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Pharmacodynamic Drug-Drug Interactions Considered to be Added in the List of Contraindications with Pharmacological Classification in Korea.

Nam Kyung JE ; Dong Sook KIM ; Grace Juyun KIM ; Sukhyang LEE

Korean Journal of Clinical Pharmacy.2015;25(2):120-128.

OBJECTIVES: Drug utilization review program in Korea has provided 'drug combinations to avoid DCA)' alerts to physicians and pharmacists to prevent potential adverse drug events or inappropriate drug use. Seven hundred and six DCA pairs have been announced officially by the Ministry of Food and Drug Safety (MFDS) by March, 2015. Some DCA pairs could be grouped based on the drug interaction mechanism and its consequences. This study aimed to investigate the drug-drug interaction (DDI) pairs, which may be potential DCAs, generated by the drug class-drug class interaction method METHODS: Eleven additive/synergistic and one antagonistic drug class-drug class interaction groups were identified. By combining drugs of two interacting drug class groups, numerous DDI pairs were made. The status and severity of DDI pairs were examined using Lexicomp and Micromedex. Also, the DCA listing rate was calculated. RESULTS: Among 258 DDI pairs generated by the drug class-drug class interaction method, only 142 pairs were identified as official DCA pairs by the MFDS. One hundred and four pairs were identified as potential DCA pairs to be listed. QT prolonging agents-QT prolonging agents, triptans-ergot alkaloids, tricyclic antidepressants-monoamine oxidase inhibitors, and dopamine agonists-dopamine antagonists were identified as drug class-drug class interaction groups which have less than 50 % DCA listing rate. CONCLUSION: To improve the clinicians' adaptability to DCA alerts, the list of DCA pairs needs to be continuously updated.
Alkaloids ; Classification* ; Dopamine ; Drug Interactions ; Drug Utilization Review ; Drug-Related Side Effects and Adverse Reactions ; Humans ; Korea* ; Oxidoreductases ; Pharmacists ; Pharmacokinetics

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Survey of Correlations on the Drug Use Patterns between Children and Their Parents.

Mi Young HWANG ; Joon Seok BANG ; Uy Dong SOHN

Korean Journal of Clinical Pharmacy.2015;25(2):111-118.

BACKGROUND: It is thought that drug use of parents is related to that of young children. The status of drug among young children's parents and a correlation of with parents and their children on drug use was surveyed by questionnaire. METHOD: The questionnaire is composed of 34 items, and the data was collected by 108 parents of young children from March to April of 2012. RESULTS: On the basis of the analysis results, the following conclusions were drawn. About half of parents thought the minimum use of drug was better for health, and 44% parents thought drug is essential for cure. When parents had queries on prescription, they mostly consult with doctors and pharmacists. Most parents had a household medicine. A fever reducer was the most common household medicine (92.5%). They pick the household medicine by consulting with pharmacist. Parents usually checked the expiration date of drug before they use and they dumped the drugs when the expiration date was due (82.4%). Over half of young children and their parents took a dietary supplements. They got an information about a dietary supplement by associates (30.5%) and internet (19.4%). Most parents tried to follow the directions as prescribed. However, more than half of the parents stopped taking the drug when the symptoms disappeared. CONCLUSION: Drug use of parents and that of young children had a very strong positive correlation, suggesting that correct drug use of parents have an impact on their young children's drug use.
Child* ; Dietary Supplements ; Family Characteristics ; Fever ; Humans ; Internet ; Parents* ; Pharmacists ; Prescriptions

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Perception Gap between Preceptors and Pharmacy Students on Introductory Pharmacy Practice Education in Community Pharmacy Practice Setting.

Ji Young PARK ; Hye Kyung JIN ; Ji Eun KANG ; Sandy RHIE

Korean Journal of Clinical Pharmacy.2015;25(2):102-110.

