Pharmacists’ social networking service activities and perceptions regarding e-professionalism and e-communication in South Korea

양윤석 중앙대학교 대학원 2018 국내석사

4차 산업혁명 시대를 맞이하여 SNS가 전자커뮤니케이션의 수단으로 발전하고 있으며, 제약산업에서도 이런 흐름이 확산되고 있다. 이런 흐름에 발맞춰 본 연구는 약사의 SNS를 활용한 전자커뮤니케이션 활성화를 예측해보고자 시작하였다. 약사의 전자커뮤니케이션에서 SNS 활용 가능성, 온라인 상 약사의 전문성 향상 방안, 약사의 새로운 미래 커뮤니케이션 모델 가능성을 알아보기 위해 국내 수도권 약학대학을 졸업한 약사를 대상으로 전자설문을 통해 약사의 SNS 사용 현황, 전자전문성 조사, 약사와 환자 간에 SNS를 활용한 전자커뮤니케이션 조사를 수행하였다. 설문 결과(N=108), 대다수의 약사(98.1%)가 SNS를 사용하고 있었으며 SNS 중 페이스북과 인스타그램의 접근도가 가장 높았다. SNS 사용 목적은 정보 획득(48.1%)이 가장 많았으며, SNS가 대인관계 유지에 도움이 된다고 생각하는 약사(68.5%)가 도움이 되지 않는다고 생각하는 약사(31.5%)보다 많았다. 전자전문성에서는 6년제 졸업 약사에 비해 4년제 졸업 약사가 SNS 상에서 보건 의료 전문가로서 높은 기준으로 이미지를 관리해야 한다는 생각과 약사로서 게시하는 글이 타인에게 영향을 미칠 것이라고 생각하는 약사 비율이 유의하게 높았다(p=0.0015, 0.001). 그리고 전자전문성 향상을 위한 교육은 현직 약사의 교육(53.7%)보다는 약학대학 학부 과정에서 교육(68.5%)을 보다 선호하는 것으로 나타났다. SNS를 활용하여 환자와 전자커뮤니케이션을 하고 있는 약사는 극소수(2.8%)였으며, 전자커뮤니케이션을 하지 않는 이유로는 시간 부족(26.7%), 인프라 부재(23.8%)를 주요하게 제시하였다. SNS를 활용한 전자커뮤니케이션의 필요성에 대해서는 대다수의 약사가 공감하고 있었으나(84.7%), 향후 본인의 활용 계획을 갖고 있는 약사(41.0%)는 이보다 적은 것으로 나타났다. 본 설문 결과를 통해, 다수의 약사가 정보 교환의 목적으로 SNS를 활용하고 있어 SNS가 약사의 전자커뮤니케이션 수단으로 활용될 가능성이 높으며, 주로 사용하는 페이스북과 인스타그램이 플랫폼 후보가 될 수 있을 것이다. 또한 전자전문성 형성에는 약사로서 경험이 주요하게 작용하며, 전자전문성 향상을 위해 약학대학 커리큘럼 상에 관련 교육을 신설하거나 임상 경험을 확대하는 것이 하나의 방안이 될 수 있을 것이다. SNS를 활용한 환자와의 전자커뮤니케이션의 필요성을 대다수의 약사가 공감하고 있어 새로운 미래 커뮤니케이션으로 활성화할 필요가 있으며, 이를 위해 인프라 구축, 보험 약가 신설을 통한 약사 보상 강화 등의 구체적인 대책이 필요할 것이다. During the 4th industrial revolution, social networking service (SNS) has become a new means of electronic communication (e-communication), and this trend is spreading throughout the pharmaceutical industry. In line with this trend, we started this study to predict the activation of pharmacists’ e-communication using SNS. In order to find out the possibility of using SNS for e-communication, the status of electronic professionalism (e-professionalism) as online pharmacists, and the possibility of new communication models for the future, we conducted an electronic survey of pharmacists. As a result of the survey (N=108), most pharmacists (98.1%) were using SNS, and Facebook and Instagram were familiar with pharmacists. Pharmacists used SNS mainly for obtaining various information (48.1%), and the proportion of pharmacists who thought SNS helped to maintain interpersonal relationships was 68.5 percent. The percentage of 4-year pharmacists who thought that they should manage their image as a health care professional on SNS and who thought posting as a pharmacist would have an impact on others was significantly higher than that for 6-year pharmacists (p=0.0015, 0.001). Most pharmacists (68.5%) thought that they needed more education during college to improve their e-professionalism. Very few pharmacists (2.8%) communicated with patients using SNS, and the main reasons for not communicating with patients were a lack of time (26.7%) and lack of infrastructure (23.8%). Most pharmacists (84.7%) agreed on the need for e-communication using SNS, but only 41.0 percent of pharmacists wanted e-communication in the future. Therefore, since most pharmacists are using SNS for information exchange, SNS will be used as pharmacists’ e-communication tool. In particular, Facebook and Instagram can be candidates for SNS platform. Experience as a pharmacist plays a key role in the formation of e-professionalism, so one option would be to add such a class to the pharmacy college curriculum to improve e-professionalism of pharmacists. In addition, in order to activate pharmacists’ e-communication using SNS with patients, it is necessary to establish specific SNS infrastructure and to strengthen appropriate insurance compensation for e-communication.

