Cheon, Young Ju;Kim, Sug Hyun;Kim, Ok Ju;Hong, Se Hwa;Yang, Jin Wook;Kim, Jung Tae;Lim, Sung Cil
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.
The purpose of this study is to investigate drug information sources which influence physician's prescriptions, and to compare the differences of drugh information sources between private practitioners and hospital physicians. In addition, the ultimate goal of this study is to provide better quality of drug information for both groups of physicians through the professional drug information system. 264 physicians, including general practitioners and all types of specialists who were working in hospitals and private clinics in Taejon and Chungnam area, participated in this study which was conducted by mail. The results are summarized as follows ; 1. Both physician groups received drug informations mainly from medical journals, but there were differences in secondary sources of drug information. Namely, hospital physicians got drug information from annual meetings and textbooks, and private practitioners got it from detail men and colleagues. 2. Drug effect was the first consideration for drug selection in both physician groups. But, in the 2nd consideration, private practitioners concerned about the price, insurance and rebates, but hospital physicians were not. 3. Only 9.2% of the private practitioners satisfied with the sufficiency of drug information, whereas 22.0% of hospital physicians satisfied with it. The most insufficient area of information was drug interaction in both groups and 91.9% of the physicians suggested that a professional drug information system should be introduced. 4. Both physician groups had contacted with detail men frequently. However, it was rare for them to contact with a pharmacist. This phenomenon was more severe in the case of private practitioners. 5. Neither physician groups knew very much about drug informatio centers. However, they would be willig to participate if a professional drug information system were established. Also, they indicated that the information most required was drug interaction.
Background: The over-prescription of acid-suppressive therapy for the provision of stress ulcer prophylaxis (SUP) in hospitalized patients has been identified in a proceeding study. Objective: This study was conducted to evaluate clinicians' beliefs, knowledge and other factors that influence the over-prescribing of SUP in low-risk, non-intensive care unit (non-ICU) patients. Method: A cross-sectional survey consisting of multiple-choice queries and close-ended questions was distributed to healthcare personnel at a major teaching hospital in Korea. Results: More than half of total respondents reported that they would continue SUP following patients discharge from the ICU (77.8%, 43.5%, and 39.7% in the physician, pharmacist, and nurse groups, respectively). Over 55% of physicians would also initiate non-ICU patients on SUP upon hospital admission, and 42.6% of physicians would even continue prophylaxis post hospital discharge. The mean knowledge score regarding SUP indications and side effects was higher in pharmacists compared to physicians and nurses (12.44, 7.40, and 7.28, respectively; p<0.001). High-prescribing behavior was associated with a prescriber's belief that SUP is effective for preventing bleeding (odds ratio 7.40; 95% confidence interval 1.57 to 31.94; p=0.012). Low knowledge score and computerized order set also showed statistically significant association with the overutilization of SUP.
This study is designed to evaluate the contents of the separation of prescribing and dispensing roles(SPD) policy based on the theoretical backgrounds. The results are as follows; Considering the purpose of SPD policy, 'increasing the efficiency in manpower management by separating the role of medical doctor and pharmacist and improving the quality of SPD service through specialization of function' as a policy objective is valid and very important agenda in health care. But the objectives are not working well by no keeping the detail means to actualize it. Also, some policy objectives are unclear or inappropriate and it makes the focus of that policy obscure or misleads inadequate policy alternatives. In terms of means of policy, it is evaluated to have some limits in effectiveness, efficiency, equity, rationality, technical feasibility, economic feasibility, administrative feasibility, social and time feasibility. In conclusion, it's necessary to investigate the some problem mentioned in this paper with empirical evidence. Also, it should be needed to improve the validity of policy by correcting policy objectives and means in execution of policy.
Background: This study aimed to assess the most common physical side effects experienced by local chemotherapy patients. Their perceptions of these side effects and informational needs from clinical pharmacists were also evaluated. Materials and Methods: This was a single-center, cross-sectional study. A face-to-face interview guided by a structured questionnaire with cancer patients admitted to receive repeated cycles of chemotherapy was conducted. Information collected included chemotherapy-related side effects after last chemotherapy experience, the most worrisome side effects, the side effects overlooked by healthcare professionals and the preferred method, amount and source of receiving related information. Results: Of 99 patients recruited, 90 participated in this survey (response rate: 90.9%). The majority were in the age range of 45-64 years (73.3%) and female (93.3%). Seventy-five (83.3%) and seventy-one (78.9%) experienced nausea and vomiting, respectively. Both symptoms were selected as two of the most worrisome side effects (16.7% vs. 33.3%). Other common and worrisome side effects were hair loss and loss of appetite. Symptoms caused by peripheral neuropathies were perceived as the major symptoms being overlooked (6.7%). Most patients demanded information about side effects (60.0%) and they would like to receive as much information as possible (86.7%). Oral conversation (83.3%) remained as the preferred method and the clinical pharmacist was preferred by 46.7% of patients as the educator in this aspect. Conclusions: The high prevalence of chemotherapy-related side effects among local patients is of concern. Findings of their perceptions and informational needs may serve as a valuable guide for clinical pharmacists to help in side effect management in Malaysia.
