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.

약사의 가정방문 복약지도 서비스가 환자의 치료성과에 미치는 영향

김대중 중앙대학교 대학원 2024 국내박사

Effects of Pharmacists’ Home Visiting Services on Patient Outcomes Dae Jung Kim Major in Health, Social and Clinical Pharmacy The Graduate School of Chung-Ang University Objective: The purpose of this research was to measure the effect of the home visiting care services provided by pharmacists in the areas of: medication adherence, changes in the number of drugs taken, changes in the occurrence of side effects, and satisfaction of pharmacists’ services. Methods: The pharmacists’ visiting services at patients’ homes were provided to teach patients about the safe use of drugs, adverse effects of medications, medication compliance and storage, and counseling about overall medication management. To evaluate the impact of pharmacists visiting services, a structured questionnaire was administered to patients before the first visit and 4 weeks after the first visit. The evaluation index included medication adherence, change in the number of prescription drugs taken, changes in the occurrence of side effects, and service satisfaction. Data was analyzed using McNemar’s chi-squared test for count data and the paired t-test for continuous data to compare the effect of pharmacists visiting service before and after implementation. Factor analysis with maximum-likelihood estimation was used to identify key items associated with the study variables. Generalized estimating equation analysis was used to evaluate effects of services after adjusting for the study variables in the repeated measurement design. Results: Pharmacists visited a total 176 patient homes. Rate of medication adherence and compliance with the instruction of taking medications were improved after providing the service, but the results were not statistically significant. Both the patients’ rate of medication compliance and the degree of knowledge of drugs currently being taken was significantly improved after pharmacists visiting services were provided (p< 0.001). The number of prescription drugs taken slightly increased after service use by 0.06 drugs per patient. This increase may be because most of patients who were taking the medications did not have a chance to consult with their physicians during the 4 weeks. The occurrence of experiencing side effects decreased from 55.1% before the service to 43.2% after the service and this change was statistically significant. Patients’ satisfaction of the pharmacists’ visiting service was very high overall ranging from 3.73-4.01 points out of 5 on a Likert scale. Conclusion: The pharmacist home visiting services improved rates of medication compliance and reduced the occurrence of side effects and patients were highly satisfied with the services. The pharmacist home visiting services may become useful to implement as a broader care program and implementing this kind of direct home visiting services have the potential to increase patients’ quality of life and reduce medication costs by reducing rates of adverse effects that are caused by medication- related problems. If pharmacists take on a more active role to provide services in community care, pharmacists would have an expanded role in their communities and could provide cost effective care. Keywords: Home visiting care, Community care, Pharmacist home visiting service 본 연구의 목적은 약사에 의한 가정 방문 복약지도 서비스가 환자의 복약 순응도, 처방약제 수의 변화, 부작용 발생의 변화, 그리고 약사 서비스에 대한 환자 만족도에 미치는 영향을 측정하는 것이었다. 방법: 환자의 자택에 약사가 방문하여 환자들에게 안전한 약물 사용, 부작용, 복약 준수 및 약품의 저장, 전반적인 약물 관리에 대해 교육을 제공하였다. 약사 방문 서비스의 효과를 평가하기 위해 첫 방문 전과 첫 방문 후 4주 후에 환자들에게 구조화된 설문지를 배포하였고, 평가 지표에는 복약 순응도, 처방 약제 품목수의 변화, 부작용 발생의 변화, 서비스 만족도가 포함되었다. 수집된 데이터는 McNemar의 카이제곱 검정을 이용하여 카운트 데이터를, 대응표본 t-검정을 이용하여 연속 데이터를 분석하여 약사 방문 서비스의 전후 효과를 비교하였다. 최대우도 추정을 이용한 요인 분석을 통해 연구 변수와 관련된 주요 항목을 식별하였으며, 반복 측정 설계에서 연구 변수를 조정한 후 일반화 추정 방정식 분석을 이용하여 서비스의 영향을 평가하였다. 결과: 총 176명의 환자에 대해 방문 복약 서비스가 이루어졌다. 복약 순응도 및 현재 복용 중인 약물에 대한 지식 수준은 유의미하게 개선되었으며 (p<0.001), 복약의 어려움도 많이 개선되는 것으로 나타났다. 서비스 이후 환자 당 처방 약물 수가 약간 증가한 것으로 나타났는데, 이는 환자들이 4주 동안 병원에 간 적이 없거나 새로이 처방을 받은 약물이 없어서 발생한 것으로 보인다. 부작용 발생은 서비스 이전의 55.1%에서 서비스 후 43.2%로 유의미하게 감소하였다 (p<0.05). 환자들은 약사 방문 서비스에 대해 매우 높은 만족도를 보였으며, Likert 척도에서 평균적으로 3.73에서 4.01 점을 받았다. 결론: 약사의 방문 복약 서비스는 복약 순응도를 개선하고 부작용 발생을 줄이며, 환자들의 서비스에 대한 만족도를 매우 높였다. 약사의 자택 방문 서비스는 보다 확장된 의료 프로그램의 일환으로써 시행될 수 있으며, 이러한 직접적인 방문 서비스는 약물 관련 문제로 인한 부작용을 줄임으로써 환자의 삶의 질을 향상시키고 약물 비용을 절감할 수 있는 잠재력을 가지고 있다. 그러므로, 약사가 지역 사회에서 더욱 적극적이고 확장된 역할을 수행함으로써 비용 효율적인 환자 관리를 제공할 수 있다.