OBJECTIVE: This study was to investigate the perception gap between preceptors and pharmacy students on community pharmacy experiential education. METHODS: The online survey was performed for 55 preceptors and 215 pharmacy students separately from April 1 to April 30, 2014. The preceptors were who completed community pharmacy practice experience at least a session and the students were who involved in community pharmacy practice for more than 21 days. The questionnaires were prepared based on the lesson contents guideline of Introductory Pharmacy Practice Education of Community Pharmacy by Korea Association of Pharmacy Education. The survey questions were consisted with demographic characteristics, evaluation of student and preceptors, benefits and disadvantages of pharmacy practice for both groups. RESULTS: A total of 27 (49.1%) preceptors and 103 (47.9%) pharmacy students responded to the survey questionnaires. Preceptors indicated that students lacked face-to-face communication ability with patients, caregivers, and physicians. One of the Benefits of participating in pharmacy practice education as a preceptor included the improvement of self-esteem (70.37%). Disadvantages were identified as workload burden due to teaching and preceptor responsibilities at the same time. All students responded that benefits of experiencing pharmacy practice education were helping them determine their career, and they would consider working in community pharmacies (68.93%). However, handling over-the-counter drugs and communicating with doctors or nurses were identified as barriers. In addition, preceptors and pharmacy students expressed necessity of the standard text books and curriculums. CONCLUSION: This study identified the perception gap on community pharmacy experiential education between preceptors and pharmacy students. For the successful implementation of pharmacy practice experience, the effective and appropriate methods should be developed.
Caregivers ; Communication ; Curriculum ; Education* ; Education, Pharmacy ; Humans ; Korea ; Nonprescription Drugs ; Pharmacies* ; Pharmacy* ; Students, Pharmacy*

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Pharmacists' Perceptions of Barriers to Providing Appropriate Pharmaceutical Services in Community Pharmacies.

Hyun Soon SOHN ; Seong Ok KIM ; Kyung Mi JOO ; Hyekyung PARK ; Euna HAN ; Hyung Tae AHN ; Sang Eun CHOI

Korean Journal of Clinical Pharmacy.2015;25(2):94-101.

BACKGROUND: In order to achieve the goals of community pharmacy practice, its legal, labour-related, and economic barriers need to be identified. This study examined pharmacists' perceptions of constraints on providing optimal pharmacy services in order to identify underlying factors and analyse the associations between barriers and pharmaceutical services in community pharmacies. METHODS: A survey targeting pharmacy owners was conducted from May to June 2012 using a structured questionnaire including nine pharmaceutical service items. According to the service provision level, we classified pharmacists as inactive (fewer than 5 items among the listed 9 service items) and active providers (5 or more items). Principal component analysis was used to group significant factors for barriers into four thematic components. Associations between the participants' demographics and pharmacy characteristics and the services provided were explored by logistic regression analyses. RESULTS: Participants were 402 pharmacists. Over 60% provided disease management services for hypertension, diabetes, and hyperlipidaemia. Variables that affected pharmaceutical services included the lack of separate areas for patient counselling (OR: 2.12, 95% CI: 1.18-3.80), and clinical knowledge and information-related barriers (OR: 0.59, 95% CI: 0.36-0.97). CONCLUSION: Strategies for improving clinical knowledge and providing expeditious information are necessary in order to improve community pharmacy services.
Community Pharmacy Services ; Demography ; Disease Management ; Humans ; Hypertension ; Logistic Models ; Pharmaceutical Services* ; Pharmacies* ; Pharmacists ; Pharmacy ; Principal Component Analysis

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Prophylactic Effect of Pegfilgrastim on Febrile Neutropenia in Patients with Non-Hodgikin's Lymphoma.

Juhee JO ; Joon Seok BANG

Korean Journal of Clinical Pharmacy.2015;25(2):80-93.

