• Health Policy and Management
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• v.11 no.4
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• pp.88-108
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• 2001

Separation of prescribing and dispensing practice in Korea has changed the service pattern of the pharmacy. The prescription dispensing activities, however, are concentrated excessively on the pharmacies near hospitals or clinics. Thus this study was conducted to estimate the number of optimal dispensing cases for the community pharmacy. Forty-six pharmacies were selected using systematic stratified random sampling method, and ninety-five pharmacists were interviewed on their workload of dispensing and other activities at pharmacies. One hundred and seventy prescriptions were chosen based on the length of drug administration and drug dosage form, and the dispensing time was measured by time-watch method. Also pharmacy benefit claims data were analyzed to identify the characteristics of the pharmacies which performed more than optimal dispensing cases. According to the study results, the average work time per pharmacist per day was found to be 10hours 32minutes and the dispensing activities occupied 7hours 36minutes. It took 5.72minutes on average for each dispensing case. The optimal dispensing case was estimated as 75 cases under the condition of 10hours 32minutes work time and 6% allowance rate. Even though the pharmacies near hospitals or clinics participated dispensing services actively, only pharmacies near clinics dealt with more than optimal dispensing cases. For the pharmacies near hospitals they dealt with less than optimal cases, but drug administration period per prescription was almost 3 times longer than that of pharmacies near clinics. Thus the intensity of dispensing activities such as drug administration period is to be considered to estimate optimal dispensing cases more accurately.

• Korean Journal of Clinical Pharmacy
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• v.27 no.4
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• pp.228-237
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• 2017

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.

• Korean Journal of Clinical Pharmacy
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• v.24 no.1
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• pp.45-52
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• 2014

Objective: To evaluate the clinical manifestations and causative drugs of the outpatient adverse drug reactions (ADRs) reported by community pharmacy. Methods: From April 2013 to September 2013, all outpatient ADRs reported by community pharmacy to Regional Pharmacovigilance Center of Korean Pharmaceutical Association were included. The causality of ADRs was assessed by the criteria of WHO-Uppsala Monitoring Centre. The clinical features and the offending drugs were analyzed using the WHO-Adverse Reaction Terminology and the classification of American Hospital Formulary Service Drug Information, respectively. Results: 2,826 (97.0%) of the total 2,912 ADRs had causal relationship. The 1,923 patients with mean age of 55.1 years and female fraction of 66.5% were included in the ADRs. Gastrointestinal (33.6%), nervous system (14.9%), and skin (13.5%) symptoms were common in ADRs. Analgesic drugs (19.7%), gastrointestinal drugs (17.7%), and central nervous system drugs (11.0%) were prevalent offending drugs. The leading causative generic drug was the complex of acetaminophen and tramadol. Among 203 ADRs by the nonprescription drugs, the most common clinical features were skin (37.4%) and gastrointestinal (23.6%) symptoms and the most prevalent offending drugs were analgesic drugs (40.0%) and mucocutaneous system drugs (16.3%). The combination of acetaminophen and chlorzoxazone was the leading causative generic in nonprescription drugs. Conclusion: In this study, gastrointestinal symptom was the most common manifestation and analgesic drug was the most common causative drug in outpatient ADRs reported by community pharmacy.

• YAKHAK HOEJI
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• v.58 no.2
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• pp.129-140
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• 2014

Background: As elderly population has been increasing, pharmacists need to possess special knowledge and skills to provide enhanced pharmaceutical care for senior patients. Purpose: This study aims to systematically review on (1) the certified geriatric pharmacists (CGP) system, (2) the curriculum related to geriatric pharmacy education, and (3) the CGP's performance in terms of clinical, economic and humanistic outcomes in the U.S. Method: The information related to CGP system and curriculum was obtained through the official websites of 'American Society of Consultant Pharmacists', 'Commission for Certification in Geriatric Pharmacy' and the selected pharmacy school samples. Articles about on the outcomes of pharmacist-provided cognitive services including Medication Therapy Management were searched through PubMed. Results: To gain the CGP credential, pharmacists need 2-year experience as pharmacist in advance and take the CGP examination. This certification must be renewed every 5 year. Most pharmacy schools provide geriatric-related curriculum through didactic or pharmacy practice classes for pharmacy students and certificate or dual degree in gerontology are given on completion. Most previous outcomes research reported that pharmacists have played a role in yielding favorable results regarding clinical, economic and humanistic outcomes for nursing facilities, hospitals and community pharmacy settings. Conclusion: Considering the organized CGP certification system and concrete educational courses established the basis for pharmacists to exert their ability for senior patients of the U.S., it is suggested to build a geriatric pharmacist credential model for pharmacists to provide the increasing elderly patients with the requisite safe and effective pharmacy care in Korea.