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.

국내 약국 약사의 반도핑 교육 및 상담 경험에 따른 지식과 태도

정상원 연세대학교 보건대학원 2024 국내석사

국문 요약 국내 약국 약사의 반도핑 교육 및 상담 경험에 따른 지식과 태도 배경 및 목적 세계약사연맹(The International Pharmaceutical Federation, FIP)에서는 스포츠 약학을 도핑금지약물로부터 운동선수를 보호하는 영역으로 정의하면서 약사의 책임과 역할을 규정했다. 최근 생활체육 참여율이 증가하는 가운데, 생활체육인이 전문 선수에 비해 도핑인식 및 반도핑 교육 경험률이 매우 낮고 도핑금지성분 사용 경험률이 높다고 보고되어, 약국이라는 공간에서 전문 선수 및 생활체육인들에게 복약지도를 기반으로 도핑 상담을 해야 하는 약사에 대한 반도핑 교육 필요성이 증가하고 있다. 최근 대한약사회는 스포츠약사 자격 인증과정을 통해 1,177명의 1기 스포츠약사를 양성하였으나, 실제 약국이라는 환경에서 도핑 상담에 대응할 약사 인력에 대한 국내 연구는 찾아보기 어렵다. 이에 본 연구는 국내 약국 약사의 반도핑 경험에 따른 지식과 태도에 대하여 연구하고자 한다. 연구방법 약국 개업자 또는 지역약국 근무 약사 169명을 편의표집으로 모집하여 온라인 설문을 통해 구조화된 설문에 자가응답 방식으로 응답하도록 하였다. 일반적 특성, 반도핑 경험 여부, 반도핑 지식, 도핑에 대한 태도 및 인식을 조사하였으며, 도핑에 대한 태도에 대해서는 운동수행능력 향상에 대한 태도 척도(Performance Enhancement Attitude Scale, PEAS)를 한국어로 번역한 ‘한국형 PEAS’를 도구로 사용하였다. 반도핑 지식 수준을 구분은 우수한 지식 수준은 반도핑 지식 점수가 80%를 초과하는 경우(31문항 중 25개 이상)로 정의하였다. 반도핑 교육 경험 및 상담 경험 여부에 따른 반도핑 지식 수준, 도핑에 대한 태도 수준은 교차분석, 로지스틱 회귀분석을 이용하여 분석하였고, 반도핑 교육 경험 및 상담 경험 여부에 관련된 요인을 확인하기 위하여 로지스틱 회귀분석을 실시하였다. 연구결과 전체 169명의 국내 약국 약사가 설문에 응답하였고, 남성이 78명(46.2%)였으며, 연령대는 30~39세가 61명(36.1%)로 가장 높았다. 임상경력 10년 이상은 94명(55.6%), 최종학력은 학사가 144명(85.2%)이었다. 근무지역의 경우 수도권(서울, 경기, 인천)이 116명(68.6%)였다. 약사 대상 반도핑 교육을 이수한 약사가 이수를 하지 않은 약사에 비해 반도핑 지식 수준이 우수한 경우가 많았다(p<0.001). 또한 12개월 이내 선수 대상 상담 경험이 있는 약사가 없는 약사에 비해 반도핑 지식 수준이 우수한 경우가 많았다(p<0.001). 국내 약국 약사의 도핑에 대한 태도는 평균 32.2±10.9점으로 기준인 긍정적인 태도에 기준인 59.5점 이상 보다 낮은 점수로 국내 약국 약사는 도핑에 대하여 부정적인 태도를 보였다. 반도핑 교육 및 상담 경험 중 약사를 대상으로 한 반도핑 교육을 이수한 경우는 27.2%였고, 12개월이내 선수를 대상으로 한 상담 경험한 경우는 30.2%였다. 국제 및 국내 대회(올림픽, 전국체전 등)내 스포츠 약국을 경험한 경우는 1.2%에 불과하였다. 반도핑 지식 점수는 총 31점 만점에 평균 20.3±5.5점이었으며, 도핑 금지 물질인 인슐린의 정답률이 34.9%로 매우 낮았다. 또한 한약제제와 스포츠 보충제의 금지성분에 대한 지식이 부족했다. 추가적으로 운동선수 대상 반도핑 교육에서 약사의 역할에 대해 4점 만점에 3.59±0.59점으로 중요하게 인식하고 있지만, 스스로 충분한 지식이 있는지에 대해서는 4점 만점에 1.82±0.74점으로 상대적으로 부족하다고 인식했다. 결론 약사 대상 반도핑 교육을 이수하였거나, 12개월 이내 선수 대상 상담 경험이 있는 약국 약사는 그렇지 않은 약국 약사에 비해 반도핑 지식 수준이 높았으며, 전체 응답자는 대부분 도핑에 대한 부정적인 태도를 가지고 있었다. 의도하지 않는 도핑을 방지하기 위해 약사의 역할이 중요하다는 의견의 비율이 높았으나, 스스로 운동선수를 상담하고 교육할 수 있는 충분한 지식을 가지고 있지 않다고 평가하여, 향후 생활체육인의 정의와 도핑 현황과 상담 및 교육 상황 등에 대한 연구와 현재 반도핑 활동에서 약사의 현재 직능과 잠재적 역할의 분석 및 국내의 다양한 반도핑 교육 프로그램의 평가 및 개발 등 다양한 후속 연구가 필요하다. Background and purpose The International Pharmaceutical Federation (FIP) defines sports pharmacy as the area of protecting athletes from anti-doping substances and defines the responsibilities and roles of pharmacists. With the recent increase in participation in recreational sports, it has been reported that recreational athletes have a much lower rate of doping awareness and anti-doping education than professional athletes, and a higher rate of use of prohibited substances, thus increasing the need for anti-doping education for pharmacists who provide anti-doping counselling to professional and recreational athletes in the pharmacy. Recently, the Korean Pharmaceutical Association created a sports pharmacist certification system and trained 1,177 sports pharmacists, but there are no domestic studies on pharmacists' ability to respond to doping counselling in the actual pharmacy setting. Therefore, this study aimed to investigate the knowledge and attitudes of pharmacists in Korean pharmacies according to their anti-doping experience. Research methods A convenience sample of 169 pharmacists working in independent or community pharmacies was