OBJECTIVE: Pegfilgrastim is recently introduced that is long acting G-CSF for prophylaxis of febrile neutropenia. Treatment of non-Hodgikin's lymphoma (NHL) with R-CHOP is classified with relative high risk of febrile neutropenia. The study evaluated the prophylactic effect of pegfilgrastim to reduce the incidence of febrile neutropenia associated with R-CHOP of patient in NHL. And the risk factors associated with the incidence of FN and related events were evaluated. METHODS: This retrospective study reviews the Electronic Medical Record of 68 NHL patients who received R-CHOP chemotherapy in single center between September 2013 and August 2014. These patients were classified who receive prophylaxis pegfilgrastim or no prophylaxis. RESULTS: Sixty eight patients received R-CHOP with NHL. In 144 cycles of patients receiving pegfilgrastim, compared with no prophylaxis 178 cycles, had a lower incidence of febrile neutropenia (5.5% vs. 23.6%, p = 0.001), grade 3 or grade 4 neutropenia (14.4% vs. 89.8%, p < 0.001) and neutropenia related events (p < 0.05). The risk of febrile neutropenia after prophylaxis was significantly associated with age > or = 65 (OR: 5.87, 95% CI 1.07-32.27, p = 0.042), IPI > or = 3 (OR: 7.2, 95% CI 1.31-39.6, p = 0.023), S.alb < 3.5 g/dL (OR: 31.01, 95% CI 6.32-152.17, p < 0.0001). In multiple logistic regression analysis, lower baseline serum albumin (OR: 21.1, 95% CI 3.8-116.98, p = 0.001) was significantly associated with occurrence of febrile neutropenia. CONCLUSION: The study recommends prophylactic pegfilgrastim through risk assessment of febrile neutropenia in patients with non-Hodgikin's lymphoma receiving R-CHOP.
Drug Therapy ; Electronic Health Records ; Febrile Neutropenia* ; Granulocyte Colony-Stimulating Factor ; Humans ; Incidence ; Logistic Models ; Lymphoma* ; Neutropenia ; Retrospective Studies ; Risk Assessment ; Risk Factors ; Serum Albumin

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Comparative Effectiveness between Dipeptidylpeptidase-4 Inhibitors and Sulfonylureas in Combination with Metformin in Type 2 Diabetes Mellitus Patients.

Ji Hye PARK ; Sunny PARK ; Jae Youn KIM ; Joo Hee KIM ; Hye Sun GWAK

Korean Journal of Clinical Pharmacy.2015;25(2):74-79.

OBJECTIVE: Treatment with sulfonylureas in combination with metformin improves glycemic control in type 2 diabetes mellitus (T2DM), but is associated with hypoglycemia and weight gain. This retrospective study aims to compare the effectiveness of dipeptidylpeptidase-4 (DPP-4) inhibitors and sulfonylureas as an add-on therapy to metformin in patients with T2DM. METHODS: Data from medical records of 355 T2DM patients received therapy either DPP-4 inhibitors (DPP-4 inhibitor group) or sulfonylurea (SU group) in combination with metformin from 1 March 2009 to 30 September 2011 were retrospectively reviewed. Of total 355 patients, 231 patients were in DPP-4 inhibitor group and 124 patients were in SU group. Baseline Hemoglobin A1c (HbA(1c)) level in SU group was higher than DPP-4 inhibitor group with a statistically significant difference (8.6% vs. 7.8%). Comparative analysis between DPP-4 inhibitor group and SU group was performed for HbA(1c) values, amounts of HbA(1c) changes, and rates of HbA(1c) changes from baseline at 6-month intervals and incidence rates of major cardiocerebral events. RESULTS: SU group showed larger HbA(1c) changes in both amounts and rates compared to DPP-4 inhibitor group, although statistical significance was not found in all study periods. Proportions of patients with stable HbA(1c) <6.5% or 7% were significantly higher in DPP-4 inhibitor group than SU group (<6.5%: 30.4% vs. 13.4%, <7%: 72.3% vs. 41.2%). Time to achieve stable HbA(1c) <6.5% was not significantly different, but time to achieve stable HbA(1c) <7% was shorter in DPP4 inhibitor group than SU group with a significant difference. The incidence rate of cardiocerebral events in group of patients with or without previous events was 1.7%, not significantly lower than that in DPP-4 inhibitor group (4.0%). For newly encountered cardiocerebral events during the treatment, incidence rates of two groups did not differ significantly. CONCLUSION: DPP-4 inhibitors were as effective as sulfonylureas in achieving the HbA(1c) goal of less than 6.5% or 7% and cardiocerebral event rates did not differ between the two drugs.
Diabetes Mellitus, Type 2* ; Humans ; Hypoglycemia ; Incidence ; Medical Records ; Metformin* ; Retrospective Studies ; Weight Gain