약학대학의 임상실습교육 도입에 관한 의식조사

장혜경 중앙대학교 의약식품대학원 2000 국내석사

The purpose of this study is to propose the effective ways of introduction of clinical pharmacy practice in the curricular of College of Pharmacy. In order to investigate the current condition of clinical pharmacy practice and pharmacist's consciousness, a questionnaire was written with a list of questions related to the clinical pharmacy practice, and given to pharmacists via mail or personal visitation during the period of October 16 to November 6. In the practice site level, the questionnaire was delivered to personnels in charge of clinical pharmacy practice training in twenty six (26) hospitals, and the response rate was 80.8% (n=21). In the hospital pharmacist level, the questionnaire was sent to 250-person subjects, and the response rate was 76.0% (n=190). In the community pharmacist level, the questionnaire was sent to 150-person subjects, and the response rate was 40.0% (n=60). The research results was a follows ; The ratio of pharmacists to technicians in the practice site was 7/3, and the hospital pharmacists experienced with five or more years of pharmacy service reached 51.1%. The hospital pharmacists involved in the clinical pharmacy educational course, managed by the Korean Society of Health-system Pharmacists (KSHP), were 52.6%, and the hospital pharmacists with M.S. or Ph.D's degree were 20.7%. In the clinical pharmacy practice, preceptor pharmacists made training for the students with a education program for two weeks during the summer or winter vacation. The main targets of the clinical pharmacy practice were focused on drug distribution, intravenous (IV) admixture, and drug information, and relatively less interest was made on communication skill with health care professionals, medical terminology, chart review, case study, rounding, and conference. Roughly speaking, it is presumed that the personal sources and educational conditions for the clinical pharmacy practice in the current practice site level would satisfy some expected qualities. Most of the hospital/community pharmacists agreed that the clinical pharmacy practice course should be provided in the academic pharmacy education (96.8%/100%). They answered for the question of duration of clinical pharmacy practice training that it should be one month in the current 4-year academic pharmacy education course (45.5%/31.7%), or one session in the future 5 or 6-year education course (43.6%/41.7%). The students should make payment for the pharmacy practice training to the relevant training institutions (71.4%/61.7%), and the service career of preceptor pharmacists should be five years or more (48.1%/39.7%). Furthermore, it was proposed that specialized educational program for training the preceptor pharmacists should be established (52.6%/66.1%). The clinical pharmacy practice training should be made at both of the privileged hospital and community pharmacies for a predetermined time period (73.3%/80.0%). The privileged hospital pharmacy would be selected from the qualified hospitals currently with a doctor training program. The privileged community pharmacy would be the one certified by the competent authorities to the effect that it well conforms to the requirements of good pharmacy practice (GPP). Concerning the relative importance of various clinical pharmacy practice programs based on five (5) rating scales, most of the hospital and community pharmacists granted the greatest degree to the drug distribution program (4.22/4.27). The hospital pharmacists highly appreciated the importance of clinical services such as communication skill with health care professionals, case study, chart review, rounding, conference, drug information, IV admixture, and therapeutic drug monitoring. By contrast, the community pharmacists gave high scores to the importance of patient consultation, and drug information. It follows that differential education programs should be provided for the hospital and the community pharmacies, respectively. It was expressed that initiation of the clinical pharmacy practice training course in the academic pharmacy education should be made "after the suitable pharmacy education conditions were established at a reasonable degree" (55.1%/47.5%). Then, the steering responsibilities for the course will be assigned to a conference group designated by the Korean Pharmaceutical Association (KPA)/KSHP and College of Pharmacy (51.9%/44.8%). Pursuant to the separation of prescribing and dispensing practice, the demand for clinical pharmacy practice has been heightened with the sympathy of the pharmacist society. In this situation, it becomes a pressing need that effective pharmacy practice training plans should be made in the current 4-year academic pharmacy education course rather than waiting for the remote establishment of complete pharmacy education conditions. Thereafter, such plans should be improved piece by piece to be well adapted for the future five or six-year academic pharmacy education course.

Assessing the efficacy of pharmacist-engaged interventions in influencing antibiotic prescribing behavior among general practitioners (meta-analysis)

Sara Badreldin Rabie Ali Graduate School of Public Health, Yonsei Universit 2024 국내석사

