본문 바로가기
KERD
논문KCI 등재

국내 병원약사의 중재활동과 성과에 대한 체계적 문헌고찰

A Systematic Review of Outcomes Research in the Hospital Pharmacists’ Interventions in South Korea

조은|이소영
한국임상약학회 (Korean College Of Clinical Pharmacy)|2019.09|한국임상약학회지 (Korean Journal of Clinical Pharmacy)|제29권 제3호|pp. 193-201|DOI 10.24304/kjcp.2019.29.3.193

2

조회

0

다운로드

11

인용

0

참고문헌

키워드

Koreasystematic reviewclinical pharmacistpharmacist interventionHospital pharmacist
주제분류약학

초록

Background and Objective: Since the introduction of hospital pharmacy residency programs in 1983, hospital pharmacists in South Korea have been expected to expand their roles. However, their services and the outcomes have not been fully understood. In this study, we conducted a systematic review of Korean hospital pharmacist-provided interventions with regard to intervention type, intervention consequences, and target patient groups. Methods: A literature search of the following databases was performed:Embase, PubMed, Medline, KoreaMed, RISS, KMbase, KISS, NDSL, and KISTI. The search words were “hospital pharmacist”, “clinical pharmacist”, and “Korea”. Articles reporting clinical or economic outcome measures that resulted from hospital pharmacist interventions were considered. Numeric measures for the acceptance rate of pharmacist recommendations were subjected to meta-analysis. Results: Of the 1,683 articles searched, 44 met the inclusion selection criteria. Most articles were published after 2000 (81.8%) and focused on clinical outcomes. Economic outcomes had been published since 2011. The interventions were classified as patient education, multidisciplinary team work, medication assessment, and guideline development. The outcome measures were physicians’ prescription changes, clinical outcomes, patient adherence, economic outcomes, and quality of life. The acceptance rate was 80.5% (p < 0.005). Conclusion: Studies on pharmacist interventions have increased and showed increased patient health benefits and reduced medical costs at Korean hospital sites. Because pharmacists’ professional competency would be recognized if the economic outcomes of their work were confirmed and justified, studies on their clinical performance should also include their economic impact.

Abstract

Background and Objective: Since the introduction of hospital pharmacy residency programs in 1983, hospital pharmacists in South Korea have been expected to expand their roles. However, their services and the outcomes have not been fully understood. In this study, we conducted a systematic review of Korean hospital pharmacist-provided interventions with regard to intervention type, intervention consequences, and target patient groups. Methods: A literature search of the following databases was performed:Embase, PubMed, Medline, KoreaMed, RISS, KMbase, KISS, NDSL, and KISTI. The search words were “hospital pharmacist”, “clinical pharmacist”, and “Korea”. Articles reporting clinical or economic outcome measures that resulted from hospital pharmacist interventions were considered. Numeric measures for the acceptance rate of pharmacist recommendations were subjected to meta-analysis. Results: Of the 1,683 articles searched, 44 met the inclusion selection criteria. Most articles were published after 2000 (81.8%) and focused on clinical outcomes. Economic outcomes had been published since 2011. The interventions were classified as patient education, multidisciplinary team work, medication assessment, and guideline development. The outcome measures were physicians’ prescription changes, clinical outcomes, patient adherence, economic outcomes, and quality of life. The acceptance rate was 80.5% (p < 0.005). Conclusion: Studies on pharmacist interventions have increased and showed increased patient health benefits and reduced medical costs at Korean hospital sites. Because pharmacists’ professional competency would be recognized if the economic outcomes of their work were confirmed and justified, studies on their clinical performance should also include their economic impact.

