開設藥師와 病院藥師의 健康生活 및 職務滿足度와 關聯要因 硏究

趙南春,南喆鉉 대한보건협회 2000 대한보건연구 Vol.26 No.1

The purpose of this study was to investigate the health behaviors and affecting factors on the job satisfaction of pharmacists working at community pharmacy and hospital pharmacy. Subjects served for this study consisted of 1,180 pharmacists including 844 pharmacists working at community pharmacy and 336 hospital pharmacists. Data were collected through questionnaire survey for 4 months from 1st May to 31st August in the year 1998. The results were as follows: (1) The general characteristics among the subjects showed that the pharmacists working at community pharmacy were predominantly more male(M : F ratio = 54.1 : 45.9), higher age, and higher married status than hospital pharmacists who are predominantly more female(M : F ratio = 9.2 : 90.8). Also the pharmacists working at community pharmacy described that they have more concerns on their own health status, exercises and drug medications for healthy life, but showed higher frequency of smoking and alcohol drinking rather than hospital pharmacists. (2) The job satisfactions of the pharmacists working at community pharmacy were influenced by several factors such as their own healths, family-member, good residential environment, good relationship with their neighborhood, and community activities. On the other hand, the job satisfactions of hospital pharmacists were increased according to higher age, married status, and the longer working career. The comparison of the job satisfactions between two groups showed that hospital pharmacists responded positively to the levels of self-developments, work loads, working times, and incomes, but they were negative to acknowledgements to their job professional levels from others. (3) The positive factors related to job satisfactions among the pharmacists working at community pharmacy were higher incomes, proper work loads, speciality perceived by themselves, the levels of self-developments, and good acknowledgements to their job professional levels from others. But those among hospital pharmacists were the levels of self-developments, work loads, speciality perceived by themselves, working times, and incomes in these orders. (4) The comparison of the correlations between job satisfactions and the factors of two groups showed that in case of the pharmacists working at community pharmacy, the important factors were incomes, the levels of self-developments, work loads, speciality perceived by themselves, etc. in these orders, but in case of hospital pharmacists, those were work loads, the levels of self-developments, working times, acknowledgements to their job professional levels from others and age levels. And incomes was lower-level factor on job satisfactions. (5) Pharmacists who always managed their physical fitness showed the higher levels in job satisfactions than the pharmacists who did not. From the results of this study, it was found that the job satisfactions of the pharmacists working at community pharmacy and hospital pharmacists were influenced by working loads, the levels of self-developments, speciality perceived by themselves and acknowledge-ments to their job professional levels perceived by themselves. And it was recommended that the managing authorities should build up the facilities for physical fitness and welfare facilities for the employee, and offer the employee chance of self-actualization through education and information supply of clinical pharmacy.

국내 의료기관에서 종양약료서비스 현황과 전문약사의 역할

박애령,문진영,서정애,고종희,이윤선,천주향,홍소연,이정현,김경임 한국병원약사회 2019 병원약사회지 Vol.36 No.4

Background : The Korean Society of Health-System Pharmacists conducted the first certified oncology pharmacist examination in 2010. Currently, there are more than 180 certified oncology pharmacists in Korea. The purpose of this study was to investigate the current status of oncology pharmacy service and the role of pharmacists and suggest future paths for certified oncology pharmacists in Korea. Methods : The survey was conducted on pharmacists working at oncology pharmacies, as well as doctors and nurses with oncology pharmacy services experience. Additionally, the focus group interview was conducted with certified oncology pharmacists to evaluate pharmacists’needs regarding improving the certified pharmacist system. Results : The survey was completed by 99 pharmacists, 33 doctors, and 65 nurses in 33 hospitals. Among the certified oncology pharmacists currently working, the percentage of those who work specifically in oncology pharmacies was 24.9%. Oncology pharmacy services comprise prescription review and intervention, medication history management, attending round and conference, education, quality improvement activity and research activity. When asked about the services provided by oncology pharmacists, the medical staff responded with prescription review and intervention, providing drug information, patient education, therapeutic drug monitoring consulting, adverse drug reaction monitoring, and medication history management. And the medical staff showed more than average satisfaction in each service field. In the focus group interview, similar findings were confirmed. Meanwhile, dissatisfactory factors included the combination of clinical and dispensing tasks, discontinuity of work due to department circulation, and difficulties caused by lack of manpower. Conclusions : The results show that certified oncology pharmacists were performing more advanced services than general pharmacists. Also, the medical staffs were fully aware of the oncology pharmacy services and satisfied with such services. However, the current certified pharmacist system has a limitation in that it lacks laws as well as a compensation system.

