1.Participation and Awareness of Community Pharmacists in Daegu Regarding Prevention Activities for Narcotics Addiction: Focused on the Majung Pharmacy Activities
Iyn-Hyang LEE ; Hyang-Yi LEE ; Jin-Won KWON
Korean Journal of Clinical Pharmacy 2024;34(2):108-117
Background:
This study aimed to explore the current activities of pharmacists in local pharmacies for preventing narcotics addiction, identify areas for improvement, and support initiatives to enhance and expand the activities of “narcotics addiction prevention counseling pharmacies” (hereinafter referred to as “Majung Pharmacies”).
Methods:
Surveys were conducted targeting local community pharmacists participating in the Majung Pharmacy activities in Daegu.
Results:
Out of 42 pharmacists who registered in the Majung Pharmacy movement in 2021, 41 responded (response rate of 98%). After excluding three participants who met the exclusion criteria, data from 38 participants were analyzed. The participating pharmacists were generally well aware of the conditions for pharmacists to serve as “accessible experts” in the forefront of drug addiction prevention. It was observed that the activities of Majung Pharmacies, particularly among highly engaged pharmacists, led to positive effects such as an increased focus on medication coun-seling for psychotropic drugs, thereby enhancing their professionalism. However, a significant number of participants also expressednegative opinions. Factors such as enthusiasm for professional activities and perceptions of the pharmacist’s social role were important in shaping perceptions of Majung Pharmacy activities, whether positively or negatively. Additionally, this study underlined that pharmacists in practice are highly aware of the seriousness of issues arising from the use of narcotics by prescriptions.
Conclusion
Suggestions were outlined for both short-term and long-term strategies aimed at ensuring the stable growth and expansion of Majung Pharmacy initiatives.
2.Enhancing Communication on Medication Side Effects: Insights from a Survey Study
Ji Hye CHOI ; Hye Seong HAN ; Mi Kyong SHIM ; Hyun Soon SOHN
Korean Journal of Clinical Pharmacy 2024;34(2):126-133
Background:
Medication’s benefits and harms require careful management. Laws mandate pharmacists to provide essential med-ication details since inadequate counseling may pose risks. This study explores public expectations for pharmacist-provided side effect information to enhance safety.
Methods:
A self-developed questionnaire was created for participant to self-report, refined through pilot surveys with experts and laypersons. Nineteen items were categorized into four sections, using closed-ended ques-tions. Adults over 20, having obtained prescription medications within the past year, were surveyed via convenience sampling.Data analysis employed descriptive statistics and T-tests using IBM SPSS Statistics 21 and Microsoft Excel.
Results:
The study involved 189 participants, with a slightly higher proportion of females (59.3%) than males (40.7%), predominantly in their 20s (45.0%) and college graduates (57.1%). Health professionals represented 76.2% of respondents. Over half visited pharmacies at least 5 times yearly for prescriptions. Indirect experience with side effects was more common (30.2%) than direct experience (17.5%). Most (82.0%) showed interest in media-reported side effect events. Satisfaction with pharmacist-provided side effect explanations was low (59.7%), but importance was high (98.9%). Preferences favored combined verbal and written explanations (65.1%), with a majority desiring explanations for common but less serious side effects (82.5%). Healthcare professionals found explanations significantly more sufficient than non-professionals did. Older individuals, those living with elderly, and frequent pharmacy visitors attributed greater importance to pharmacist-provided explanations.
Conclusion
Koreans view pharmacist-pro-vided medication side effect explanations as vital but find current services lacking. Enhancements in content and delivery meth-ods are needed in pharmacy counseling to meet public expectations.
3.Trends in Artificial Intelligence Applications in Clinical Trials: An analysis of ClinicalTrials.gov
Jeong Min GO ; Ji Yeon LEE ; Yun-Kyoung SONG ; Jae Hyun KIM
Korean Journal of Clinical Pharmacy 2024;34(2):134-139
Background:
Increasing numbers of studies and research about artificial intelligence (AI) and machine learning (ML) have led to their application in clinical trials. The purpose of this study is to analyze computer-based new technologies (AI/ML) applied on clini-cal trials registered on ClinicalTrials.gov to elucidate current usage of these technologies.
Methods:
As of March 1st, 2023, protocols listed on ClinicalTrials.gov that claimed to use AI/ML and included at least one of the following interventions—Drug, Biological, Dietary Supplement, or Combination Product—were selected. The selected protocols were classified according to their context of use: 1) drug discovery; 2) toxicity prediction; 3) enrichment; 4) risk stratification/management; 5) dose selection/optimization; 6) adherence; 7) synthetic control; 8) endpoint assessment; 9) postmarketing surveillance; and 10) drug selection.
Results
The applications of AI/ML were explored in 131 clinical trial protocols. The areas where AI/ML was most frequently utilized in clinical trials included endpoint assessment (n=80), followed by dose selection/optimization (n=15), risk stratification/management (n=13), drug discovery (n=4), adherence (n=4), drug selection (n=1) and enrichment (n=1). Conclusion: The most frequent application of AI/ML in clinical trials is in the fields of endpoint assessment, where the utilization is primarily focuses on the diagnosis of disease by imag-ing or video analyses. The number of clinical trials using artificial intelligence will increase as the technology continues to developrapidly, making it necessary for regulatory associates to establish proper regulations for these clinical trials.