참고문헌 (72)

  1. American Journal of Health-System Pharmacy, "ASHP statement on pharmaceutical care", American Journal of Health-System Pharmacy, 50(8), pp.1720~1723 (1993)
  2. 박선영, "우리나라 종합병원에서 실시되고 있는 전문약사과정의 운영 및 교육과정 현황", 약 학 회 지, 53(4), pp.165~172 (2009), 대한약학회
  3. Oh SY, "Study on the direction of improvement of the system of pharmacy specialties in Korea", 석사, pp.2016
  4. Kwon KH, "A study on the pharmacy manpower project ‘vision 2030’", pp.2013
  5. "Board Certified Pharmacist 2004"[URL]
  6. "BPS Specialties"[URL]
  7. Seon CJ, "The introduction of BPS(Board of Pharmaceutical Specialties)", J Kor Soc Health-Syst Pharm, 25(1), pp.1~4 (2008)
  8. Kang JE, "Pharmacist-involved care for patients with heart failure and acute coronary syndrome: a systematic review with qualitative and quantitative meta-analysis", Journal of clinical pharmacy and therapeutics, 41(2), pp.145~157 (2016)
  9. Gallagher J, "Economic evaluations of clinical pharmacist interventions on hospital inpatients: a systematic review of recent literature", International journal of clinical pharmacy, 36(6), pp.1101~1114 (2014)
  10. Carmen CG, "Characterization of pharmacists’ interventions in asthma management: A systematic review", Journal of the American Pharmacists Association, 58(2), pp.210~219 (2018)
  11. Omran D, "Systematic review of pharmacist interventions to improve adherence to oral antidiabetic medications in people with type 2 diabetes", Canadian Journal of Diabetes, 36(5), pp.292~299 (2012)
  12. Al Aqeel S, "Interventions for improving pharmacist-led patient counselling in the community setting: a systematic review", Systematic reviews, 7(1), pp.71~ (2018)
  13. Moher D, "Preferred reporting items for systematic review and meta-analysis protocols (PRISMA-P) 2015statement", Systematic reviews, 4, pp.1~ (2015)
  14. 이준영, "메타분석", Endocrinology and Metabolism, 23(6), pp.361~378 (2008), 대한내분비학회
  15. Ah YM, "Clinical and economic evaluation of pharmacists' contribution to patient care on a multi-disciplinary liver transplant team", International journal of clinical pharmacology and therapeutics, 54(2), pp.102~109 (2016)
  16. Han JM, "Clinical and economic impact of pharmacists’ intervention in a large volume chemotherapy preparation unit", International journal of clinical pharmacy, 38(5), pp.1124~1132 (2016)
  17. Park SJ, "Evaluation of a clinical pharmacist dosage-adjustment intervention in a teaching hospital medical intensive care unit", Latin America J of Pharmacy, 33(4), pp.579~586 (2014)
  18. 송영주, "Impact of an Antimicrobial Stewardship Program on Unnecessary Double Anaerobic Coverage Prescription", Infection and Chemotherapy, 47(2), pp.111~116 (2015), 대한감염학회[DOI]
  19. Choe HM, "Implementation of the first pharmacist-managed ambulatory care anticoagulation clinic in South Korea", American journal of health-system pharmacy: AJHP:official journal of the American Society of Health-System Pharmacists, 59(9), pp.872~874 (2002)
  20. Tae Yun Park, "Pharmacotherapeutic Problems and Pharmacist Interventions in a Medical Intensive Care Unit", Acute and Critical Care, 30(2), pp.82~88 (2015), 대한중환자의학회
  21. 한영현, "Rituximab 항암화학요법에 대한 약사의 환자 교육 개선 및 적용 효과", 병원약사회지, 31(2), pp.724~734 (2014), 한국병원약사회[DOI]