• The Korean Journal of Health Service Management
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• v.14 no.1
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• pp.55-65
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• 2020

Objectives: To provide guidance for agency planning by identifying barriers faced by Korean pharmaceutical companies in global regulatory affairs. Methods: A questionnaire survey on global regulatory affairs was administered by email to personnel at Korean pharmaceutical companies. From a total of 60, 28 responses were collected. Respondents' companies were classified as small-sized or large-sized, based on whether their annual sales amounted to KRW 100 billion. Results: Small-sized companies were experiencing greater difficulties in receiving drug approvals from advanced countries, particularly during the Investigational New Drug (IND) and Good Manufacturing Practice (GMP) processes. Conclusions: Support measures to specifically help small-sized companies enter more advanced markets and further improved global regulatory guidelines that can meet large-sized companies' expectations are needed. Moreover, domestic and global regulatory standards should be harmonized to benefit both groups.

• The Journal of the Korea Contents Association
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• v.22 no.6
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• pp.712-728
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• 2022

World-widely, there has never been a greater need for people to access high-quality expertise about the effective and safe use of medications. Therefore, the profession of pharmacy should meet these needs of the times, as the demographic shifts have led to a situation where older adults now outnumber children, and polypharmacy is also a commonplace. However, the reimbursement system covered by the National Health Insurance (NHI) in Korea is still limited to the traditional dispensing and compounding role of pharmacist. To provide a take-home message to Korean pharmacy reimbursement system, we aimed to review and analyze the international trends in pharmacy remuneration systems. This is a comparative study between Korea, Japan, the United Kingdom, and the United States. Comparison was conducted by reviewing each country's policy and enforcement programs, as well as the related literature. Japan, the UK and the US systems remunerate diverse patient-centered pharmaceutical care services. The Korean pharmacy service fee is, however, narrowly focused on the traditional product-oriented pharmacy services. This study discussed the future direction of improving pharmacist reimbursement systems in Korea, by expanding professional pharmacy service coverage and diversifying fee schedule.

• Journal of Evidence-Based Herbal Medicine
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• v.3 no.1
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• pp.1-7
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• 2010

While herbal medicine including mineral herbal medicine mostly provides microelements to the human body thanks to abundant metallic elements, its harmfulness has been raised due to elements of heavy metals. Harmfulness of mineral herbal medicine needs to be analyzed quantitatively as well as qualitatively so that specificity of herbal medicine including mineral herbal medicine can be reflected. Consequently, the following aims should be set up to mineral herbal medicine, REALGAR, standard processing of REALGAR and the standards of processed drugs should be secured. On the basis of the results of this study, the reasonable measures to develop the processing method and the test method for heavy metals were presented. Such measures are expected to give the following results. First, consumers may take food and medicine without anxiety, and food and medicine may be effectively managed, and the national service may be improved, and also safety against heavy metals may be publicized. Second, as the principal ingredients and microelements of mineral herbal medicine are qualitatively analyzed, such results are expected to contribute to the advance of national analytics for herbal medicine.