recruited and asked to respond to a structured questionnaire via an online survey. General characteristics, anti-doping experience, anti-doping knowledge, and attitudes and perceptions towards doping were examined. The Korean version of the Performance Enhancement Attitude Scale (PEAS) was used to measure attitudes towards doping. The level of anti-doping knowledge and attitudes towards doping were analyzed using crosstabulation and logistic regression analyses. Logistic regression analysis was also conducted to identify factors associated with anti-doping education experience and counselling experience. Research results A total of 169 Domestic pharmacy pharmacists responded to the survey, 78 (46.2%) were male, and 61 (36.1%) were aged between 30 and 39 years old. 94 (55.6%) had more than 10 years of clinical experience, and 144 (85.2%) had a bachelor's degree. In terms of work location, 116 (68.6%) were in the Metropolitan area (Seoul, Gyeonggi, Incheon). Pharmacists who had completed anti-doping education for pharmacists were more likely to have higher levels of anti-doping knowledge than those who had not (p<0.001). Pharmacists who had counselled athletes within the previous 12 months were also more likely to have higher levels of anti-doping knowledge than those who had not (p<0.001). ‘Excellent knowledge’ was defined as an anti-doping knowledge score of more than 80% (at least 25 out of 31 questions). The attitudes towards doping of domestic pharmacy pharmacists were negative, with a mean score of 32.2±10.9, which was below the benchmark positive attitude of 59.5 and above the benchmark negative attitude of 59.5, indicating that domestic pharmacy pharmacists had negative attitudes towards doping. In terms of anti-doping experience, 27.2% of pharmacists had received anti-doping education and 30.2% had counselled an athlete within the last 12 months. Only 1.2% had experience of sports pharmacy in international and national competitions (Olympics, national championships, etc.). The average anti-doping knowledge score was 20.3±5.5 out of a possible 31, with 34.9% correctly identifying insulin as a prohibited substance, and a lack of knowledge about the prohibited substances in herbal preparations and sports supplements. Furthermore, although the role of pharmacists in anti-doping education for athletes is recognized as important, with a mean score of 3.59±0.59 out of 4, they perceive themselves to be relatively inadequately knowledgeable, with a mean score of 1.82±0.74 out of 4. Conclusion Pharmacists who had attended anti-doping education for pharmacists or had counselled athletes within the last 12 months had higher levels of anti-doping knowledge than those who had not, and most respondents overall had negative attitudes towards doping. Although many agreed that pharmacists have an important role to play in preventing unintentional doping, they did not feel they had sufficient knowledge to counsel and educate athletes on their own. Future research needs to be conducted on the definition and doping status of living athletes and their counselling and education situation, analysis of the current and potential role of pharmacists in anti-doping activities, and evaluation and development of various anti-doping education program.

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)

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.