time' (m=3.32, SD=1.21), 'lack of updated clinical information' (m=3.11, SD=1.17), and 'negative feedbacks or refusals from prescribers' (m=3.00, SD=1.38). There were significant differences among the groups by location, employed number of pharmacists and acceptability to the proposed GPP standards. Conclusion: Difficulties in managing patient clinical information and lack of time were found to be the major barriers in providing pharmaceutical care services in community pharmacies in Korea. Further research is recommended to determine ways to reduce these barriers in order to provide quality pharmaceutical care service that is in compliance with the internationally recognized GPP guidelines.

• Archives of Plastic Surgery
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• v.51 no.2
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• pp.182-186
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• 2024

Kearns-Sayre syndrome (KSS) is a rare mitochondrial disease that affects young adults, due to a deletion of mitochondrial DNA and characterized by the triad: age of onset lower than 20 years, chronic progressive external ophthalmoplegia, and an atypical pigmentary retinopathy. It is also characterized by other endocrine, neurological, and especially cardiac impairment with a very high risk of cardiac complications during surgical procedures under all types of anesthesia. We report a case of KSS revealed by severe bilateral ptosis and confirmed by a muscle biopsy with "ragged red fibers." The ptosis was surgically managed by cautious Frontal suspension under local anesthesia "Frontal nerve block." Through this case, we discuss challenges in the management of KSS patients.

• The Journal of Korean Medicine
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• v.38 no.1
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• pp.81-92
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• 2017

Objectives: Herbal dispensaries can be installed separately from medical institutions. This study was done to suggest directions of regulation on management of externally installed herbal dispensaries. Methods: In this study, we visited and investrigated 7 representative herbal dispensaries to understand current status of herbal dispensaries. After comprehending current domestic regulations on herbal dispensaries, we referred "Management Practice on Dispensary Facility of Traditional Chinese Medicine in Medical Institution", "Enforcement Rule of Decree on Institution Standard of Manufacturing and Importation for Drugs, etc." and "Enforcement Rule of Food Sanitation Act" to suggest improved regulations for herbal dispensaries. Results: We suggested reasonable regulations for facility standards including location of building, dispensary room, water supply facility, lavatory and storage facility, etc.. Conclusions: We hope that results of this study could be baseline data for developing regulations on facility standards of herbal dispensaries.

• Korean Journal of Clinical Pharmacy
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• v.34 no.1
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• pp.1-20
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• 2024

This review examines the pivotal clinical trials that evaluated the efficacy and safety of semaglutide, a glucagon-like peptide-1 (GLP-1) receptor agonist, in the management of obesity. The reported findings underscore significant and sustained weight loss achieved with semaglutide in diverse patient groups, although gastrointestinal disorders occurred frequently, leading to therapy discontinuation. Overall, the studies demonstrated the potential of semaglutide as a therapeutic option not only for type 2 diabetes but also for obesity. The treatment landscape in obesity is evolving, as reflected in changing regulatory approvals and clinical guidelines, suggesting a paradigm shift toward personalized approaches in this chronic disease states to achieve optimal treatment outcomes for patients.

• Korean Journal of Clinical Pharmacy
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• v.32 no.4
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• pp.303-312
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• 2022

Objective: The purpose of the study was to analyze the difference in the importance and performance of the educational content of the community pharmacy practice and find the factors that influence it. Methods: A 5-point Likert scale questionnaire asked about the importance and performance of the pharmacy practice education items to community pharmacy preceptors, current students, and professors. Data were analyzed using Microsoft office 365 Excel and IBM SPSS 21.0. Results: A total of 117 people participated. The averages of importance and performance were 4.34±0.34 and 3.71±0.45, respectively. Except for the computational entry of prescriptions and medication history, the average score for the importance of all educational items was statistically significantly higher than the one for performance. Importance Performance Analysis (IPA) identified over-the-counter medication counseling, over-the-counter drug selection consultation, pharmacy management, adverse drug reaction monitoring, and understanding and implementation of drug use evaluation as the items that needed focused effort. Borich's needs were highest in the adverse drug reaction monitoring. Conclusions: Overall, high importance and low performance indicate a need for improvement in community pharmacy practice education. Since the demand for education was high in over-the-counter medication counseling, adverse drug reaction monitoring, and OTC drug selection consultation, various supports are urgently needed to strengthen pharmacy practice education in this area in the future.

• Korean Journal of Clinical Pharmacy
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• v.25 no.3
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• pp.145-150
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• 2015

Objective: Pain is very common in the elderly, so there is a high prevalence of analgesic use among this population. The purpose of this study was to assess patterns of analgesic use and evaluate factors associated with analgesic use in elderly patients. Method: The subjects of this study were patients over 65 years old hospitalized in a teaching hospital located in Chuncheon-si, Korea between January 1, 2014 and March 31, 2014. Data collection regarding analgesic prescriptions and baseline characteristics was conducted using computerized hospital database by medical information team. Logistic regression analysis was used to identify factors related to analgesic use. Results: A total of 2,394 patients were finally included. Among these patients, 700 (29.2%) took analgesics; 521 (74.4%) out of these 700 patients were received opioid analgesics and 179 (25.6%) were received only non-opioid analgesics. The most frequently prescribed opioid analgesic was pethidine (45.7%), and the most frequently prescribed non-opioid analgesic was acetaminophen (44.1%). Fracture was associated with increased odds of opioid analgesic prescriptions (OR = 2.766, 95% CI = 2.019-3.790, p < 0.001) and any analgesic prescriptions (OR = 2.394, 95% CI = 1.766-3.244, p < 0.001). Stroke or cerebral infarction was associated with decreased odds of opioid analgesic prescriptions (OR = 0.636, 95% CI = 0.471-0.858, p = 0.003). Conclusion: A significant proportion of hospitalized elderly patients use analgesics. Health care professionals should consider factors associated with analgesic use in this population to improve pain management.

