• Korean Journal of Clinical Pharmacy
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• v.26 no.4
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• pp.318-323
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• 2016

Background: Multidisciplinary team care (MTC) is a collaborative approach to treatment plan and ongoing care. We aimed to evaluate the clinical effect of MTC on the regulation of chronic kidney disease-mineral and bone disorder (CKD-MBD) complications in dialysis patients. Methods: This retrospective observational study was approved by the institutional review board. Among patients who have undergone dialysis at admission, the patients admitted to the nephrology ward were allocated to MTC group, and the others to usual care (UC) group. The MTC group had collaborative care by nephrologists, nurses, pharmacists, and nutritionists. The endpoints were the regulation of corrected calcium (cCa) and phosphate (P), the percent of patients in target level of cCa-P product ($cCa{\times}P$), and the prescription rate of non-calcium based P-binders. Results: A total of 163 patients were included from January to December 2009. A significant difference was shown in the percentage of patients in target $cCa{\times}P$ level at admission (MTC vs. UC, 81.40% vs. 91.67%; P = 0.038), but there was no significant difference at discharge. During admission, the cCa and P levels of patients in only UC group were significantly changed. In addition, compared with UC group, patients in MTC group were more likely prescribed appropriate P-binders, when they had higher $cCa{\times}P$ levels than $55mg^2/dL^2$ (P <0.001). Conclusion: It was found that MTC had beneficial effect on improving the regulation of CKD-MBD and the appropriate phosphate binder uses. Therefore, application of the MTC is anticipated to enhance quality of clinical care in chronic diseases.

• 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.19 no.2
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• pp.131-145
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• 2009

Background: Medication counseling is important to improve qualify of pharmaceutical care, but there are lack of studies to investigate satisfied counseling practice in community pharmacies. Purpose: This study was to investigate current medication counseling provided by community pharmacists. Method: Questionnaires to assess medication counseling practices were mailed to nationwide 1,269 community pharmacists who were Sookmyung Women's University alumni. Result: One hundred sixty five pharmacists were responded to the questionnaires (response rate 13.63%). 16.8% of them all respondents had counseling room in their pharmacies. 75% and 29.9% of respondents provided patient counseling always for new and refilled prescriptions, respectively. Counseling was provided primarily by verbal, but especially for drug name, usage and storage, it was provided in written concurrently. 31.1% of respondents was satisfied with counseling practices by themselves, and a major barrier of unsatisfied counseling was lack of time in 64.6% of respondents. Majorities of respondents (66.3% and 76.3%) spent 1-3 minutes and <1 minute, for new prescription and refilled prescription, respectively. Approximate 99% of respondents presented necessity of standardized patient counseling information for drugs and 97.6% responded that quality of patient counseling would be improved by using software containing counseling information. Old respondent group had higher accumulative patient counseling practice scores and pharmacy owner group took much time for counseling, resulting in higher scores too. Conclusion: This study showed that qualified patient counseling practice has not been reached in community pharmacies. Much more discussion to seek ways to improve the quality would be necessary.

• Korean Journal of Clinical Pharmacy
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• v.26 no.3
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• pp.230-237
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• 2016

Background: Since the use of opioid analgesics is frequent in operation rooms (OR), the risk of medication error is high; however the use of medication in the OR has been operating independently with the hospital pharmacy. Therefore, the assessment on management of medication use in operation and the pharmacist's role is needed. Methods: We conducted the literature review and survey from anesthesiologists, operating nurses at Chung-Ang Hospital on management of medication for operation use, awareness on need for medication management efficiency, need for satellite pharmacy in the operating room and its effect. Results: 56% of medical staffs responded that management of medication in the operating room is efficient; however, 82.6% responded that they felt the inconvenience in medication delivery to the OR when additional prescription was ordered. 51.5% also responded that extra time was required for management of narcotics and inventory/record keeping. 80% agreed that there could be lost costs due to prescription missed. Medical staffs responded improving the drug management system could increase the OR efficiency (87%), and eventually bring the increase in hospital revenue (80.4%). Those who responded that implementation of OR satellite pharmacy was needed include physicians (84.6%), nurses (63.6%), and also responded that it'd bring more profit to the hospital by increasing the efficiency in OR (60.9%). Conclusion: For efficient management of medications, implementation of OR satellite pharmacy would lead to improved drug management and increased efficiency in OR and reduced cost and improved patient care.