Background A meta-analysis study was undertaken to examine antibiotic resistance, specifically by assessing the effectiveness of pharmacist interventions in influencing the rate of antibiotic prescriptions compared to their impact on adherence to antibiotic prescribing guidelines. Objective: Evaluating the effectiveness of pharmacist interventions in influencing the rate of antibiotic prescriptions, in contrast to their impact on adherence to antibiotic prescribing guidelines. Method: A comprehensive literature review up to the year 2016 was conducted, examining a total of 215 relevant studies. Among these, 15 specific studies were chosen for inclusion, encompassing a population of 298,339 individuals who initially demonstrated antibiotic resistance. Within this group, 134,004 individuals were exposed to interventions involving pharmacist participation, while 164,335 served as controls. The calculation of odds ratios (OR) and 95% confidence intervals (CIs) was employed to assess antibiotic resistance in pharmacists involved in antibiotic prescribing rates as compared to those involved in antibiotic prescribing adherence rates. This analysis utilized dichotomous approaches and employed both fixed and random models. Result: When pharmacists participated in interventions targeting antibiotic prescribing rates, a considerable reduction in antibiotic resistance was observed (Odds Ratio, 0.86; 95% Confidence Interval, 0.78-0.95, p<0.00001). However, these findings exhibited a significant degree of heterogeneity (I2 = 90%). Conversely, in interventions focusing on improving antibiotic prescribing adherence rates involving pharmacists, a substantial increase in antibiotic resistance was noted (Odds Ratio, 1.96; 95% Confidence Interval, 1.56-2.45, p<0.00001), with similarly high heterogeneity in the results (I2 = 91%). These outcomes were specifically evident in individuals grappling with antibiotic resistance issues. Conclusion: Pharmacist-led interventions targeting antibiotic prescribing rates led to a noteworthy decrease in antibiotic resistance compared to scenarios without pharmacist involvement in such interventions. Nonetheless, it is crucial to approach the interpretation of these results with caution, given the limited sample size in certain studies incorporated into the meta-analysis.

병원약사의 이직의도에 관한 결정요인

신동영 연세대학교 대학원 2002 국내석사

본 연구는 의약분업 이후 병원약사들의 이직의도에 영향을 미치는 요인과 그 효과를 밝혀내어, 이직에 관련된 문제에 대한 대안모색의 근거를 제공하고자 한다. 이를 위해 독립변수, 매개변수 및 종속변수간의 인과관계를 가정한 모델을 설정하고 경로분석기법을 이용하여 분석하였다. 자료수집은 서울, 인천, 경기지역에 위치한 병원에 근무하고 있는 병원약사를 대상으로 2001년 10월 24일부터 11월 14일까지 21일간 자기기입식 설문을 통해 이루어졌고, 최종 분석에 사용된 사례수는 252부였다. 본 연구의 결과는 다음과 같다. 첫째, 각 독립변수들이 직무만족도를 매개변수로 했을 때 이직의도에 미치는 직접, 간접 및 총 효과를 분석한 결과, 외부취업기회가 이직의도에 正(+)의 총 효과를 가지며, 기대충족도, 직무만족도, 승진기회, 직무의 다양성의 크기순으로 이직의도에 負(-)의 총 효과를 가지는 것으로 나타났다. 이 인과관계모델에서 독립변수와 매개변수 직무만족도가 전체적으로 이직의도의 변이의 43.2%를 설명해 주고 있다. 둘째, 각 독립변수들이 조직애착도를 매개변수로 했을 때 이직의도에 미치는 직접, 간접 및 총 효과를 분석한 결과, 외부취업기회가 이직의도에 正(+)의 총 효과를 가지며, 기대충족도, 조직애착도, 승진기회, 직무의 다양성의 크기순으로 이직의도에 負(-)의 총 효과를 가지는 것으로 나타났다. 이 인과관계모델에서 독립변수와 매개변수 조직애착도가 전체적으로 이직의도의 변이의 48.3%를 설명해 주고 있다. 본 연구의 결과를 분석하면, 병원약사의 이직에 관련한 문제점들을 풀어나가기 위해서는 기대 충족도, 승진기회, 직무의 다양성 등을 향상시키기 위한 병원경영진의 노력이 요구된다고 이야기 할 수 있다. 그리고, 대부분의 유의한 변수들이 직무만족도와 조직애착도를 통해 이직의도에 영향을 미치는 것으로 나타났기에, 병원경영자들이 병원약사들의 직무만족도와 조직애착도에 영향을 미치는 요인을 파악하고 대안을 모색하는 노력이 필요할 것으로 평가한다. 이러한 노력이 뒤따른다면, 외부취업기회의 상승으로 인한 이직문제를 해결하는데에도 기여될 것으로 예측할 수 있을 것이다. 본 연구의 제한점은 표본추출이 임의 추출에 의한 점, 의약분업에 관련된 변수의 추가가 부족했던 점, 단면연구로써의 한계점을 들 수 있다. 추후에는 이와 같은 점을 개선하고, 다각적인 인과관계모델의 설계와 이미 이직한 병원약사를 대상으로 하여 연구를 진행한다면 병원약사의 이직에 대한 좀 더 명확한 설명이 가능할 것으로 예측된다. 이러한 일련의 연구가 진행되어 나감에 따라, 병원경영자들은 이직을 좀 더 명확히 예측하여 더욱 합리적인 인사계획 및 조직계획을 세울수 있을 것이라고 기대한다. The purpose of this study is to investigate some determinants and their effects for intent to leave by hospital pharmacists and to propose a base of an alternative plan for their issues. The models of this study are developed by two casual model of turnover and analyzed using path analysis The sample used in this study consisted of 252 pharmacists working at hospitals in Seoul, Inchon and Kyunggi province. And, the samples are collected with self-administered questionnaires form Oct. 24 to Nov. 14 in 2001. The results are as follows. 1. In the casual model of using intervening variable by job satisfaction, the results of this model indicate; (1) job opportunity has significant positive total effect on intent to leave of hospital pharmacists, (2) the following variables, listed in order of size, have significant negative total effects of intent to leave of hospital pharmacists : met expectations, job satisfaction, job chance, variety, (3) the model explains 43.2% of the variance in intent to leave of hospital pharmacists. 2. In the casual model of using intervening variable by organizational commitment, the results of this model indicate; (1) job opportunity has significant positive total effect on intent to leave of hospital pharmacists, (2) the following variables, listed in order of size, have significant negative total effects of intent to leave of hospital pharmacists : met expectations, organizational commitment, job chance, variety, (3) the model explains 48.3% of the variance in intent to leave of hospital pharmacists. In this results, (1) managerial support for improving the met expectations, job chance, variety for hospital pharmacists are needed, (2) managerial support for finding the determinants and alternative plans of the job satisfaction and organizational commitment for hospital pharmacists are needed, (3) if, improvement of job satisfaction and organizational commitment for hospital pharmacists is achieved, it is expected to inflict positive effect to the resolution of increasement in the job opportunity.