  22. 이종혜, "개정된 원내 노인부적절약물 목록을 활용한 입원환자의 약물 평가 및 임상적 중재에 의한 회피비용 분석", 병원약사회지, 31(1), pp.629~637 (2014), 한국병원약사회[DOI]
  23. 류재은, "노인포괄평가 시행 전후의 약물 복용 현황 및 처방 변화", 병원약사회지, 25(2), pp.1~12 (2008), 한국병원약사회[DOI]
  24. 박태영, "담당약사의 처방중재활동에 대한 약물유해반응 예방의 비교 분석", 병원약사회지, 31(1), pp.638~643 (2014), 한국병원약사회[DOI]
  25. 이영화, "대장암 환자에서 oxaliplatin으로 유발된 peripheral neuropathy의 발현율 및 임상약사의 환자상담을 통한 부작용 감소 효과", 병원약사회지, 28(2), pp.118~126 (2011), 한국병원약사회[DOI]
  26. 이소영, "류마티스 관절염 환자에서 약사의 교육 전후에 따른 약물 인지도 변화", 병원약사회지, 26(3), pp.244~251 (2009), 한국병원약사회[DOI]
  27. Lee JE, "Ca and P levels in ESRD patients and the evaluation of a patient education", J Kr Soc Hosp Pharm, 16(4), pp.489~494 (1999)
  28. Choi SI, "Development and evaluation of anticoagulation clinical pharmacy service for ambulatory patients in a community hospital", Kor J Clin Pharm, 5(2), pp.17~31 (1995)
  29. Kim SR, "Development and evaluation of pharmacists’ medication management guideline in pediatric intensive care unit", JKrSocHospPharm, 21(4), pp.389~403 (2004)
  30. 오윤경, "신생아 중환자실 영양요법치료에서 약사의 역할과 영향", 한국임상약학회지, 23(2), pp.167~174 (2013), 한국임상약학회
  31. 양혜란, "신생아중환자실에 입원한 미숙아에서영양지원팀 활동의 임상적 의의", Pediatric Gastroenterology, Hepatology & Nutrition, 12(1), pp.39~45 (2009), 대한소아소화기영양학회
  32. 유소현, "약사에 의한 항암처방 중재 분석 및 처방 오류 개선 효과", 병원약사회지, 29(2), pp.131~138 (2012), 한국병원약사회[DOI]
  33. Park JA, "Cost-effectiveness analysis of pharmacist’s clinical pharmacokinetics-Vancomycin", J Kor Soc Health-Syst Pharm, 29(2), pp.107~120 (2012)
  34. 안지용, "약사의 항생제 관리 업무 시행 방안 및 효과", 병원약사회지, 33(4), pp.341~348 (2016), 한국병원약사회[DOI]
  35. 강민경, "약사의 항암제 처방감사를 통한 약물오류 예방", 병원약사회지, 28(3), pp.288~295 (2011), 한국병원약사회[DOI]
  36. 최인, "영양집중지원팀의 업무개선 활동의 효과 평가", 병원약사회지, 28(4), pp.390~395 (2011), 한국병원약사회[DOI]
  37. 정정원, "외과계 중환자실 약사의 처방중재효과 평가", 병원약사회지, 31(4), pp.908~918 (2014), 한국병원약사회[DOI]
  38. Kim SE, "The effect of medication teaching activities of clinical pharmacist on drug compliance in patients with hypertension in an ambulatory setting", J Kr Soc Hosp Pharm, 9(1), pp.44~48 (1992)
  39. 김정희, "인공신장실 환자 복약지도에 의한 환자 인식도 변화", 병원약사회지, 22(3), pp.1~6 (2005), 한국병원약사회
  40. Chung JW, "Preliminary study for Economic evaluation of clinical pharmacist intervention", J Kor Soc Health-Syst Pharm, 28(4), pp.327~336 (2011)
  41. 신문희, "입원한 암환자에 대한 약사의 복약지도 서비스 평가", 한국임상약학회지, 12(2), pp.76~84 (2002), 한국임상약학회
  42. 정유진, "장기이식 약사의 역할에 관한 연구: 장기이식 입원 환자를 위한 처방 중재", 병원약사회지, 31(6), pp.1099~1109 (2014), 한국병원약사회[DOI]
  43. Ahn SS, "The cost-effectiveness evaluation for the pharmacist’s therapeutic intervention in type-2 diabetes patients", J Kor Soc Health-Syst Pharm, 28(4), pp.317~326 (2011)
  44. 권소영, "주요 복부 수술에서의 수술 전 영양 평가와 TPN 투여의 효과", 병원약사회지, 25(3), pp.1~9 (2008), 한국병원약사회[DOI]
  45. 곽은정, "직접 대면 방식과 병행한 전화를 이용한 복약상담이 제 2형 당뇨병 환자의 치료성과에 미치는 영향", 약 학 회 지, 59(6), pp.270~277 (2015), 대한약학회
  46. Lee MB, "Clinical outcome of educational program using self-monitoring of peak expiratory flow rate for asthma patients", Kor J Clin Pharm, 9(2), pp.97~102 (1999)
  47. 김수진, "천식환자에 대한 표준화된 병원약사대상 교육과 반복적인 환자대상 복약지도를 통한 성과 분석", 약 학 회 지, 54(6), pp.507~521 (2010), 대한약학회
  48. 박인경, "치료의 증진을 위한 당뇨전문약사의 필요성", 약 학 회 지, 53(4), pp.217~221 (2009), 대한약학회
  49. Han EA, "Cost-benefit analysis of clinical pharmacokinetic consultation service of theophylline", Quality Improvement in Health Care, 7(2), pp.168~179 (2000)