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Comparison of Pharmacy Practice Experience in Pharmacy School between Korea and Canada.

Minku KANG

Korean Journal of Clinical Pharmacy.2015;25(2):68-73.

With the changes in the pharmacy curriculum from a 4 year program to a 6 year program in 2009, a new subject called Pharmacy Practice Experience (PPE) has been launched into the curriculum. The purpose of introducing this subject is to increase the competency of new pharmacy graduates in providing quality healthcare to the community. This study has been done, via comparison among different pharmacy schools in Canada and Korea, to ensure that the competency of future Korean pharmacists can be increased with the introduction of this subject. In general, the Introductory Pharmacy Practice Experience (IPPE) in Korea consists of 60 hours while Canada consists of 320 hours (minimum). Furthermore, the Advanced Pharmacy Practice Experience (APPE) required in Korea is 1340 hours while Canada requires minimum of 960 hours. Specifically, comparing the Korean PPE curriculum to the PPE curriculums of University of Toronto (UT) and University of Waterloo (UW), UT and UW required a minimum of 75% and 89% direct clinical patient care experience respectively, either in hospital or community setting, compared to 45% in Korea; the remaining percentage in any of the universities can be fulfilled by taking other electives that may not require direct patient care experience. Observing these differences, it seems clear that the current PPE experience in Canada takes more of a patient focused approach than in Korea. Thus, with the recent movement in the Korean pharmacy community towards a more patient focused approach rather than a product focused approach, it would be beneficial to learn the differences between the PPE curriculums in Korea and Canada and apply any new understandings to the relatively newly introduced PPE program in Korea to further enhance the value of the new curriculum in helping to deliver quality patient care.
Canada* ; Curriculum ; Delivery of Health Care ; Humans ; Korea* ; Patient Care ; Pharmacists ; Pharmacy* ; Schools, Pharmacy*

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Study of the UK Pharmacy Education and the Pharmacy Registration Assessment: In England and Wales.

Yun Jung KIM

Korean Journal of Clinical Pharmacy.2015;25(2):61-67.

Pharmacy education and training is continuously evolving to meet the requirement from the society in the UK. Most pharmacy schools offer the Master of pharmacy degree which is a four year undergraduate programme followed by a year of pre-registration placement spanning a year supervised by a professional pharmacist who has at least 3 years' post-registration experience; however, some universities provide either a 5-year sandwich course where the pre-registration training is split up into two periods of 6 months or a 2-year OSPAP programme for those who are already qualified as a pharmacist outside of the UK. The GPhC has announced that the format of the registration assessment is set to change in 2016. The exam questions from 2016 will be more clinical, practical and based around a patient in a real-life scenario. This article addresses important aspects of UK pharmacy education such as university curriculum, training programme, and licence exam, therefore, could potentially offer a significant contribution to the debate about raising academic standards of pharmacy education in South Korea.
Curriculum ; Education, Pharmacy* ; England* ; Humans ; Korea ; Pharmacists ; Pharmacy* ; Schools, Pharmacy ; Wales*

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Retrospective Pharmacotherapeutic Evaluation of Dutasteride not Approved by US FDA for Androgenetic Alopecia in Korea.

Young Ju CHEON ; Jung Tae KIM ; Sung Cil LIM

Korean Journal of Clinical Pharmacy.2015;25(3):171-177.

