Earticle

Pharmacists should maintain professional competencies to provide optimal pharmaceutical care services to patients, which can be achieved through continued commitment to lifelong learning. Traditionally continuing education (CE) has been widely used as a way of lifelong learning for many healthcare professionals. It, however, has several limitations. CE is delivered in the form of instructor-led education focused on multiple learners. Learning is passive and reactive for participants, so it sometimes does not lead to bringing behavioral changes in workplace performance. Therefore, recently the concept of lifelong learning tends to move from CE toward continuing professional development (CPD). CPD is an ongoing process that improves knowledge, skills, and competencies throughout a professional’s career. It is a more comprehensive structured approach toward the enhancement of personal competencies. It emphasizes an individual’s learning needs and goals and enables learning to become proactive, conscious, and self-directed. CPD consists of four stages: reflect, plan, learn, and evaluate. CE is one component of CPD. Each stage is recorded in a CPD portfolio. There are many practical difficulties in implementing the complete CPD system for lifelong learning of pharmacists in many countries including Korea. Applying a hybrid form that utilizes CPD and CE together, as in the case of some countries, could be an alternative. Furthermore, in undergraduate pharmacy education, it is necessary to teach students about CPD and train them on how to perform CPD as a pharmacist.

Objective: Community pharmacists are frontline health care providers, but have been considered as underutilized professionals on a daily basis. The purpose of this scoping review was to identify information about the impact of the COVID-19 pandemic on community pharmacy services and to evaluate new services that could be applicable. Methods: We searched MEDLINE and EMBASE for studies published up to January 10, 2020. Search terms consisted of keywords relevant to this review, including “COVID-19”, “community pharmacy”, and “community pharmacist”. This review targeted studies of pharmacist services provided by community pharmacies in OECD member countries during the COVID-19 pandemic period. Results: Twenty-seven studies were included in this review. Changes in community pharmacist services due to the COVID-19 pandemic were broadly classified into four categories. First, as the face-to-face services became challenging, various non-face-to-face services were being tried. Second, community pharmacists directly participated in the services to prevent the spread of COVID-19. Third, community pharmacists made efforts to support continuity of care for patients who experienced difficulties due to the reduced professional care as health and medical resources are concentrated in response to COVID-19. Fourth, community pharmacist services were emerging, targeting patients suffering from greater health inequality during the pandemic. Patients expressed high demand and satisfaction for the service of the community pharmacist, and pharmacists reported self-efficacy and professional pride. Conclusion: This study demonstrated that in the era of the COVID-19 pandemic, various community pharmacist services have been tried and received positive evaluations from patients in several OECD countries.

Objective: The purpose of the study was to analyze the difference in the importance and performance of the educational content of the community pharmacy practice and find the factors that influence it. Methods: A 5-point Likert scale questionnaire asked about the importance and performance of the pharmacy practice education items to community pharmacy preceptors, current students, and professors. Data were analyzed using Microsoft office 365 Excel and IBM SPSS 21.0. Results: A total of 117 people participated. The averages of importance and performance were 4.34±0.34 and 3.71±0.45, respectively. Except for the computational entry of prescriptions and medication history, the average score for the importance of all educational items was statistically significantly higher than the one for performance. Importance Performance Analysis (IPA) identified over-the-counter medication counseling, over-the-counter drug selection consultation, pharmacy management, adverse drug reaction monitoring, and understanding and implementation of drug use evaluation as the items that needed focused effort. Borich’s needs were highest in the adverse drug reaction monitoring. Conclusions: Overall, high importance and low performance indicate a need for improvement in community pharmacy practice education. Since the demand for education was high in over-the-counter medication counseling, adverse drug reaction monitoring, and OTC drug selection consultation, various supports are urgently needed to strengthen pharmacy practice education in this area in the future.

Background: Serotonin syndrome is a life-threatening disease if not appropriately treated. This study aimed to investigate the prescription status of contraindicated drug combinations that cause serotonin syndrome and identify the related factors. Methods: A cross-sectional study was conducted using nationwide claims data. Adult patients taking serotonergic drugs with Parkinson’s disease or mental disorders were selected. Based on international medical databases (MDBs) and the Korean Drug Utilization Review (DUR), the status of prescribing contraindicated drug combinations that induce serotonin syndrome, the related factors, and the difference between international MDBs and the Korean DUR were analyzed. Results: Of the 49,773 study subjects, 163 (0.3%) were prescribed contraindicated serotonergic drug combinations based on international MDBs, and among them, only 105 (64.4%) were contraindicated by the Korean DUR. Positive influencing factors for prescribing contraindicated drug combinations include patient age between 65 and 74 and physician’s specialties (neurologists, and orthopedists). Negative influencing factors were physician’s specialty (internists) and medical institution (primary institutions). Conclusion: Despite the implementation of DUR, 3 out of 1,000 study subjects received contraindicated drug combinations that caused serotonin syndrome. Hence, it is necessary to comply with the DUR and improve it in accordance with international MDBs.