  50. 손기호, "통원치료센터 단기항암요법 환자의 부작용 양상 및 약사의 중재활동 효과", 병원약사회지, 29(2), pp.149~160 (2012), 한국병원약사회[DOI]
  51. Cho E, "The effect of anticoagulation service on patient satisfaction and hospital profit", J Kor Soc Health-Syst Pharm, 16(2), pp.214~224 (1999)
  52. Ye KN, "Effect of anticoagulation service on patients treated with warfarin", J Kr Soc Hosp Pharm, 22(1), pp.46~53 (2005)
  53. Mun Y, "The factors influencing the health-related QOL in hemodialysis patients", J Kor Soc Health-Syst Pharm, 19(3), pp.269~282 (2002)
  54. Kwon MG, "The approaches to enhance the efficiency of patient education for chronic respiratory diseases", J Kor Soc Health-Syst Pharm, 22(1), pp.19~22 (2005)
  55. Yun EH, "The effect of patient counseling at the respiratory clinic in eulji general hospital", J Kor Soc Health-Syst Pharm, 16(2), pp.209~213 (1999)
  56. 손호연, "호흡기약물 상담의 환자 만족도 평가", 병원약사회지, 24(2), pp.124~130 (2007), 한국병원약사회[DOI]
  57. Lim JK, "Assessment of the inhalation technique after medication counseling using the request form for inhaler", J Kor Soc Health-Syst Pharm, 17(1), pp.127~134 (2000)
  58. 강민경, "외과계중환자실 담당약사의 약물유해반응 예방에 대한 처방중재효과", Acute and Critical Care, 28(1), pp.17~24 (2013), 대한중환자의학회
  59. 유성근, "흡입제의 올바른 흡입방법 교육 시 전산화 평가프로그램을 이용한 반복교육의 효과", Tuberculosis and Respiratory Diseases, 63(6), pp.491~496 (2007), 대한결핵및호흡기학회
  60. Newman SP, "Improvement of drug delivery with a breath actuated pressurised aerosol for patients with poor inhaler technique", Thorax, 46(10), pp.712~716 (1991)
  61. Prasanna D, "Assessment of clinical pharmacist intervention in tertiary care teaching hospital of Southern India", Asian Journal of Pharmaceutical and Clinical Research, 6(Suppl 2), pp.258~261 (2013)
  62. Shareef J, "Clinical pharmacist interventions in drug therapy in patients with diabetes mellitus and hypertension in a university teaching hospital", International Journal of Pharmaceutical Sciences and Research, 6(10), pp.4424~4432 (2015)
  63. Leape LL, "Pharmacist participation on physician rounds and adverse drug events in the intensive care unit", JAMA, 282(3), pp.267~270 (1999)
  64. Claudia L, "Clinical pharmacists’ interventions in a German university hospital", Pharm World Sci, 32(2), pp.194~199 (2010)
  65. Somers A, "Evaluation of clinical pharmacist recommendations in the geriatric ward of a Belgian university hospital", Clinical interventions in aging, 8, pp.703~709 (2013)
  66. Suzan N K, "Pharmacists on rounding teams reduce preventable adverse drug events in hospital general medicine units", Arch Intern Med, 163(17), pp.2014~2018 (2003)
  67. Lee ES, "Safe and secure handling of medicine strengthening pharmaceutical care systems", pp.2017
  68. Hammick M, "A best evidence systematic review of interprofessional education", Medical teacher, 29(8), pp.735~751 (2007)
  69. "Revision of Pharmaceutical Affairs Law ‘Order-Hospital pharmacist should participate in Drug intervention work· Multidisciplinary care service’"[URL]
  70. 김미정, "한국 전문간호사의 업무 성과", 성인간호학회지, 26(6), pp.630~641 (2014), 한국성인간호학회[DOI]
  71. 성영희, "전문간호사의 성과지표 개발", 임상간호연구, 16(3), pp.157~174 (2010), 병원간호사회
  72. "Difficulty of Institutionalization of Advanced Practice Nursing"[URL]