의료시설 및 개국약국에서의 의약정보 활동과 campus-based 중앙집중식 의약정보센타의 필요성에 대한 연구

강진숙,신현택 한국병원약사회 1993 병원약사회지 Vol.10 No.3

A questionnaire survey study on drug information activities of pharmacists in both hospitals and community pharmacies and the need for a campus-based drug information center was conducted. Questionnaires were prepared both for hospital pharmacists and community pharmacists in separate formats asking their drug information activities regarding three basic aspects of drug information center with comprehensive drug information resources. Questionnaires were mailed out to 130 hospital pharmacies in country and randomly sampled 2,000 community pharmacies in Seoul, August 14, 1993 and collected until November 5, 1993. Total 112 hospital pharmacies answered to questionnaires showing high response rate of 86% and 312 community pharmacists answered showing poor response rate of 16%. All questionnaires collected were included in the evaluation. In hospital survey, 24% of responders(27) maintained drug information centers. Among those hospital pharmacies which maintain drug information centers, 82%(22/27) had one or two drug information pharmacists on full-time basis. However, 54% of DI pharmacists had relatively short period of experience shorter than I year in drug information service revealing potential problem in maintaining consistent quality services. Most centers had the basic facilities and equipments for drug information service but, only 3 centers were equipped with CD-ROM drive and only 1 center with microfiche viewer showing that most of centers were not utilizing comprehensive retrieval systems. Regarding other information resources, a few number of centers maintained variety of tertiary resources and major pharmacy journals and, otherwise, few primary and tertiary resources. 89% of centers were receiving less than 15 information requests daily and only 4% were receiving more than 20 requests daily. The difficulties in operating centers that responders felt most seriously were the insufficiency of information resources(30%), pharmacists' inability in providing effective information(26%), manpower shortage(22%), poor financial support from hospital( 13%) and users' poor understanding about drug information. About half of hospital pharmacies were not maintaining or publishing drug formulary and newsletter. When DI pharmacists could not find the answers to requests, they utilized manufacturers(49%), other DI centers (37%), or none(8%), and most of them(88%) were not satisfied with the answers, Consequently, all responders indicated that they needed a centralized drug information center with comprehensive resources and specialists. In community pharmacies, pharmacists were gaining drug informations from pharmacy periodicals(38%), weekly pharmacy newsletters(37%), detail men(14%), package inserts(8%), manufacturers' advertisements through mass media(2%) and pharmacy textbooks( 1%). They were receiving few DI requests from other health professionals showing that 77% of responders received less than one request monthly or none. When they received DI requests, most of them were dependent on other community pharmacists(46%) or manufacturers(33%) and most of them (89%) were not satisfied with the answers. Most community pharmacies had relatively few DI resources showing that half of responders had a t best a few product-oriented tertiary resources without any primary and secondary resources in questions. Most of responders( 99%) also wanted a centralized drug information center as hospital pharmacists did. In both hospitals and community environments, DI activities by pharmacists were very weak and primitive in various aspects of drug information practice. Over all, most of practicing pharmacists especially in community pharmacies were not acquainted with systemic and scientific utilization and provision of drug information, and consequently showed strong demand for a well established drug information center who will serve them with comprehensive and complete drug information resources and specialists.