• Health Policy and Management
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• v.20 no.4
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• pp.45-57
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• 2010

Background : If different cost efficiency indexes were informed to the same clinic depending on the inclusion or exclusion of pharmacy cost, it may impair the reliability of provider-profiling system. This study aimed to investigate whether the omission of pharmacy cost affects cost-efficiency rankings in medical clinics. Methods : Data for ambulatory care cost at 23,112 medical clinics were collected from the claims database, which was constructed after review by the Health Insurance Review and Assessment Service (HIRA) of Korea in April 2007. We calculated two types of cost efficiency indexes by inclusion or exclusion of pharmacy cost for a medical clinic. The agreement between the decile rankings of the two indexes was also assessed using the weighted kappa statistic of Landis and Koch. Results : When the cost efficiency index for total cost including pharmacy cost was compared with the index for total cost excluding it, the agreement between the two indexes was only 55%. The agreements between the two indexes were relatively low within specialties which have larger pharmacy volume of total cost and lower correlation between total cost with or without pharmacy cost included than the average level of all the specialties. Conclusion : These results suggest that the omission of pharmacy cost may result in contradictory outcomes that may be confusing to a medical institution and may impair the reliability of provider-profiling systems. It is very important to standardize profiling criteria for the reliability of provider profiling system.

• Proceedings of the Korea Society of Environmental Toocicology Conference
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• 2004.11a
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• pp.24-24
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• 2004

• Korean Journal of Clinical Pharmacy
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• v.28 no.2
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• pp.81-87
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• 2018

Objective: There have been many cases of spontaneous adverse drug reactions to fentanyl at a regional pharmacovigilance center in the hospital. To assess the factors causing the adverse drug reactions reported in patients receiving fentanyl patient-controlled analgesia (PCA) monotherapy or in combination with fentanyl transdermal therapeutic system (TTS) for acute post-operative pain management. Methods: We conducted a retrospective cohort study with all patients prescribed fentanyl PCA for pain management after orthopedic surgery at a single university hospital from June 2012 to May 2013. We analysed the factors causing adverse drug reactions reported by a spontaneous reporting system in patients receiving fentanyl PCA monotherapy and those receiving fentanyl TTS in combination with fentanyl PCA. Results: Based on the spontaneous adverse drug reaction reporting, the risk ratio for the incidence rate of adverse drug reaction in the fentanyl TTS combination therapy group was 3.04 (95 % CI: 2.4-4.00, P < 0.0001), which was approximately 3-fold higher than that reported for fentanyl PCA monotherapy. Only 60 % of the adverse drug reactions were reported. Conclusion: It is inappropriate to add fentanyl TTS to fentanyl PCA to manage post-operative acute pain. There is a need to improve adverse drug reaction reporting. We expect that regular analysis of adverse drug reactions reported at regional pharmacovigilance centre would aid in appropriate drug utilization by patients.

• Korean Journal of Clinical Pharmacy
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• v.27 no.4
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• pp.276-283
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• 2017

Objective: Dyslipidemia is recognized as a prominent risk factor for cardiovascular and cerebrovascular diseases but it is manageable through therapeutic and lifestyle intervention. Interpreting the latest guidelines is essential for an application of recommendation from guidelines into clinical practice. Therefore, this study aimed to compare the most recent guidelines on dyslipidemia treatment recommendations in Korea and USA. Methods: This study analyzed and compared 2015 Korean guidelines for the management of dyslipidemia, 2013 American College of Cardiology/American Heart Association (ACC/AHA) guideline and 2016 supportive guidelines from ACC. Results: A comparison was made focused on the following: target patients based on cardiovascular risk assessment, target goal, and treatment strategies including statin and non-statin therapies. Four target patient groups by risk were suggested in 2015 Korean guideline and cardiovascular risk factors were also considered for initiation of lipid lowering therapy. Titrated statin regimen was recommended by Korean guideline to reach LDL cholesterol and non-HDL cholesterol target level. In 2013 ACC/AHA guideline, four statin benefit group was introduced considering ASCVD risk and high intensity statin or intermediate intensity statin use were recommended without dose titration. 2016 update was to support non-statin therapy based on updated evidence and new consideration of ezetimibe, PCSK9-inhibitor and bile acid sequestrant was brought up. Conclusion: Guidelines are continuously updating as new and important clinical data are constantly released along with the advent of newly approved drugs for lipid disorder. This article provides resources that facilitates uptake of these recommendations into clinical practice.