Han, Ji Min;Heo, Kyu-Nam;Lee, Ah Young;Min, Sang il;Kim, Hyun Jee;Baek, Jin-Hee;Rho, Juhyun;Kim, Sue In;Kim, Ji yeon;Lee, Haewon;Cho, Eunju;Ah, Young-Mi;Lee, Ju-Yeun
Korean Journal of Clinical Pharmacy
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v.32
no.2
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pp.116-124
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2022
Background: High-alert medications (HAMs) are medications that bear a heightened risk of causing significant patient harm if used in error. To facilitate safe use of HAMs, identifying specific HAM lists for clinical setting is necessary. We aimed to develop the national level HAM list for acute care setting. Methods: We used three-step process. First, we compiled the pre-existing lists referring HAMs. Second, we analyzed medication related incidents reported from national patient safety incident report data and adverse events indicating medication errors from the Korea Adverse Event Reporting System (KAERS). We also surveyed the assistant staffs to support patient safety tasks and pharmacist in charge of medication safety in acute care hospital. From findings from analysis and survey results we created additional candidate list of HAMs. Third, we derived the final list for HAMs in acute care settings through expert panel surveys. Results: From pre-existing HAM list, preliminary list consisting of 42 medication class/ingredients was derived. Eight assistant staff to support patient safety tasks and 39 pharmacists in charge of medication safety responded to the survey. Additional 44 medication were listed from national patient safety incident report data, KAERS data and common medications involved in prescribing errors and dispensing errors from survey data. A list of mandatory and optional HAMs consisting of 10 and 6 medication classes, respectively, was developed by consensus of the expert group. Conclusion: We developed national level HAM list for Korean acute care setting from pre-existing lists, analyzing medication error data, survey and expert panel consensus.
Objective: The purpose of this study was to identify the type and frequency of chemotherapy-related prescribing errors and assess the pharmacist intervention in preventing potential harm. Methods: This study was performed in satellite pharmacy of oncology/hematology unit in tertiary teaching hospital from April to September, 2009. All chemotherapy prescribing errors detected by pharmacists were recorded. Frequency and characteristics of prescribing errors were analyzed. Pharmacists reviewed 28, 495 chemotherapy orders from 12,719 patients during 6-month periods. Results: A total of 835 prescription errors (2.93%) in 734 patients (5.77%) were detected by pharmacists. Alkylating agents (37.6%) followed by antimetabolite (23.35%), and mitotic inhibitors (21.44%) were the most prevalent classes in which errors occurs. The most common types of error detected were incorrect dose (34%), incorrect solution (33%), incorrect route (9%) and omission errors (8%). Changes in chemotherapy order due to pharmacists' intervention occurred in all error cases. Conclusion: Pharmacists' intervention in reviewing chemotherapy and drug orders intercepted potential harm due to prescribing errors. The current study provided strategies for reduction of medication errors.
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.
This study is intended to provide information to menopausal women so they can control their symptoms. The basic data was gathered by interviewed 200 postmenopausal women on a HRT program. The women were questioned about their perception of menopause and compliance to the therapy with the fellowing result $71.7\%$ of the women experianced hot flushes, and $64.1\%$ experienced short term memory loss and some psychological symptoms. The women reported that these symptoms reduced their quality of life. $53\%$ of the women responded that menopause is a natural state and $59.1\%$ agreed to HRT based on their doctor's recommendation. $76.2\%$ of the women reported that HRT was effective, with $74.7\%$ reporting reduced hot flush symptoms $67.3\%$ of the women reported compliance with the medication schedule. and $43.9\%$ reported periodic non-compliance. Although HRT has been shown to be an effective treatment, the study found that less than $10\%$ of postmenopausal women are currently being treated and these treated women are generally negligent in continuing with HRT, The study recommends that a program be developed that explains the benefits and risks of HRT to be distributed to patients being treated by doctors and pharmacists. In conclusions, It is very important for hormone replacement therapy on menopausal women to take more intensive medication consultation to increase medication compliance and effectiveness of pharmacotherapy.
The study objectives were to investigate the attitude of Ajou University pharmacy students toward pharmaceutical care and to identify their perceived barriers to its provision. Secondarily, their career choices and influential factors for career decision were assessed. Method: A cross-sectional survey of Ajou University pharmacy students in all professional years was conducted in May 2014. Results: Over 2 weeks, a total of 123 students participated in the study (100% response rate). All respondents agreed that pharmaceutical care is the right direction for the provision to be headed and that pharmaceutical care will improve patient health. However, professional year was inversely associated with the degree of positive attitude toward pharmaceutical care. Highly perceived barriers to pharmaceutical care included poor image of pharmacist's role in society (67%) and lack of access to the patient medical record in the pharmacy (65%). Work environment, benefits, and salary were top three influential factors for career plans, and $6^{th}$ year students considered salary most important. Patient-oriented practices (hospital and community pharmacy) were the most preferred career choices among $6^{th}$ year students. Conclusion: Pharmacy clerkships appeared to have a positive influence on career choices of those students. Efforts should be exerted to improve pharmacy clerkships and to promote pharmaceutical care.
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