대구시 개원의사와 개국약사의 의약분업에 대한 인식과 태도

이무식,윤능기,서석권,박재용,Lee, Moo-Sik,Yoon, Nung-Ki,Suh, Suk-Kwon,Park, Jae-Yong 대한예방의학회 1993 예방의학회지 Vol.26 No.1

Mail questionnaire was administrated to 370 practising physicians and 388 pharmacists in Taegu city selected by systematic sampling to examine utilization states and opinion of pharmacy under medical care insurance programme and the attitude to the functional division between physicians and pharmacists from April to May 1992. Regarding the opinion on the outcome of drug-store under medical insurance, 71.2 percent of practicing physician answered faliure but 13.4 percent of practicing pharmacists answered failure in contrast. Fifty percent of practicing physician asserted introducing functional division between physician and pharmacist while 66.9 percent of practicing pharmacist answered drug-store under medical insurance itself is sucessful programme. Average daily numbers of preparation of medicine was 32.2 case. Percentage of utilization of drug-store under medical issurance to average daily cases of preparing of medicine was 20 percent, percentage of utilization with physician's prescription was 0.7 percent. And 58.7 percent of practicing physician experienced outside the institute prescription. Regarding the opinion on the pros and cons of enforcing functional division between physician and pharmacist, 59.2 percent of practicing physician prefered pros and 17.7 percent cons, but 38 percent of practicing pharmacist prefered pros and 45.5 percent cons. And pharmacist knew better the content of functional division between physician and pharmacist than physician. As a reason for pros of enforcing functional division between physician and pharmacist, practicing physician emphasized to prevent misuse or abuse of medicine but practicing pharmacist emphasized to display physician and pharmacist's professional ability. And as an opinion on implementation style of functional division between physician and pharmacist in pros respondents, practicing physician favored mandatory enforcement (52.3%), while practicing pharmacist favored partial incomplete functional division (81.7%). As the method of prescription if functional division between physician and pharmacist will be enforced, both practicing physician and pharmacist prefered generic name (44.0%, 89%) mostly, but physician prefered brand name (35.3%) secondly. Regarding the reason for not implementing functional division between physician and pharmacist up to date, both physician and pharmacist answered problem of business right between physician and pharmacist, followed by lack of recognition, and interest of people and lack of the govermental