Earticle

Background: Polypharmacy is highly prevalent among older adults with multimorbidity and is associated with potentially inappropriate medications (PIMs), adverse drug events, falls, and functional decline. This review aimed to clarify what outcomes deprescribing has evidence for, with a focus on pharmacist-led interventions and a Korea-specific implementation pathway. Methods: We conducted a narrative review using targeted searches of major biomedical databases and relevant guidelines published since 2010, supplemented by reference list screening. We summarized commonly used deprescribing tools (e.g., Beers, STOPP/START, STOPPFrail; Medication Appropriateness Index; Drug Burden Index) and interpreted outcomes by distinguishing intermediate prescribing outcomes from hard clinical outcomes, while considering setting and follow-up intensity. Results: Deprescribing interventions generally reduce PIM exposure and medication burden across community, hospital, and long-term care settings. Evidence is more consistent for intermediate outcomes than for hospitalization or mortality, which remain heterogeneous across studies. Pharmacist-led structured medication reviews improve prescribing appropriateness and burden indices; effects on falls and medication-related harms are mixed and appear more likely when targeting high-risk drugs and providing structured follow-up. Intervention impact is context- dependent, influenced by interprofessional uptake and workflow integration. Conclusions: Deprescribing is feasible and generally safe for older adults with multimorbidity. Clinical pharmacists are central to identifying targets, supporting shared decision-making, and coordinating monitoring. Scaling deprescribing in Korea will likely require standardized documentation, access to complete medication lists, and reimbursement mechanisms supporting medication review and follow-up across care transitions.

Background: Zolpidem is widely prescribed for insomnia due to its rapid onset of action. However, concerns persist regarding its potential for misuse and serious adverse effects, such as complex sleep behaviors. This study aimed to evaluate the current status of zolpidem medication counseling in community pharmacies and identify perception gaps between pharmacists and patients. Methods: A cross-sectional survey was conducted from August to September 2025, involving 133 patients and 111 pharmacists. Questionnaire items included zolpidem usage/dispensing experience, status of medication counseling, and perceived barriers. Quantitative analysis was performed to compare perceptions of counseling topics and assess patients’ objective knowledge. Results: A high proportion of patients (62.4%) had been taking zolpidem for more than six months. A notable discrepancy in perception was observed between the two groups regarding medication counseling. While pharmacists frequently reported emphasizing “misuse/dependence potential” (60.4%) and “complex sleep behaviors” (45.0%), a significantly lower proportion of patients (35.3 and 23.3%, respectively) recalled receiving such information. Patients showed the lowest objective knowledge regarding the “recommended maximum treatment duration” (40.2% correct), which was also identified as a major area of information deficiency. Pharmacists identified “patients’ negative reactions” (52.3%) as the primary barrier to effective counseling. Conclusions: There is a substantial gap between the information provided by pharmacists and the information retained by patients regarding zolpidem safety. To ensure the safe use of zolpidem in community settings, systematic and patient-centered counseling strategies focusing on long-term safety, misuse risks, and standardized core messages are essential.

Background: Pharmacogenomics is the study of how human genetic variants influence drug efficacy and toxicity. With advances in personalized medicine, clinically relevant pharmacogenomic information is increasingly reflected in drug labeling to promote safe and effective drug use. Therefore, this study aimed to collect and analyze the up-to-date pharmacogenomic information reflected in drug labeling in South Korea. Methods: By screening the Korean Database of Pharmacogenomic Biomarkers in Drug Labeling, the U.S. Table of Pharmacogenomic Biomarkers in Drug Labeling, or newly approved by the Korean Ministry of Food and Drug Safety since 2018, only active ingredients approved in South Korea with pharmacogenomic information in their approved labeling were included in the analysis. Data on drug names, Anatomical Therapeutic Chemical (ATC) classifications, associated genes, and pharmacogenomic labeling information were collected. Frequency analyses were performed by therapeutic area and associated genes, and the results were further visualized using sunburst plots. Results: Among therapeutic areas, oncology accounted for the largest proportion. Among genes, HER2, hormone receptors, and EGFR were mainly linked to drug indications. CYP2D6 was associated with pharmacokinetic parameters, whereas G6PD was related to adverse reactions. Conclusion: This study analyzed recent pharmacogenomic information in Korean drug labeling, suggesting potential implications for clinical decision-making for personalized medicine.