Background: To implement medication management service in Korean nursing home (NH), medication review tool for residents in Korean long-term care facilities was developed. This prospective pilot study aimed to verify the applicability of this newly developed tool and to evaluate the drug related problems (DRPs) identified by pharmacists’ medication review in NH setting. Methods: This study was carried out in two NHs in Korea. The elderly residents (65 or older) using 5 or more medications were eligible. Pharmacists conducted medication review and identified the DRPs and potentially inappropriate medications (PIMs) based on the newly developed tool. Results: Among 43 NH residents, 27 residents agreed to participate. The median age was 87 and about 55.6% of them were taking 10 or more medications. Pharmacists identified a total of 37 PIMs in 18 NH residents (66.7%) and 54 DRPs in 22 residents (81.5%). The most frequent PIM was general-PIM (26 cases) followed by PIM under specific diseases or conditions (7 cases). Out of 77 items contained in the tool, 15 items were detected in study participants. ‘Continued use or regular daily use of hypnotics’ was the most highly detected item (9 cases) followed by ‘multiple prescriptions within each class of hypnotics/sedatives’ (5 cases). Among 54 DRPs identified, pharmacist intervened 39 cases (72.2%) and interventions were accepted in 18 cases (46.1%). Conclusion: This pilot study demonstrated that newly developed tool is feasible for the nursing home residents. However, further studies with larger population are warranted.

Background: Case-based learning (CBL) is becoming an important approach for improving interprofessional collaboration education. Previous studies have examined learners’ satisfaction with interprofessional education (IPE) in medical institutions. However, there are few studies on the implementation of university-led CBL interventions and their direct effects on learning outcomes. The aim of this study was to evaluate the effectiveness of CBL interventions on changes in the participants’ perception and knowledge acquisition ability. Methods: The CBL approach consisted of team-based case-based learning, self-directed learning, and post-feedback. It was conducted as a single course for pharmacy students in their 5th year in a university setting. Changes in the participants’ perceptions and self-assessments of competence levels were evaluated using survey responses. The effect of the CBL intervention on knowledge acquisition ability was directly evaluated using the exam score. Results: The majority agreed or strongly agreed that team-based case-based learning, and self-directed learning helped them to improve their knowledge and skills to a higher level and to increase the self-assessment of competency level. The average score of knowledge acquisition ability (average score of 75.0, p=0.0098) was significantly higher in the CBL intervention group than the lecture-based learning intervention group (average score of 52.0). Conclusion: The participants positively perceived that CBL intervention helped them to effectively improve their knowledge and the self-assessment of competency level. It also enhanced knowledge acquisition ability. These data, based on the survey responses, suggest that it is necessary to implement CBL interventions in a university-led single professional education.

Background: Prader-Willi Syndrome (PWS) is a rare genetic disorder. To improve the health deterioration of PWS, investigating optimal treatment options for PWS is required. Thus, we aimed to evaluate the efficacy of pharmacotherapies compared with supportive care or placebos in patients with PWS. Methods: PubMed and EMBASE databases were used to search for randomized controlled trials (RCTs) evaluating the efficacy of pharmacotherapy in PWS patients. Only RCTs that evaluating the efficacy of pharmacotherapy in PWS patients were retrieved. Results: A total of 26 studies were included to evaluate body composition, hormones, glucose levels and hyperphagia behavioral status. Pharmacological treatment group showed a significant decrease of body fat (mean difference (MD): -6.32, 95% confidence interval (CI): -10.58 to -2.06, p=0.004), a significant increase of lean body mass (LBM) (MD: 1.86, 95% CI: 1.43 to 2.30, p<0.00001) and insulin-like growth factor 1 (IGF-1) levels (MD: 241.62, 95% CI: 68.59 to 414.64, p=0.006) compared with the control group. Nevertheless, based on other outcomes evaluated by the current systematic review, pharmacological options showed different efficacy in treating PWS. Conclusion: Pharmacological therapies were effective to decrease significantly in body fat and increase significantly on LBM and IGF-1 levels in patients with PWS. However, still, individualized therapies should be considered in real-world practice in PWS treatment.

Objective: This study aimed to analyze the important medical adverse events (IMEs) of cyclosporine and tacrolimus using the reports in US FDA adverse event reporting system (FAERS) and to detect related signals. Methods: The FAERS database was used to analyze the IMEs reported for cyclosporine or tacrolimus during 2017-2021. Reporting odds ratio (ROR) and information component were used to analyze signals for adverse events of both drugs. It was investigated whether the detected signals were present on drug labels in Korea and the United States. Results: Among the total 24,688 reports, the reports on tacrolimus accounted 75.8%. Mean age of the patients was 47.9 years old and median number of adverse events was 2.0 per report. The number of patients hospitalized for adverse events was 7,979 (25.3%). Among the adverse reactions reported on the cyclosporine and tacrolimus, 576 and 1,363 events were detected as signals for cyclosporine and tacrolimus, respectively, and of these, IMEs accounted for 44.8 and 59.2%, respectively. The IMEs related with infections/infestations, renal/urinary disorders, and blood and lymphatic system disorders were reported frequently for both drugs. The most frequently detected IMEs were renal impairment for cyclosporine and acute kidney injury for tacrolimus. Among the top 3 IMEs for each reported SOC for cyclosporine and tacrolimus, 9 and 2 unexpected adverse events were identified, respectively. Conclusion: This study identified the IMEs and signals of cyclosporine and tacrolimus, and detected unidentified adverse events in a drug information database.