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.
Pharmacy practice experiences play a central role in improving the professional abilities and roles of student pharmacists in the changed '2+4'-year curricula of Korean pharmacy schools. For the first 3 years, the students usually learn theoretical areas, and for the last year, they apply learned knowledge to actual pharmacy practice environments. Especially, in order for community pharmacy practice experiences to become firmly established, it is important to evaluate students' feedbacks of community pharmacy practice experiences. However, there have been little studies regarding this area in Korea. This study was to analyze pharmacy students' perceptions and evaluations after community pharmacy practice experiences. The self-reported questionnaire using a 5-point Likert scale was utilized to collect data from the pharmacy students completing community pharmacy practice experiences. Total 62 students responded to the survey questionnaires. The average of students' evaluations of preceptors for overall evaluation items was 4.31 whereas that of student evaluations of practice sites for them was 4.03. The self-evaluations of students' expertises were mostly positive except for that of populations care. The evaluation item 'I believe this experience will help me be a better pharmacist' received the highest satisfaction. According to the results regarding open-ended questions, the students learned the needs for academic motivations and self-developments, and they thought that the curriculum should be standardized and systematized in order to improve contents for community pharmacy practice experiences. Furthermore, based on these results, the guidelines of community pharmacy practice experiences should be modified, and researches on the validation and evaluations of the modified guidelines should be implemented.
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.
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.
This study was to evaluate economic impact of a comprehensive pharmaceutical care intervention provided by community pharmacists on drug-related morbidity and mortality in the elderly population, in a societal perspective. Clinical outcomes of pharmaceutical care included compliance increase, inappropriate medication discontinuation, and subsequent drug-related morbidity and mortality reduction. Economic outcomes included cost savings from direct medical costs reduction such as medication and healthcare resource utilization. Input costs for pharmaceutical care included pharmacist time and computerized prescription review supporting program costs. Model parameters of outcomes were derived from published literatures, and costs were from literatures and health insurance statistical data in Korea. Annual costs and benefits were estimated in the year 2005. Current usual care and standardized pharmaceutical care required 0.3 and 2.0 hours per year respectively, for elderly outpatient using average 4.4 prescription drugs per visit and average annual frequency of 17.8 pharmacy visits. Comprehensive pharmaceutical care provided to overall elderly outpatients at community pharmacies would have cost of \74,994 mil. and benefit of \357,002 mil. per year. Benefit:cost ratio was 4.8:1 and net benefit was \282,008 mil/year. It was corresponded to net benefit of \73,816/year for individual elderly patient. In addition, pharmaceutical care was estimated to reduce 1,531 drug-related deaths/year. Conclusively this study, a first attempt in Korea to evaluate an economic value of pharmaceutical care at community pharmacies, proved that it was a cost-effective intervention having significant economic benefit.
Background: This study aimed to explore the current activities of pharmacists in local pharmacies for preventing narcotics addiction, identify areas for improvement, and support initiatives to enhance and expand the activities of "narcotics addiction prevention counseling pharmacies" (hereinafter referred to as "Majung Pharmacies"). Methods: Surveys were conducted targeting local community pharmacists participating in the Majung Pharmacy activities in Daegu. Results: Out of 42 pharmacists who registered in the Majung Pharmacy movement in 2021, 41 responded (response rate of 98%). After excluding three participants who met the exclusion criteria, data from 38 participants were analyzed. The participating pharmacists were generally well aware of the conditions for pharmacists to serve as "accessible experts" in the forefront of drug addiction prevention. It was observed that the activities of Majung Pharmacies, particularly among highly engaged pharmacists, led to positive effects such as an increased focus on medication counseling for psychotropic drugs, thereby enhancing their professionalism. However, a significant number of participants also expressed negative opinions. Factors such as enthusiasm for professional activities and perceptions of the pharmacist's social role were important in shaping perceptions of Majung Pharmacy activities, whether positively or negatively. Additionally, this study underlined that pharmacists in practice are highly aware of the seriousness of issues arising from the use of narcotics by prescriptions. Conclusion: Suggestions were outlined for both short-term and long-term strategies aimed at ensuring the stable growth and expansion of Majung Pharmacy initiatives.
Park, Mi Seon;Lee, Ji Hee;Lee, Heung Bum;Kim, Ju Sin;Choi, Eun Joo
한국임상약학회지
/
제32권1호
/
pp.27-36
/
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.
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.
Pharmacist-managed Anticoagulation Service(ACS) was estabilished and the effectiveness of warfarin monitoring by ACS in maintaining therapeutic INR was evaluated. The primary goal of ACS is to maximize the control of therapy, to maintain therapeutic INR and to decrease morbidity and hospitalization caused by inadequate dosage regimen. Clinical pharmacists performed chartreview, laboratory interpretation, recommendations for warfarin dosage adjustments, physician and patient education, and coordination of follow-up in ACS. Patients receiving warfarin sodium were evaluated via retrospective chart review. Sixty-two patients were referred to ACS by primary physicians were compared with 117 patients in the physician-amtrolled group. The ACS patients maintained $88.6\%$ in the therapeutic range for anticoagulant therapy and the control group maintained $63.7\%$, where the difference was statistically significant.(P<0.001) The ACS improved warfarin dose determination, PT stability, patient compliance and provided improved therapy compared with the control group. ACS offers safe and efficient anticoagulant therapy in the ambulatory setting.
DUR (Drug Utilization Review) originally referred to the evaluation of drug usage details: however DUR refers to the system used to support the services of prescribing and dispensing through linking from Health Insurance Review and Assessment (HIRA) Service in Korea. HIRA is going to begin the DUR enforcement for extending to nationwide coverage after pilot test. Objectives: The aims for this study were to evaluate and clarify the current opinions of the pharmacists for the recognition and acceptance rates before nationwide coverage concerning DUR system. Methods: A 16-question-questionnaire was developed and pilot tested. For 40 days of survey by both on-line and fax paper, it was carried out on 80 pharmacists working at community pharmacy in Goyang-si, Gyeonggi-do. Results: Most of answers were broadly positive and interested in begining the DUR system and kept in mind that the goal of DUR is safety guarantee for people. On the other hand, most of answerers worry that delay of patient waiting time and inharmonious communication with doctors in DUR processing can be a major obstacle to begin the DUR system. Conclusion: To solve several problems, the most important things are to make good reciprocal relationships between doctors and pharmacists, investigate intervention tool to shorten patient waiting time, and activate educational program of inspecting items for the pharmacists.
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