The Organization of Pharmacist-Customer Interaction in Korea

이윤경 성균관대학교 일반대학원 2015 국내석사

본 연구는 한국의 약국에서 일어나는 약사-고객 사이의 대화에 대해 상세히 분석한 연구이다. 의료 대화 중 한 분야인 병원에서 일어나는 의사-환자 대화 분석과 달리, ‘약국’이라는 장소의 특성상 ‘환자’ 라는 관점 보다는 ‘고객’이라는 보다 넓은 의미의 관점도 사용되었으며, 연구 전반에 걸쳐 ‘환자’와 ‘고객’이라는 두 가지 어휘를 번갈아 가며 적용하였다. 약사-고객 사이의 대화는 ‘약국’이라는 특수한 상황에서 일어나는 대화라는 점에서 병원에서의 대화와 마찬가지로 매우 가치있는 연구이다. 하지만, 현재 한국에서는 약국에서 발생하는 대화에 대한 연구가 전무한 만큼, 약사-고객 간의 대화 연구에 더욱 필요성을 느껴 본 연구에 착수하게 되었다. 본 연구는 대화 분석방식을 차용하여 완성되었으며, 실시간으로 자연스럽게 일어나는 약국 대화를 다루고 있다. 대화는 2014년 10월부터 11월까지 주말을 포함해 총 2주간 비디오 녹화 되었으며, 연구에 참여한 약국은 동네 약국으로, 한 곳의 약국에서만 녹화가 진행되었다. 총 44개의 대화는 분석을 위해 다시 22개의 처방전이 있는 상황과 22개의 처방전이 없는 상황으로 나뉘어졌다. 이는 처방전의 유무에 따라 대화의 구조에 영향을 미치는지 알아보기 위해서이며, 연구 전반에 걸쳐 처방전의 유무가 명시되고 있다. 본 연구에 참여한 약국에는 현직 약사 2명과 직원 2명이 일하고 있고, 약국 직원들은 대화에 종종 등장하여 고객을 안내하고, 약사를 도와주는 역할을 한다. 연구에 등장하는 모든 대화는 단계별로 나누어졌고, 각 단계 별로 설명과 분석을 하였다. 약사와 고객 간의 대화 도입 부분에서는 인사가 (예: 안녕하세요, 어서 오세요) 상호적으로 전혀 이루어지지 않는다는 점이 드러났다. 하지만 절반 정도의 고객들이 대화 마무리 단계에서의 인사를 약사와 함께 상호적으로 표현하였다. (예: 안녕히 계세요-안녕히 가세요.) 약국 대화에서 가장 중요한 단계는 ‘문제 제시 (problem presentation)’ 단계라고 할 수 있는데, 이 단계에서 주목할만한 커뮤니케이션 특징들이 많이 드러났기 때문이다. 문제 제시 단계에서 나타나는 특징으로는 고객이 아무런 말 없이 처방전을 제출하는 행동, 상호 시선 교환의 부재, 그리고 대화의 주도권 잡기가 가장 대표적이었다. 앞서 언급했듯이, 약국 대화에 대한 연구가 매우 부족한 상황이기 때문에 보다 심도 있는 연구를 위해 영어 문화권의 의사-환자 간 대화를 인용하여 한국 약국 대화와 비교, 대조하고 분석하였다. 의사-환자, 약사-고객 대화의 구조와 특징들을 비교 분석함으로써, 앞으로의 추가적인 연구에 대해 미리 생각해 볼 수 있었다. 영어 문화권의 의사-환자 대화와 한국의 약사-고객 대화를 분석한 결과는 다음과 같이 나타났다. 한국의 경우, 대부분의 상황에서 약사가 대화의 주도권을 쥐고 대화를 이끌어 나갔다. 이러한 현상은 특히 ‘문제 제기’ 단계에서 두드러지게 나타났다. 고객들이 적극적으로 대화에 참여하고 불편함을 표현하기 보다는, 약사가 고객으로부터 답을 유도하는 방식으로 질문을 자주, 반복적으로 하는 모습을 볼 수 있었다. 반면, 영어 문화권에서는 환자들이 대화에 적극적으로 참여하려는 경향을 보였으며, 문제 제기 단계에서도 본인의 불편함이나 상황을 자세하게 설명하는 모습이 관찰되었다. 이러한 경향 때문에 의사가 대화 중간에 끼어드는 경우는 드물게 나타났고, 대화의 주도권 역시 환자에게 더 많이 주어졌다. 연구의 마지막 부분에는 현직 약사들과의 구두 인터뷰를 포함하였다. 인터뷰의 주제는 약국 대화에 대한 연구가 부재한 이유였으며, 약사들의 다양한 의견과 관점들을 위주로 인터뷰가 구성되었다. 약국 대화에 대한 연구가 부재한 이유를 설명하는 동시에 약사가 유능하고 경쟁력 있는 커뮤니케이터로서, 상담 전문가로서의 역할도 충실히 해야 할 의무도 있다고 현직 약사들은 이 인터뷰에서 강조하였다. 약사의 상담 능력은 고객과의 직접적인 교류를 위해서뿐만 아니라, 다른 의료 전문가들과 고객 사이를 원만히 이어주기 위한 중재자로서의 역할도 충실히 수행하기 위해 중요하다는 점을 알 수 있었다. This study aims to provide an in-depth analysis on pharmacist-customer interaction in Korea. Although it is very worthwhile to examine medical interaction, one type of institutional talk, studies on pharmacy interaction are virtually absent in Korea. Absence of pharmacy interaction studies has been a great motive for writing this current thesis. The study employs a conversation analysis methodology and is based on real-time pharmacy encounters between pharmacists and customers. Forty four encounters occurring at a community pharmacy are video-recorded during the course of two weeks, including evenings and weekends in from October to November 2014. The data collected then are divided into twenty two prescription encounters and another twenty two non-prescription encounters. Such division is to differentiate between two different types of pharmacy visits ─ prescription and non-prescription visits and to discover distinctive organizational features based on these two types of visits. Two practicing pharmacists with two pharmacy personnel and many customers are participants of this study. The phase structure of pharmacy interaction is analyzed in detail step by step. The result shows that there is a lack of mutual opening remarks between pharmacist and customers, whereas in the closing phase, half of the customers produce closing remarks as the interaction ends. Problem presentation is the milestone of the whole pharmacy interaction. Numerous features are found during the problem presentation phase, such as the customers’ silent prescription submission, lack of mutual eye contact and taking initiatives. Since there is insufficient evidence regarding conversation analysis on pharmacy interaction, doctors-patients interaction in the Western context is used to compare and contrast. The structure of doctor-patient interaction is compared to that of pharmacy interaction and noticeable points from both contexts are contrasted with each other for further discussion. The data collected reveals the difference between the two settings: In Korean context, the pharmacist tends to take greater initiatives when interacting with patients or customers, especially during the problem presentation phases. However, in Western context, patients are prone to participate more actively during the problem presentation phases by explaining their conditions and problems in detail and the doctors’ interruptions seem to be minimized. Also, an oral interview is conducted to discuss the absence of conversation analysis on pharmacy interaction, with five practicing pharmacists. The opinions and perspectives on pharmacy communication help unpack the importance of the pharmacist’s role as a competent communicator and counselor not only to the patients or customers, but in between other health care providers and patients or customers as well.