willness. Regarding the opinion on prior decision of condition for enforcing functional division between physician and pharmacist, practicing physician and pharmacist named uneven distribution of medical facilities and drug-store between rural and urban, inequality of physician and pharmacist manpower and the problem of manpower demand and supply mostly, and practicing physician pointed out establishing attitude of acceptance on the part of pharmacist and practicing pharmacist favored establishing attitude of acceptance on the part of physician, which was different attitudes between physician and pharmacist. Following conclusion was reached ; 1. Current drug-store under medical insurance program yield insufficient outcome, so we should consider program conversion from drug-store under medical insurance program to functional division between physician and pharmacist. 2. There were problem of business right and conflicts between physician and pharmacist at enforcing functional division between physician and pharmacist, so the goverment should search for formulating plan to resolve the problem and have neutral willness for the protection of the national health. 1989년 10월부터 실시되고 있는 약국의료보험과 의약분업제도에 관한 태도를 조사하기 위하여 대구시내 개원의사 및 재국약사를 계통적 표본추출법(systematic sampling)에 의한 표본을 선정하여 우편설문지법으로 1992년 4월 20일부터 5월 20일까지 조사하여 회신된 개원의사 184명, 개국약사 157명의 설문지를 분석한 결과를 요약하면 다음과 같다. 현재 시행중인 약국의료보험의 성과에 대해 개원의사는 71.2%가 '실패적'이라고 한 반면 개원약사는 13.4%가 '실패적'이라고 하였다. 개원의사의 50%는 약국의료보험을 폐지하고 의약분업을 도입해야 한다고 한 반면, 개국약사는 66.9%가 의약분업제도와는 관계없이 약국의료보험자체만으로도 성공적인 제도라고 하였다. 개국약사의 약국 1일 평균조제건수는 32.2회였으며, 약국의료보험 이용횟수는 6.2회로 조제건수의 20%에 불과했고, 의사처방전을 지참한 약국의료보험이용횟수는 조제건수의 0.7%였다. 그리고 개원의사의 원외처방전 발행경험자는 58.7%였다. 의약분업제도의 실시에 대해 개원의사는 59.2%가 찬성하였으며 27.7%가 반대하였으나 재국약사는 38.0%가 찬성, 45.5%가 반대 하였다. 그리고 약사가 의사보다 의약분업의 내용을 더 많이 안다고 하였다. 의약분업제도 실시의 찬성자중 찬성이유로 개원의사는 '의약품의 남오용 방지' (54.1%)를 많이 지적한 반면 개국약사는 '의사와 약사의 전문직능 발휘'(62.0%)를 많이 제기하였다. 그리고 분업찬성자에서 개원의사는 52.3%가 '완전강제분업'을 원한 반면, 개국약사는 81.7%가 '부분분업'을 원하였다. 의약분업제도 실시시에 처방전의 발행 방법에 대해서는 개원의사와 개국약사 모두 '일반명' 처방을 44.0%, 89.8%로 가장 많이 원하였고 개원의사에서는 '상품명' 처방도 35.3%나 차지하였다. 의약분업제도의 실시가 이루어지지 않은 이유에 대해 개원의사 및 개국약사 모두 '의사 약사단체 상호간의 업권문제'를 가장 많이 지적했으며 '국민들의 인식 및 관심 부족' '정부의 의지력 결여' 순으로 일치된 결과로 나타났다. 의약분업실시를 위한 선결조건으로는 '의료시설과 약국의 도시 농촌간의 균등분포'를 가장 많이 지적하였으며 의사는 '약사들의 수용태세 확립', 약사는 '의사의 수용태세 확립'을 그 다음으로 지적해 서로 상반된 결과가 나타났다. 이상의 결과를 종합해 보면 첫째, 조사대상 개원의사들은 현행 약국의료보험제도에 대해 부정적 견해를 보인 반면 개국약사들은 긍정적 견해를 보였으나 약국의료보험이용은 극히 저조하고 의사의 처방전 발행도 저조한 실정이다. 이에 약국의료보험제도에서 의약분업제도로의 제도적 전환이 고려되어야 할 것으로 생각된다. 둘째, 의사와 약사의 의약분업에 대한 의견이 상이한 점으로 미루어 유추할 수 있지만 의약분업제도 실시의 장애요인으로 의 약사단체 상호간의 업권문제와 의약사간의 갈등이 지적되는 바, 이들 모두를 만족 할 대안을 선택하는 것이 쉬운일 아닐 것이므로 국민의 건강보호차원에서 정부의 중립적 의지가 있어야 할 것으로 생각된다.