관련 논문AI추천

상급종합병원 병동담당약사 업무 현황 및 의료인의 인식과 기대 분석김정은, 백시진, 이정화, 이주연, 전수정, 최나예, 남궁형욱, Eunkyung Euni Lee한국임상약학회 · 한국임상약학회지2022 · 제32권 제1호담당약사의 처방중재활동에 대한 약물유해반응 예방의 비교 분석김윤희, 박태영, 이은숙, 이정화, 정영미한국병원약사회 · 병원약사회지2014 · 제31권 제1호병원약사 약제서비스의 업무량 상대가치 조사김정미, 김혜린, 이정화, 이주연, 전은용, 조윤희한국병원약사회 · 병원약사회지2021 · 제38권 제2호약사의 항생제 관리 업무 시행 방안 및 효과김형숙, 김홍빈, 안지용, 이은숙, 이정화, 정영미, Eunkyung Euni Lee한국병원약사회 · 병원약사회지2016 · 제33권 제4호병원약사에 의해 수행되는 약제서비스의 현황 및 업무량 분석김성환, 김시형, 김아정, 김현정, 김혜린, 배혜정, 백진희, 서성연, 신은정, 임정미, 장홍원, 조윤숙, 조윤희, 조은정, 최나이, 최정윤한국병원약사회 · 병원약사회지2020 · 제37권 제2호약사 업무의 표준화를 위한 입원환자의 의약품 처방 검토 및 약물 조정 제고: 지참약관리 및 다약제 사용관리를 중심으로견진옥, 김다은, 김진경, 나대복, 유윤미, 이영희, 정혜련, 한재은한국병원약사회 · 병원약사회지2024 · 제41권 제2호

이 간행물의 다른 논문 (7건)

국민건강보험 12년 표본코호트자료를 이용한 프로톤펌프억제제 사용과 골절 위험의 연관성김종주, 조준우, 장은진, 손현순pp. 147-155국내 여자 대학생에서 과민성 장증후군과 스트레스에 관한 연구신지은, 방준석, 김광준pp. 156-165성인 고형암 환자의 고칼슘혈증 치료현황과 치료효과 분석서성연, 조윤숙, 박설희, 김성환, 조윤희, 임석아, 이주연, 신다은pp. 166-172설문조사를 통한 전문가 대상 예방접종 후 이상반응 관련 우선순위 연구주제 선정 기준모델 제시신주영, 노윤하, 김현정, 윤동원, 김주환, 이혜성pp. 173-185혈당강하제 단독요법 투여 당뇨병환자에서 암발생률 평가: 후향적 코호트 연구정한영, 이숙향pp. 186-192
원문 보기