한약사의 보완통합요법 활용방안

하동훈 전주대학교 일반대학원 2021 국내박사

Until now, in Korea, studies on how to apply complementary integrative therapy to various fields have been actively conducted, but no research has been done on how to use complementary integrative therapy in the workplace by Korean pharmacists. Therefore, this study aims to find ways that Korean pharmacists can use complementary integrative therapies more effectively in the workplace by examining the system and function of Korean pharmacists and analyzing various complementary integrative therapies. Among the various complementary integrated therapies in relation to pharmacy work which is the main function of an Korean pharmacist, nutritional therapy, stress management techniques and chiropractic, which are expected to be used directly or indirectly in the clinical scene of Korean pharmacists, are intensively studied and analyzed in order to produce basic materials that Korean pharmacists could refer to. In addition, this study reviewed the education that must be performed in advance in order to use various complementary integrative therapies effectively in the workplace for Korean pharmacists. If Korean pharmacists develop the knowledge of complementary integrative therapy and engage in medicine business in the workplace, they could not only give an explanation for choosing medicine in the consultation with patients, but also provide active advice so that patients can engage in more integrated health care.

Perspectives on Emergency Department-Initiated Buprenorphine Among Clinical Pharmacists

Justen, Marissa Yale University ProQuest Dissertations & Theses 2023 해외박사(DDOD)

소속기관이 구독 중이 아닌 경우 오후 4시부터 익일 오전 9시까지 원문보기가 가능합니다.