우리 나라에서 21세기를 대비한 약사인력의 적절성 평가

최은영,김진수 대한보건협회 2000 대한보건연구 Vol.26 No.2

The purpose of this study was to examine the projection of the supply and demand of pharmacists until year 2012. Based on the results of this study, valuable suggestions were provided to the policy makers for pharmacists manpower planning for the 21st century. In this study two major factors were examined to forecast the demand of pharmacists. One was the number of pharmacists to the population ratio, and the other was the number of pharmacists to the physician ratio. The results of this study indicate that pharmacists will be oversupplied in the near future. With regard to this aspect, the supply of pharmacists need to be decreased. However, to reduce it, the policy makers should consider the following factors: the supply of foreign studied students; education programs; the expansion of oriental pharmacists; and the drug dispensing by pharmacists and the prescription by doctors. Specifically, it has to be carefully investigated how the introduction of the separation of prescription from the drug dispensing will affect the supply and demand of pharmacists. Thus, to make proper future policies, further studies should examine the effects of those factors into the demand and supply of pharmacists.

Public Trust in Community Pharmacists in South Korea : A Survey Study

Sung Won Yoon,Hye Sung Han,Hae-Young Park,Hyun Soon Sohn 한국임상약학회 2021 한국임상약학회지 Vol.31 No.4

Background: Trust is a key component for the good relationship between patients and healthcare professionals but trust for community pharmacists has not been studied much. Objectives: This study aimed to measure public trust in community pharmacists and to investigate variables that affect trust level in South Korea. Methods: A total of 25 questions, including 13-items for three dimensions of trust (pharmacists’ behavior/attitude, technical competence, communication skills) and 1-item for overall trust were developed. The survey was conducted online and the data from 416 respondents were analyzed with a t-test, an ANOVA and a multiple linear regression analysis. Results: The average scores (mean ± standard deviation) for the three dimensions of trust in community pharmacists were 3.47±1.05 (out of 5 points) for pharmacists’ behavior/attitude, 3.67 ± 0.99 for technical competence, and 3.66±0.99 for communication skills. The average of the 13 items incorporating all parameters was 3.56±1.02 and the overall trust level was 7.16±1.62 (out of 10 points). The total sum of the 13 items differed significantly by age group (p=0.02) and frequency of pharmacy visits (p=0.04). Each dimension had an independent impact on the trust level, and pharmacists’ behavior/attitude had the greatest impact on trust levels. Conclusions: This study showed that pharmacists’ behavior/attitude had the most significant impact on the trust level. However, the level of trust in pharmacists’ behavior/attitude is not yet sufficiently satisfactory, and further improvements are required to increase trust in community pharmacists.

외과계 중환자실 전담약사 유무에 따른 중재활동 변화 및 회피비용 분석

신상미,허은정,김윤희,최경숙,이은숙,Eunkyung Euni Lee,송인애 한국병원약사회 2017 병원약사회지 Vol.34 No.4

Background : The prevention of adverse drug events had been documented by pharmacists in critically ill patients. The purpose of this study was to evaluate the effect of the designated pharmacists’interventions, acceptance rate and cost avoidance in the surgical intensive care unit (SICU) at a tertiary hospital in Korea. Methods : A retrospective observational study was conducted using electronic medical records. The frequencies of the interventions, acceptance rate, and type of interventions were observed. Cost avoidance was calculated from the potential benefit or harm of the pharmacists’recommendations and the expected extension of hospitalization without a pharmacist intervention. Results : The frequencies of the intervention increased from 0.16% to 0.56%(p 0.001) and the acceptance rate of the pharmacist intervention increased from 69% to 89%(p 0.05). Since the introduction of the designated pharmacist, pharmacists’interventions have expanded into the clinical field, such as total parenteral nutrition (TPN), drug recommendations and sharing treatment plans, possible adverse drug reactions, and therapeutic drug monitoring (TDM). The calculated avoidance cost per month associated with a designated pharmacists’intervention was 9,335,382 won/month. Conclusion : With the designated pharmacist, the frequencies of the pharmacists’intervention and the acceptance rate of interventions among the medical team increased. The cost avoidance from the pharmacists’interventions imply a potential economic advantage; therefore, it is necessary to evaluate the further economic effects of the pharmacists’intervention.

미국의 노인전문약사 제도에 대한 체계적 고찰: 인증, 교육 및 성과

남혜연,조은 대한약학회 2014 약학회지 Vol.58 No.2

As elderly population has been increasing, pharmacists need to possess special knowledge and skills to provide enhanced pharmaceutical care for senior patients. Purpose: This study aims to systematically review on (1) the certified geriatric pharmacists (CGP) system, (2) the curriculum related to geriatric pharmacy education, and (3) the CGP’s performance in terms of clinical, economic and humanistic outcomes in the U.S. Method: The information related to CGP system and curriculum was obtained through the official websites of ‘American Society of Consultant Pharmacists’,‘Commission for Certification in Geriatric Pharmacy’ and the selected pharmacy school samples. Articles about on the out-comes of pharmacist-provided cognitive services including Medication Therapy Management were searched through PubMed. Results: To gain the CGP credential, pharmacists need 2-year experience as pharmacist in advance and take the CGP exam-ination. This certification must be renewed every 5 year. Most pharmacy schools provide geriatric-related curriculum through didactic or pharmacy practice classes for pharmacy students and certificate or dual degree in gerontology are given on com-pletion. Most previous outcomes research reported that pharmacists have played a role in yielding favorable results regarding clinical, economic and humanistic outcomes for nursing facilities, hospitals and community pharmacy settings. Conclusion:Considering the organized CGP certification system and concrete educational courses established the basis for pharmacists to exert their ability for senior patients of the U.S., it is suggested to build a geriatric pharmacist credential model for pharmacists to provide the increasing elderly patients with the requisite safe and effective pharmacy care in Korea.