BACKGROUND: Androgenetic alopecia (AGA), one of alopecias, requires continuous treatment in order to prevent or stop it, and patient's compliance is very important. Currently, only two drugs (finasteride, minoxidil) have been approved for AGA by Food and Drug Administration of United States (US FDA). However, another alpha-2 reductase inhibitor, dutasteride, is approved by Korea Ministry of Food and Drug Safety (MFDS) through a phase III trial. For treatment, pharmacotherapy of AGA usually combines topical minoxidil 7% with one of oral alpha-2 reductase inhibitor. OBJECTIVES: We evaluated the comparative efficacy and adverse effect between topical minoxidil 7%/finasteride 1 mg and topical minoxidil 7%/dutasteride 0.5 mg pharmacotherapy for outpatients with AGA. Also we evaluated the relationship between therapeutic effect and regular hospital visit. METHOD: This study was performed retrospectively based on electronic medical record (EMR) data of total 98 patients (topical minoxidil 7% with dutasteride 0.5 mg (Avodart(R)) or finasteride 1 mg (Alopecia(R), Propecia(R)) with diagnosis of AGA from department of dermatology at a secondary hospital from January 1st, to May 31st, 2014. RESULTS: The efficacy and adverse event of topical minoxidil 7%/dutasteride 0.5 mg (DUTA group) were 100% and 45.7%, and of topical minoxidil 7%/finasteride 1 mg (FINA group) were 92.1% and 33.3%, respectively. The mean onset time of responses and adverse events in the FINA group were 3.86 months and 4.43 months. Those in the DUTA group were 3.97 months and 5.06 months. CONCLUSION: Both FINA and DUTA group were highly effective, but the DUTA group showed higher efficacy and adverse effects than those in the FINA group. Dutasteride may be another alternative in AGA treatment.
Alopecia* ; Compliance ; Dermatology ; Diagnosis ; Drug Therapy ; Electronic Health Records ; Finasteride ; Humans ; Korea* ; Minoxidil ; Outpatients ; Oxidoreductases ; Retrospective Studies* ; United States ; United States Food and Drug Administration ; Dutasteride

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Retrospective Clinical Analysis of Treatment for Primary Warm Autoimmune Hemolytic Anemia.

Hong Seop MOON ; Chiyoung PARK

Korean Journal of Clinical Pharmacy.2015;25(3):166-170.

BACKGROUND: Primary warm autoimmune hemolytic anemia (AIHA) is a relatively rare hematologic disorder resulting from autoantibody production against red blood cells. There has been very few studies about primary warm AIHA in South Korea because of its low incidence. We retrospectively analyzed the treatment outcome of primary warm AIHA. METHOD: We reviewed retrospectively the medical records of 9 primary warm AIHA patients from December 2002 to January 2015. We analyzed the causes and clinical characteristics of primary warm AIHA patients. We retrospectively analyzed the clinical data in electronic medical records for 9 Korean patients with AIHA patients who were diagnosed during the period from December 2002 to January 2015 at the Regional University Hospital in Korea. The study protocol was approved by the Institutional Review Board (IRB #2015-08-007, Chosun University Hospital IRB). RESULTS: The mean age was 52 years (range 27~78), the mean hemoglobin level was 5.0 g/dL (range 2.5~6.4 g/dL). All patients received steroids at therapeutic dosages (corticosteroid 1 mg/Kg) as first line treatment. Eight of them showed complete response (5/8, 62.5%) and partial response (3/8, 37.5%), one patient required second-line treatment with rituximab. Two patients who responded first line treatment were relapsed at 86 weeks and 24 weeks after response, respectively. Only one patient of them was retreated with corticosteroid because of anemic symptoms. CONCLUSION: This study indicates that oral corticosteroid is an effective therapy for primary warm AIHA.
Adrenal Cortex Hormones ; Anemia, Hemolytic, Autoimmune* ; Electronic Health Records ; Erythrocytes ; Ethics Committees, Research ; Humans ; Incidence ; Korea ; Medical Records ; Retrospective Studies* ; Steroids ; Treatment Outcome ; Rituximab

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