Clinical pharmacists are well positioned to enhance efforts to promote Emergency Department (ED)-initiated buprenorphine to treat opioid use disorder (OUD). Among clinical pharmacists in urban EDs, we sought to characterize barriers and facilitators for ED-initiated buprenorphine to inform future implementation efforts and enhance access to this highly effective OUD treatment.This study was conducted as a part of Project ED Health (CTN-0069, NCT03023930), a multisite effectiveness-implementation study aimed at promoting ED-initiated buprenorphine that was conducted between April 2017 and July 2020. Data collection and analysis were grounded in the Promoting Action on Research Implementation in Health Services (PARIHS) framework to assess perspectives on the relationship between 3 elements: evidence for buprenorphine initiation, the ED context, and facilitation needs to promote ED-initiated buprenorphine. Using content analysis, an iterative coding process was used to identify overlapping themes within these 3 domains.Eight focus groups/interviews were conducted across four geographically disparate EDs with 15 pharmacist participants. Six themes were identified. Themes related to evidence included (1) varied levels of comfort and experience among pharmacists with ED-initiated buprenorphine that increased over time and (2) a perception that patients with OUD have unique challenges that require guidance to optimize ED care. Regarding the context, clinical pharmacists identified: (3) their ability to clarify scope of ED care in the context of unique pharmacology, formulations, and regulations of buprenorphine to ED staff, and that (4) their presence promotes successful program implementation and quality improvement. Participants identified facilitation needs including: (5) training to promote practice change and (6) ways to leverage already existing pharmacy resources outside of the ED.Clinical pharmacists play a unique and critical role in the efforts to promote ED-initiated buprenorphine. We identified 6 themes that can inform pharmacist-specific interventions that could aid in the successful implementation of this practice.

동물약국의 인식현황 및 약사의 동물용의약품 교육의 필요성

이영아 충북대학교 2014 국내석사

The use of veterinary drugs has been consistently increasing. The market size for veterinary drugs for pet is also expanding with an increase in the number of households owning a pet. Therefore pharmacists must be aware of veterinary drugs to prevent abuse and misuse of the drugs, and to ensure the safety of livestock under the veterinarian prescription system. In this study, the awareness of animal pharmacies was surveyed in order to find out the role of animal pharmacies and the necessity of veterinary drug education for pharmacists. A survey was conducted by 187 animal owners from July 21, 2013 to August 10, 2013. Each participant answered the questionnaire, which included questions about their awareness of the existence of animal pharmacies, and their purchase intention in the animal pharmacies. Another survey on 115 community pharmacists was conducted with questions about awareness, pharmaceutical law and notification of animal pharmacies from July 21, 2013 to July 30, 2013. Study results showed that 80% of the animal owners who participated in this survey had purchased drugs for their animals. 63% of respondents were not aware of the existence of animal pharmacies. The best selling drug class for animals was antiparasitic. The most common drug that respondents wanted to buy in animal pharmacies was also antiparasitic. About 80% of respondents answered affirmatively on the question of whether they would buy the drugs from animal pharmacies regardless of the location of the pharmacies. Most community pharmacists were aware of the existence of animal pharmacies. In addition, 70% of pharmacists who answered the questionnaire had considered trading in veterinary drugs. 41% of respondents answered that they did not trade in them because they were not familiar with veterinary drugs. 80% of respondents answered that what they needed most was education (education from the pharmaceutical association: 68%, curriculum in university: 10%) in order to increase the number of animal pharmacies. Pharmacies for animal will expand the choice of animal owners, and enable pharmacists to improve their specialty as well as to diversify the pharmacy services. To achieve this, promotion of animal pharmacies and education about veterinary drugs for pharmacists would be needed in regular education system.

Multidisciplinary Team Care of Anemia Management in Chronic Kidney Disease Patients