4.Review of Updated Guidelines and Evidence for Antithrombotic Therapy in Acute Ischemic Stroke
Korean Journal of Clinical Pharmacy 2024;34(2):79-99
Background:
There was an important revision of the Korean Clinical Practice Guideline for Stroke (KCPGS) for antithrombotic therapy in patients with acute ischemic stroke in 2022. This review is to provide an updated information in this revision.
Methods:
The revision history by year after the first announcement was examined for each topic, focusing on antithrombotic therapy duringacute phase which was revised in 2022. We compared before and after the revision, and investigated the clinical outcomes presented as evidence. It was also compared with the current U.S. guidelines.
Results:
The major changes about antiplatelet therapy are a clause stating that dual antiplatelet therapy with clopidogrel and aspirin initiated within 24 hours from the stroke onset and maintained for up to 21-30 days is recommended as an acute treatment, as well as the clause that antithrombotic therapy may be initiated within 24 hours after intravenous thrombolytics and that the use of glycoprotein IIb/IIIa receptor antagonists can be considered inhighly selected patients as rescue therapy taking into account of benefit and risk. The change to the use of anticoagulants is that itmay be reasonable to start oral anticoagulant between 4 and 14 days after stroke onset for patients with acute ischemic stroke and atrial fibrillation.
Conclusions
It will be helpful in improving health outcomes for clinical pharmacists to be aware of the latest information for antithrombotic therapy and to actively use it in pharmaceutical care of stroke patients.
5.Patterns of Depressive Symptoms on Cognitive Function Decline: An Investigation in Middle-Aged Koreans Based on the Korean Longitudinal Study of Aging (KLoSA)
Korean Journal of Clinical Pharmacy 2024;34(2):118-125
Background:
Numerous studies have consistently demonstrated that depression can be associated with cognitive function decline, primarily focusing on older adults due to the neurodegenerative characteristics of dementia. With persistent depression frequentlyreported in patients with early-onset or young-onset dementia, this study aimed to assess the impact of depression, specifically thechanges in depressive symptoms over time, on the risk of cognitive function decline in middle-aged adults in Korea.
Methods:
This retrospective study utilized data from the first four waves (2006-2012) of the Korean Longitudinal Study of Aging (KLoSA), focus-ing on middle-aged adults with normal cognitive function at baseline. Changes in depressive symptoms were categorized into four groups based on the CES-D score, and their association with cognitive function decline was evaluated using a multivariate logistic regression model.
Results:
Of the initial 10,254 participants, 3,400 were included in the analysis. Depressive status, particularlynewly onset (adjusted odds ratio [aOR] 1.96; 95% confidence interval [CI] 1.32-2.93) and persistent depression groups (aOR 5.59;95% CI 2.90-10.78), were significantly associated with cognitive function decline. In contrast, recovery from depressive symptoms was not significantly associated with cognitive function decline (p=0.809).
Conclusions
Our study showed a significant associationbetween changes in depressive symptoms and cognitive function decline in middle-aged Korean adults. This suggests that management of depressive symptoms could be crucial for the prevention of cognitive function decline in this population.
6.Signal Detection of DPP-IV Inhibitors using Spontaneous Adverse Event Reporting System in Korea
Hyejung PYO ; Tae Young KIM ; Su Been CHOI ; Hyeong Jun JO ; Hae Lee KANG ; Jung Sun KIM ; Hye Sun GWAK ; Ji Min HAN
Korean Journal of Clinical Pharmacy 2024;34(2):100-107
Background:
The purpose of this study was to detect signals of adverse events (AEs) of DPP-IV inhibitors using the KIDs-Korea Adverse Event Reporting System (KAERS) database.
Methods:
This study was conducted using AEs reported from January 2009to December 2018 in the KIDs-KAERS database. For signal detection, disproportionality analysis was performed. Signals of DPPIV inhibitor that satisfied the data-mining indices of reporting odds ratio (ROR) were detected.
Results:
Among the total number of 10,364 AEs to all oral hypoglycemic agents, the number of reported AEs related to DPP-IV inhibitors was 1,674. Analysis of re-ported AEs of DPP-IV inhibitors at the SOC levels showed that Respiratory system disorders were the highest at 4.31 (95% CI 3.01-6.17), followed by Skin and appendages disorders at 2.04 (95% CI 1.74-2.38). When analyzing AEs reported at the PT level, phar-yngitis was the highest at 73.90 (95% CI 17.59-310.49), followed by arthralgia at 6.08 (95% CI 2.04-18.11), and coughing at 5.21 (95% CI 2.07-13.15).
Conclusions
Based on the result of the study, deeper consideration is required according to the characteristics of the patients in prescribing DPP-IV inhibitors among oral hypoglycemic agents, and continuous monitoring of the occurrence of related Adverse Drug Reactions during administration is also required.