• Korean Journal of Clinical Pharmacy
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• v.24 no.1
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• pp.53-61
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• 2014

Background: The use of health functional food (HFF) is increasing and will continue to rise worldwide. Concerns about HFF-drug interactions are increasing as HFF are becoming more widely used. Therefore, awareness of consumers' perceptions and behaviors associated with HFF use may help health care providers improve their communications with patients. Purpose: The aim of this study was to assess the characteristics, perceptions, and behaviors associated with HFF use in South Korea. Method: The online survey was conducted from September 21th to October 7th, 2013. With the aid of Social Network Service (SNS) and google, the questionnaire was posted online on internet website targeting people aged 15 years or older so that self-reported data covering 4 domains were collected from 257 Koreans. Results: A total of 257 people responded the questionnaire. Among them, 81.3% reported experiences of HFF use. Female were more likely than male to use HFFs. There were no differences in demographic characteristics between HFF users and non-users in relation to age, education, and household income. Higher level of education was associated with high-level perception of HFF function (OR 3.9, 95% CI 1.48, 10.1) and a positive relationship was observed between the maximum number of HFFs used concurrently and age of the respondents. Among the HFF users, 42.6% reported concurrent HFF-medication use. However 73.3% of them did not disclose their use to physician or pharmacist and only 30.2% were informed about potential drug-HFF interactions. Pharmacy was most commonly reported as the source from which the respondents were informed about potential interactions. Conclusion: Many people had used HFF and medications concurrently while not being informed about potential HFF-drug interactions. Pharmacists and physicians should be vigilant for risk of the interactions and actively determine whether the patient is using an HFF before prescribing and administrating medications.

• Korean Journal of Clinical Pharmacy
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• v.28 no.3
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• pp.250-253
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• 2018

When stenting is applied to treat myocardial infarction, antiplatelet agents are administered to prevent thrombosis, which increases the risk of bleeding. Patients with myocardial infarction are also more likely to have osteoarthritis simultaneously, because both diseases occur frequently in elderly patients. Patients with osteoarthritis often use analgesics, especially nonsteroidal anti-inflammatory drugs (NSAIDs); hence, patients with both diseases use analgesics and antiplatelet agents simultaneously. The risk of bleeding increases with the use of antiplatelet agents and this is further increased when NSAIDs are added. We would like to report a case that reflects this situation. A 60-year-old man underwent stenting after ST-elevation myocardial infarction, and was treated with aspirin and clopidogrel. This patient also received a pelubiprofen prescription from another physician to treat osteoarthritis. After the patient took pelubiprofen twice, he found a bruise on his wrist and reported it to the pharmacist. It is unlikely that this is rare in community pharmacies, so pharmacists should pay careful attention to the concomitant administration of analgesics to patients receiving antiplatelet agents and should provide appropriate education to patients.

• Korean Journal of Clinical Pharmacy
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• v.10 no.1
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• pp.30-37
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• 2000

Adverse drug reactions (ADR) may result in increased hospital admissions, morbidity and mortality, adding extra cost to healthcare expenditures. Thus, it is critical to activate ADR monitoring and reporting program in tertiary hospitals in developing countries such as Korea. This study was performed to identify the types of ADR being reported in a tertiary hospital, Samsung Medical Center, and to find out the ways to improve current ADR monitoring system. Of 464 ADR reports submitted to the pharmacy department during the 6-month survey period, $97.8\%$ of the reports were from out patient and $48.5\%$ were from patients aged between 50 and 60. The medical department with the highest frequency in ADR reporting was Internal Medicines $(35.6\%)$. The most common ADR manifestations were gastrointestinal complaints $(43.4\%)\;and\;75\%$ of the reported cases were mild in their severity. The most common drugs suspected of causing ADR were CNS drugs which accounted for $32.8\%$. In terms of causality assessment, $85.1\%$ of the reports were probable cases by WHO causality assessment criteria. In regards to sources of report, $75.6\%$ of ADR were reported by physicians and $24.4\%$ by nurses. There were no ADR reported by pharmacists. In conclusion, there is an urgent need to improve ADR monitoring system for inpatient and to motivate pharmacist involvement in ADR monitoring and reporting in Korea.