전다혜 서울대학교 대학원 2012 국내석사

만성콩팥병(chronic kidney disease, CKD)에서 발생하는 빈혈은 적절한 치료가 이루어지지 않는 경우가 많으므로, 적절한 치료를 위하여 팀 의료(multidisciplinary team care, MTC)를 통한 환자 치료가 필요하다. 적절한 치료가 이루어지지 않는 이유 중 대표적인 이유가 부적절한 약제의 사용이기 때문에 팀 의료 구성원 중 임상약사의 역할은 매우 중요하다. 팀 의료를 통한 만성콩팥병 환자의 빈혈 치료에 대한 연구가 국내에서 분석된 적이 없으며, 적절한 만성콩팥병 빈혈 치료를 위해서는 임상약사를 위한 특이적인 알고리즘이 필요하다. 따라서 본 연구에서는 현재 국내 3차 의료기관에서 이루어지고 있는 팀 의료를 통한 만성콩팥병 환자의 빈혈 치료 현황을 분석하고, 임상약사를 위한 근거중심의 만성콩팥병 빈혈 치료 알고리즘을 개발하였다. 팀 의료를 통한 만성콩팥병 환자의 빈혈 치료 현황은 국내 3차 대학병원에서 환자-대조군 연구로 분석하였다. 2010년 10월과 2011년 9월 사이에 신장내과로 입원 및 퇴원한 모든 만성콩팥병 빈혈 환자를 대상으로 하였으며, 환자들은 입원 병동에 따라 팀 의료군(MTC군)과 일반 치료군(non-MTC군)으로 나누었다. 팀 의료군은 의사, 임상약사, 간호사, 영양사가 포함되는 “팀 의료” 치료를 받았고, 일반 치료군은 의사와 간호사만 참여하는 치료를 받았다. 팀 의료군에서 임상약사는 모든 입원환자들의 처방약물 및 검사결과를 확인하여 적절성을 평가하였다. 적절성을 평가하는 기준은 KDOQI 치료지침, 병원 치료지침, 국내 보험기준을 참고하였다. 임상 결과는 헤모글로빈(hemoglobin, Hb), 페리틴(ferritin), 트랜스페린 포화도(transferrin saturation, Tsat)로 평가하였으며, 약물관련 문제(drug-related problem, DRP)과 약물관련 중재(drug-related intervention, DRIs)도 분석하였다. 또한, 만성콩팥병에서의 빈혈 치료 현황, 각종 전문서적, 임상치료지침, 최신 안전성 정보, 최근 국내 보험기준 등을 참고하여 임상약사를 위한 근거 중심의 만성콩팥병 빈혈 치료 알고리즘을 개발하였다. 팀 의료군은 94명, 일반 치료군은 37명의 환자가 포함되었다. 목표 헤모글로빈으로부터의 차이(ΔHbtarget)는 팀 의료군에서 보다 적절한 조절이 나타났다(추적관찰시 ΔHbtarget: 팀 의료군 0.08 g/dL 대 일반 치료군 -0.29 g/dL). 목표 헤모글로빈 이하인 환자의 비율도 팀 의료군에서 유의하게 감소하였다(p<0.001). 목표 페리틴에 도달한 환자의 비율도 팀 의료군에서 유의하게 중가하였고(p=0.035) 일반 치료군에서는 유의하게 감소하여 (p=0.010), 팀 의료로 인한 만성콩팥병 빈혈 치료 향상을 나타냈다. 가장 빈번한 DRP 및 DRI는 철분보충제에서는 “적응증이 없는 처방”이었으며, 조혈제(erythropoietin-stimulating agent, ESA)에서는 “용량 조절 필요”이었다. 또한, 만성콩팥병 환자에서 빈혈에 대한 검사가 부족한 경우가 많은 것으로 나타났다. 추후 임상에서 최적의 임상약제서비스를 위하여 만성콩팥병의 빈혈치료에 대한 4가지 알고리즘(빈혈 검사, 철결핍성 빈혈, 에리트로포에틴 결핍성 빈혈, 비타민 B12 및 엽산 결핍성 빈혈)이 개발되었다. 본 연구는 국내에서 임상약사가 참여한 팀 의료를 통한 만성콩팥병 환자의 빈혈치료를 분석한 첫 연구이다. 본 연구의 결과에서 빈혈치료에 대한 팀 의료의 유효성과 잠재력을 발견할 수 있었다. 또한, 본 연구에서 개발된 근거 중심의 만성콩팥병 빈혈 치료 알고리즘을 추후에 적용하여 빈혈 조절과 심혈관질환 예방을 통한 이환률 및 사망률의 감소도 기대할 수 있겠다. Anemia in chronic kidney disease (CKD) is frequently undermanaged. This emphasizes the necessity of patient care involving a multidisciplinary team for adequate treatment. Clinical pharmacists may especially be helpful in clinical patient care, since inadequate medication use is the most frequent cause of under management. However, assessment on the effects of multidisciplinary team care (MTC) in CKD anemia treatment has not been evaluated in Korea and an algorithm adequate for clinical pharmacists is necessary. The goal of this study was to assess the current status of CKD anemia treatment with multidisciplinary team care (MTC) in an academic tertiary hospital in Korea and to develop an evidence-based CKD anemia treatment algorithm for clinical pharmacists. The assessment of the current status of CKD anemia treatment with MTC was carried out as a case-control study at a university affiliated tertiary hospital in Korea. All CKD patients with anemia who admitted to and discharged from the nephrology department between October 2010 and September 2011 were included. The patients were categorized into the MTC group and non-MTC group depending on the ward of admission. The MTC group received care from the “multidisciplinary team care (MTC)” from physicians, clinical pharmacists, nurses, and a dietician, while the non-MTC group had usual patient care involving only physicians and nurses during their stay at the hospital. The clinical pharmacists reviewed all prescribed medications and test results for every patient in the MTC nephrology ward based on KDOQI guidelines, hospital guidelines, and domestic insurance guidelines. Clinical outcomes of hemoglobin (Hb), ferritin, and transferrin saturation (Tsat) targeting levels, drug-related problems (DRPs) and drug-related interventions (DRIs) were evaluated. An evidence-based algorithm for CKD anemia treatment was developed based on the results of the current CKD anemia treatment assessment, textbooks, current clinical practice guidelines from accredited references, recent safety updates, and domestic national health insurance guidelines. 94 patients in the MTC group and 37 patients in the non-MTC group were included. The hemoglobin difference from target range (ΔHbtarget) showed better targeting of hemoglobin in the MTC group (ΔHbtarget at follow-up: MTC group 0.08 g/dL vs. non-MTC group -0.29 g/dL). The percentage of patients below Hb target level also decreased more significantly in the MTC group (p<0.01). The percentage of patients in ferritin target level increased significantly in the MTC group (p=0.035) and decreased significantly in the non-MTC group (p=0.010), indicating an improvement of CKD anemia treatment by MTC. The most frequent DRPs and DRIs for iron supplements were “indication without prescription” while “dosage adjustment necessary” was the most frequent in erythropoietin-stimulating agents (ESAs). Also, insufficient monitoring of anemia in CKD patients was discovered. Four algorithms (anemia work-up, iron-deficient anemia, erythropoietin-deficient anemia, vitamin B12 or folate-deficient anemia) on CKD anemia treatment were developed for future implementation. This is the first study to evaluate CKD anemia treatment with MTC involving clinical pharmacists in Korea. Effectiveness and potential of multidisciplinary team care has been shown with the clinical outcomes of anemia in this study. In addition, application of the detailed evidence-based CKD anemia treatment algorithm for clinical pharmacists may improve anemia status and prevent cardiovascular diseases, resulting in a decrease in morbidity and mortality.