7.A Survey of Public Preferences on Repeat Dispensing
Young Mi LEE ; Daejin KIM ; Eunjoo LEE ; Hyun Soon SOHN
Korean Journal of Clinical Pharmacy 2024;34(1):30-38
Background:
This study examined the public’s perceptions of repeat dispensing as one of the measures to reduce the harmful effects of long-term prescriptions in Korea.
Methods:
From January 11 to 25, 2021, an online survey was conducted for adults using convenience sampling. A self-developed questionnaire was used.
Results:
There were 310 respondents, of which 228(73.5%) preferred repeat dispensing. When considering the additional fee payment, 188 (60.6%) preferred repeat dispensing, and54 (67.5%) out of a total of 80 chronic disease patients preferred it. It was confirmed that there was a difference in the willingnessto repeat dispensing considering the additional cost depending on whether the patient had a chronic disease and the distance from home to the nearest pharmacy. As a result of subgroup analysis for patients with chronic diseases, frequency of outpatient visit, number of prescription days, method of packaging pharmaceuticals, and distance from home to the nearest pharmacy were iden-tified as variables that could well predict the willingness to repeat dispensing considering paying additional fees. The preferencefor repeat dispensing may vary depending on conditions such as additional cost range, frequency and period of prescription use, disease and patient characteristics, so a careful approach is necessary.
Conclusion
It is necessary for the government to consider the introduction of repeat dispensing with interest in the public demand.
8.Evaluation of Pharmacists’ Intervention Activities in Community Pharmacy
Hyunji KOO ; Jong-Mi SEONG ; Sun-Young JUNG ; Kyeong Hye JEONG
Korean Journal of Clinical Pharmacy 2024;34(1):62-70
Drug-related problems have the potential to threaten patient health, and pharmacists are in a position to prevent such problems through prescription reviews and patient counseling, actively engaging in pharmaceutical care activities. This study aims to categorize and analyze the intervention activities of pharmacists in community pharmacies concerning drug-related problems, following international criteria. Methods: Over a six-month period, prescription interventions completed in a com-munity pharmacy in Seoul were selected as the research subjects. The causes of interventions were classified according to the Pharmaceutical Care Network Europe (PCNE) drug-related problems (DRPs) classification system and the types and frequencies of DRPs were identified. Results: Among a total of 49,334 prescriptions, 527 interventions were completed, constituting approximately 1.07% of the daily average filled prescriptions. Individuals over 60 years of age represented more than 50%. The primary cause of DRPs was prescribing and drug selection issues, comprising 256 cases (48.58%), with specific subcategories including109 cases of drug selection, 79 cases of treatment duration errors, 47 cases of dose selection, and 21 cases of inappropriate dosage form selection. Patient-related issues accounted for 204 cases (38.71%). Conclusion: The study demonstrated that the pharmacists’ intervention in community pharmacies contributes to the safe use of medication by patients.
9.Review of Efficacy and Safety of Semaglutide in the Management of Obesity
Korean Journal of Clinical Pharmacy 2024;34(1):1-20
This review examines the pivotal clinical trials that evaluated the efficacy and safety of semaglutide, a glucagon-like peptide-1(GLP-1) receptor agonist, in the management of obesity. The reported findings underscore significant and sustained weight lossachieved with semaglutide in diverse patient groups, although gastrointestinal disorders occurred frequently, leading to therapy discontinuation. Overall, the studies demonstrated the potential of semaglutide as a therapeutic option not only for type 2 diabe-tes but also for obesity. The treatment landscape in obesity is evolving, as reflected in changing regulatory approvals and clinicalguidelines, suggesting a paradigm shift toward personalized approaches in this chronic disease states to achieve optimal treatment outcomes for patients.
10.The Impact of Drug Interactions with Tyrosine Kinase Inhibitors on Adverse Event Development based on the changes of drug concentration level: Meta-analysis
Korean Journal of Clinical Pharmacy 2024;34(1):71-78
Background:
Oral cancer drugs, particularly tyrosine kinase inhibitors (TKIs), are increasingly popular due to their convenience.However, they pose challenges like drug interactions, especially with medications like azole antifungals. While the FDA providessome guidance, more detailed information is needed to manage these interactions effectively. A meta-analysis was conducted tounderstand the impact of interactions between TKIs and azole antifungals on adverse events during clinical studies.
Methods:
A meta-analysis followed PRISMA guidelines. Data from PubMed, EMBASE, and references were searched until November 30, 2021. Inclusion criteria encompassed studies on TKI-antifungal interactions in English. Study selection and quality assessment were conducted by two independent investigators.
Results:
Out of 158 articles, 11 were selected for analysis. Combination therapy showed a slight increase in adverse events but was not statistically significant (OR 1.02, 95% CI 0.49-2.13, p=0.95). AUC and Cmax fold changes did not significantly impact adverse event development. Both itraconazole and ketoconazole showed no significant difference in adverse event development compared to TKI alone.
Conclusions
Study finds TKI-DDI not significantlylinked to AE increase; azole antifungal types not related to AE. Future DDI research crucial for drug development.

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