• Korean Journal of Clinical Pharmacy
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• v.31 no.2
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• pp.104-114
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• 2021

Objective: To explore the perception of drug utilization review (DUR) system and DUR modernization pilot project among healthcare professionals and patients. Methods: We conducted 8 times of focus group interviews (FGI) between August 1, 2019 to December 31, 2019. The healthcare professionals and patients who participated in the DUR modernization pilot project were included in the present study. Based on the type of project participation or medical institution, the participants were divided into the following four groups: group 1, hospital; group 2, clinic; group 3, pharmacy; and group 4, patient. Within each group, interviews were conducted under a pre-defined agenda to identify the implicit perceptions of the participants; the contents of the interviews were, then, categorized. Results: Healthcare professionals established a consensus on the positive aspects of the DUR system and DUR modernization pilot project. However, substantial concerns remain, such as additional workload associated with monitoring adverse events or acquiring consents from patients. Furthermore, a difference of opinion over the DUR convenience system was observed. Among 3 DUR convenience system, the personal medication history review service was highly utilized, but pop-up hold function and communication system was rarely used. Conclusion: We observed that systematic intervention using the DUR system is effective for both healthcare providers and consumers. Adverse events caused by inappropriate drug use can be prevented by continuous patient monitoring. Therefore, the role of DUR system needs to be expanded to establish a safe drug management system.

• Korean Journal of Clinical Pharmacy
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• v.33 no.3
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• pp.168-177
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• 2023

Background & Objectives: Fixed-dose combinations (FDCs) offer advantages in adherence and cost-effectiveness compared to free combinations (FCs), but they can also complicate the prescribing process, potentially leading to therapeutic duplication (TD). This study aimed to identify the prescribing patterns of FDCs for dyslipidemia and investigate their associated risk of TD. Methods: This was a retrospective cohort study involving drugs that included statins, using Health Insurance Review & Assessment Service-National Patient Sample (HIRA-NPS) data from 2018. The unit of analysis was a prescription claim. The primary outcome was TD. The risk ratio of TD was calculated and adjusted for patient, prescriber, and the number of cardiovascular drugs prescribed using a multivariable Poisson model. Results: Our study included 252,797 FDC prescriptions and 515,666 FC prescriptions. Of the FDC group, 46.52% were male patients and 56.21% were aged 41 to 65. Ezetimibe was included in 71.61% of the FDC group, but only 0.25% of the FC group. TD occurred in 0.18% of the FDC group, and the adjusted risk ratio of TD in FDC prescriptions compared to FC was 6. 44 (95% CI 5. 30-7. 82). Conclusions: Prescribing FDCs for dyslipidemia was associated with a higher risk of TD compared to free combinations. Despite the relatively low absolute prevalence of TD, the findings underline the necessity for strategies to mitigate this risk when prescribing FDCs for dyslipidemia. Our study suggests the potential utility of Clinical Decision Support Systems and standardizing nomenclature in reducing medication errors, providing valuable insights for clinical practice and future research.

• Korean Journal of Clinical Pharmacy
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• v.33 no.4
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• pp.242-253
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• 2023

Background: Arrhythmia due to QT prolongation is one of the most serious adverse events with drug interactions in the elderly. This study aimed to examine the incidence of arrhythmia in Korean elderly patients who administered both cytochrome P450 3A4 (CYP3A4) substrates and inhibitors. Methods: Patients using CYP3A4 substrate and inhibitor were selected from the 2017 elderly patient dataset (the Korean Health Insurance Review and Assessment Service - Aged Population Sample). Selection criteria were patients with a medication possession ratio over 80%, medication duration of at least 7 days, and a follow-up period of 3 months or more. The patient's basic information is age, gender, health insurance type, and comorbidities. The top 50 drug pairs and comorbidity with high-incidence arrhythmia were presented. Results: In patients with drug combinations for over 7 days, there were 981 incidences of arrhythmia, and 351 incidences in those with combinations for over 30 days. The comorbidities of congestive heart failure and myocardial infarction had a significant association with incidence of arrhythmia. Among patients with 7 days or longer, the drug pairs [substrates-inhibitors] with significant adjusted odds ratio (aOR) were [propranolol-cimetidine] (aOR, 2.25; 95% confidence interval [CI], 1.66-3.04). Among patients with 30 days or longer, the drug pairs with significant aOR were [tramadol-amiodarone] (aOR, 2.87; 95% CI, 1.97-4.19). Conclusions: In elderly patients, the incidence of arrhythmia was high with drug interactions of CYP3A4 substrates and inhibitors. The comorbidity of congestive heart failure was the risk factor.