전공의의 약사의 복약상담에 대한 인식도 조사

이지현,최혜정,홍경란,황보신이 韓國病院藥師會 2004 병원약사회지 Vol.21 No.4

Patient counseling for medicine is not generalized during hospital stay and on discharge. Pharmacists have tried to conduct counseling service to patients at several hospitals. A survey was conducted to assess physicians' perception and needsabout medication counseling service for advancing the service with a team approach. One hundred two(75.6%) out of 135 physicians responded the survey in St. Mary's Hospital during October, 2002. Questions were asked about four areas; 1) request experience of counseling by pharmacists, 2) current situation of providing medication information by physicians, 3) concerns and needs about counseling by pharmacists, 4) necessity and request intention in future for counseling by pharmacists. The survey showed that 63.7% knew counseling practice by pharmacists, but 73.8% haven't had request experience. Physicians provided medication information in explaining treatment therapy (52.0%). Oral medications that physicians desired to counsel by pharmacists were steroids, antidiabetics, anticancer agents, anticoagulants and antituberculosis agents. Physicians desired to counsel with emphasis on side effect (58.8%), compliance (55.9%). A primary negative concern was to counsel inconsistently from physician's intention (76.5%). Most physicians accepted pharmacist's role in medication counseling(94.1%) and thought pharmacist's counseling would improve outcome of pharmacotherapy (90.2%). Physicians had an intention of counseling request in 82.4%. This survey suggested that, physicians' perception was favorable and they had strong intention to request medication counseling with an expanded role of pharmacists. However, request process hasn't been fully utilized. Pharmacist's counseling should be advanced with a qualified counseling, facilitation of request process and advertisement of the service. It is also necessary for physicians to have confidence and consider pharmacists as core members of health care team.

일반의약품의 전자상거래에 대한 약사의 인식도 고찰

박영달,방준석,민영실,손의동 한국임상약학회 2016 한국임상약학회지 Vol.26 No.2

Objective: Online pharmacies were introduced in some countries such as United States of America or Canada. They can provide benefits to consumer because they can buy and take conveniently drugs without limitation of location or time. In Korea, online pharmacies are illegal and only pharmacists can sell drugs to consumers or patients. Therefore, we investigated the knowledge of online pharmacy and the possible problem in Korea to survey pharmacists. Methods: We developed questionnaire based on previous articles about online pharmacy and surveyed nation-wide pharmacists by mail or e-mail. The data was analyzed by SPSS and Microsoft Excel. P-values less than 0.05 were statistically significant. Results: 175 pharmacists involved in this study. About introduction of online pharmacies, 53.1% were opposition while 10.3% were approval and 36.6% were conditional. Although online pharmacies were introduced, 46.3% pharmacists do not have a plan to start online pharmacy. However, the approval and tends about starting online pharmacies were higher in younger pharmacists (20s, 30s) (p < 0.05). The criteria of permission about opening online pharmacies were 100% pharmacist license regardless of holding off-line pharmacy. 53.7% pharmacists responded education about taking medication is impossible. When online pharmacies are introduced, 65.1% pharmacists responded traditional pharmacies are affected negatively. Pharmacists concerned that the competition with large-sized distribution corporations, reduced reliance between pharmacists and patients, illegal transaction of counterfeit drugs, increased misuse of drugs. Conclusion: These results showed that Korea pharmacists have negative standard on online pharmacies. Therefore it is required to be more cautious before introducing online pharmacy and it need strict watching system and continuous education and study for safety after introducing online pharmacy.