약사의 건강증진 생활양식 실천정도 및 관련요인

이은주 연세대학교 보건대학원 2002 국내석사

본 연구는 개국 약사의 건강증진 생활양식 실천정도와 관련요인을 규명하기 위하여 서울 서초구, 서대문구, 영등포구에서 약국을 개설하였거나 개설약국에 근무하는 약사 중 임의로 표본 추출한 173명을 대상으로 2002년4월 9일부터 4월 18일까지 10일간 자기 기입식 설문조사 방법으로 하여 자료를 수집하였다. 자료분석은 SAS 통계프로그램을 이용하였으며 시술적통계, t-검정, 분산분석, 상관분석, 다중회귀분석 방법으로 분석하였다. 본 연구의 결과는 다음과 같다. 1. 대상자들의 전체 건강증진 생활양식 실천정도의 평균은 2.53(± 0.37)이었고, 하위 영역별로는 영역별로는 영적 성장 영역이 2.83(± 0.48)으로 가장 높았으며, 건강책임 영역이 2.10(± 0.56)으로 가장 낮았다. 2. 일반적 특성과 경험별 건강증진 생활양식 실천정도와의 관계에서는 1일 근무시간과 지각된 건강상태에서 통계적으로 유의한 차이를 보였다. 이전의 건강관련행위는 건강증진 생활양식의 모든 영역에서 유의한 양의 상관관계(r=0.76, p<0.01)를 보였다. 3. 인지 및 감정요인, 행동계획 수립과 건강증진 생활양식 실천정도와의 관계에서는 자기효능감(r=0.48, p<0.01), 행위관련 감정(r=0.52, p<0.01),사회적 지지(r=0.42, p<0.01), 행동계획수립(r=0.54, p<0.01)이 건강증진 생활양식 실천정도와 유의한 양의 상관관계를 보였으며, 지각된 장애성(r=-0.33, p<0.01)은 유의한 음의 상관관계를 보였다. 4. 대상자의 건강증진 생활양식 실천정도에 관련된 주요 요인을 파악하기 위해 연령, 성별, 결혼상태, 1일 근무시간, 1일 수면시간, 지각된 건강상태, 이전의 건강관련행위와 인지 및 감정요인을 포함하여 다중회귀분석을 실시한 결고, 이전의 건강관련해위가 회귀계수 0.48(p<0.01)로 가장 영향력 있는 요인이었으며 이전의 건강관련행위가 증가할 수록 건강증진 생활양식 실천정도는 증가하였다. 다음은 자기효능감으로 회귀계수는 0.13(p<0.01)이었으며 자기효능감이 증가할 수록 건강증진 생활양식 실천정도는 증가하였다. 전체 변수의 걸명력은 72.3%였다. 결론적으로 대상자의 건강증진 생활양식 실천정도는 이전의 건강관련행위, 자기효능감과 관련이 있으므로 건강증진 생활양식 실천정도를 높이기 위해서는 건강관련행위를 하였을 때의 성취감을 통하여 자기효능감을 향상시켜야 할 것 이다. The purpose of this study was to assess the influencing factors of health-promoting lifestyle implementation among pharmacists working at community pharmacy setting in Korea. A self-administered questionnaire was conducted upon community pharmacists from 3 local areas - Seocho-Gu, Seodaemun-Gu, and Youngdeungpo-gu - in Seoul, from April 9 to April 18. The questionnaire consisted of 136 questions, which were categorized into 10 scales: general characteristics (12 questions), implementation of health-promoting lifestyles (46), prior related behavior (7), perceived benefit of health-promoting life styles (8), perceived barrier (10); self-efficacy (7); activity-related affect (11), social support (18), situational influence (5), and commitment to plan action (12). The study results showed that the average score for the health- promoting lifestyle implementation scale was 2.53 on a 4-point scale, with the highest score for the subscale of spiritual growth (average score = 2.83) while the lowest score for health responsibility (2.10). There were significant differences in the degree of health-promoting lifestyle implementation according to daily working hours (p<0.05) and perceived health status (p<0.05). The Degree of health- promoting lifestyle implementation was positively related to prior related behavior(r=0.76, p<0.01), self-efficacy(r=0.48, p<0.01), activity-related affect(r=0.52, p<0.01), social support(r=0.42, p<0.01) and commitment to a plan action(r=0.54, p<0.01) while negatively related to perceived barrier(r=-0.33, p<0.01). Multiple regression analysis results showed that the most influential and significant factor to affect the degree of health-promoting lifestyle implementation was prior related behavior(r=0.48, p<0.01), followed by self-efficacy(r=0.13, p<0.01). In conclusion, prior related behavior and self-efficacy were significantly related to the health- promoting lifestyle implementation of community pharmacists in Korea. Further research will be needed to see whether the findings of this study can be replicated with different samples and whether the results of this study can be generalized to the entire group of community pharmacists.