• Korean Journal of Clinical Pharmacy
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• v.23 no.3
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• pp.197-205
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• 2013

Background: Many factors including drugs, dietary supplements, and food intake can affect the development and organ formation of fetuses. Because of this, subject tends to avoid consuming things like coffee, alcohol, or cigarettes due to the risks they pose during pregnancy. Therefore, analysis of drugs and favorite food consumption is needed and important to ensure safe health management for subject. Purpose: This study was conducted domestically to analyze these factors in South Korea. Method: The survey was conducted from pregnancy-related online communities for six days and the survey results were received via email for analysis. Result: A total of 127 subjects answered the questionnaire via email; the characteristics of subjects are widely varied in their ages, education levels, job statuses, and residences. The questionnaire included the intake of dietary supplements during pregnancy including vitamins and the result showed that the subjects took 2.23 different kinds of supplements on average. In order of highest frequency, 101 subjects took multivitamins; 79 subjects took an iron supplement; 30 subjects took analgesics; 20 subjects took prescribed antipyretic and medication for upper respiratory diseases; 12 subjects took antibiotics; 7 subjects took antiemetics. Their compliances were different in each medication categories. Only 8% of subjects answered that they had asked a pharmacist for medication information during pregnancy. In addition, 78% of subjects answered that they never counseled with anyone about pregnancy related medication use. Conclusion: In conclusion, many subjects took medication including dietary supplements. The role of pharmacists should be actively developed to improve subject care such as education about subject's medication uses and their food consumption behavior.

• Korean Journal of Clinical Pharmacy
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• v.30 no.4
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• pp.243-249
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• 2020

Background: Despite the increased use of direct-acting oral anticoagulants, warfarin is still recommended as first-line therapy in patients with mechanical valves or moderate to severe mitral stenosis. Anticoagulation management services (AMSs) are warranted for patients receiving warfarin therapy due to the complexity of warfarin dosing and large interpatient variability. To overcome limited health care resources, we developed a messenger app-based chatbot that provides information to patients taking warfarin. Methods: We developed "WafarinTalk" as an add-on to the open-source messenger app KakaoTalk. We developed the prototype chatbot after building a database containing seven categories: 1) dosage and indications, 2) drug-drug interactions, 3) drug-food interactions, 4) drug-diet supplement interactions, 5) monitoring, 6) adverse events, and 7) precautions. We then surveyed 30 pharmacists and 10 patients on chatbot reliability and on participant satisfaction. Results: We found that 80% of the pharmacists agreed on the consistency of chatbot responses and 44% agreed on the appropriateness of chatbot. Furthermore, 47% of pharmacists said that they were willing to recommend the chatbot to patients. Of the seven categories, information on drug-food interaction was the most useful; 90% of patients said they were satisfied with the chatbot and 100% of patients said they were willing to use it when they were unable to see a pharmacist. We updated the prototype chatbot with feedback from the survey. Conclusion: This study showed that warfarin-related information could be provided to patients through a messenger application-based chatbot.

• Korean Journal of Clinical Pharmacy
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• v.32 no.2
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• pp.93-105
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• 2022

Objectives: This study aimed to identify the opinions of Gyeongsangbuk-do residents on out-of-hours (OOH) pharmacies and to examine the operating experiences of pharmacists who are operating OOH pharmacies in other areas. Methods: Cross-sectional survey was carried out for 1,000 Gyeongbuk residents employing a questionnaire via online or face-to-face, and 82 pharmacists who currently operate OOH pharmacies employing a postal questionnaire. Out of eighty-two, 46 pharmacists replied (response rate 56.1%). Results: As for the necessity of introducing OOH pharmacies in Gyeongsangbuk-do, 84.9% answered more than necessary. 86.1% favored the local government support for OOH pharmacies. The necessity of OOH pharmacies was highly evaluated among participants who experienced to be unable to use medicines or services in out of service hours, regardless of their characteristics or health condition. County residents consistently put a positive opinion for the necessity of OOH pharmacies if they have elderly family member(s), while city residents had significant differences across subgroups depending on their conditions (family members, household economics, health status, etc.). Almost all (95.7%) pharmacist participants highly evaluated the necessity of OOH pharmacies and the majority of them (63.0%) felt satisfied. However, 60.9% of participants have ever considered closing their OOH pharmacy business due to private, business management and professional reasons. Conclusion: This study made suggestions to address anticipated issues for the Gyeongbuk-style OOH pharmacy model.