Background: Community pharmacists serve as an important checkpoint in the medication-use process by identifying and managing drug-related problems (DRPs). This study evaluated the causes and severity of DRPs and the acceptance rate of pharmacist interventions in community pharmacy practice. Methods: This retrospective observational study was conducted in two Korean community pharmacies with different practice settings. Prescriptions requiring pharmacist interventions during a 4-week period were reviewed. DRPs were classified using the Pharmaceutical Care Network Europe (PCNE) classification v9.1, and severity was assessed using the National Coordinating Council for Medication Error Reporting and Prevention (NCC MERP) index. Results: Among 7,324 prescriptions, 420 (5.73%) required pharmacist interventions, with 426 DRPs identified. Most DRPs originated from prescribing and drug selection (72.07%), particularly therapeutic duplication (52.82%). Dispensing-related causes were mainly associated with drug shortages, whereas patient-related factors included intentional non-adherence. Overall, 85.71% of interventions were accepted and fully implemented, and 86.67% of DRPs were classified as totally solved. Differences in intervention patterns were observed between pharmacies, with more prescriber-level interventions in the hospital-adjacent setting and more patient counseling in the clinic-based setting. Most cases were classified as NCC MERP Category C (97.86%), indicating that errors reached the patient without causing harm. Conclusion: The findings demonstrate the role of community pharmacists in identifying and managing DRPs in routine practice. They also suggest the need for improved integration of prescribing information and expanded access to patient clinical data to support pharmacist-led management of DRPs.

Objectives: This study aimed to synthesize evidence on the clinical and economic outcomes of designated ward pharmacist services in South Korea, assess the certainty of available evidence, and identify current research gaps and methodological limitations to inform directions for future research. Methods: A systematic search of five electronic databases identified 22 eligible studies published between January 2010 and February 2026, comprising 12 comparative studies and 10 cross-sectional analyses. Evidence certainty was assessed using the GRADE methodology. Results: Designated pharmacist interventions demonstrated positive clinical trends, including reductions in inappropriate prescribing, decreased 30-day readmission rates, and improved pain management. Physician acceptance rates for these interventions ranged from 78.7 to 98.5%, with significant increases observed in most comparative studies. However, lower acceptance rates were reported in specific patient populations (54.4-68.5%), such as those with renal impairment or hematologic conditions, suggesting that patient characteristics may influence acceptance. Regarding healthcare provider perception, clinician awareness and satisfaction regarding ward pharmacist services were high, ranging from 89.9 to 91.3% and 70.0 to 79.7%, respectively. Despite reported cost-reduction trends across nine studies, inconsistent methods and omitted labor costs limited definitive conclusions. Conclusion: Designated ward pharmacists have potential to act as vital cognitive assets in enhancing medication safety and economic benefits. Nevertheless, GRADE evidence certainty remains low to very low, constrained by non-randomized single-center designs. Standardized, prospective research is warranted to support expanded implementation.

Background: Pharmaceutical affairs terminology in Korea lacks a governing body and authoritative reference. A foundational study compiled 220 terms into a prototype glossary; a companion study benchmarked six online terminology dictionaries. Neither addressed electronic glossary structure nor post-publication maintenance. Objective: To specify the information architecture, user interface, and operating framework for building and sustaining an electronic glossary of pharmaceutical affairs terminology. Methods: Benchmarking findings were converted into design requirements across three screen areas, each specified for layout, elements, user actions, and data fields. A feedback interface served as the revision entry point. Operating rules were derived from 14 terminology bodies across 2 international organizations and 7 countries, plus statutory bodies, standardization notices, regulations, committees, dictionaries, and pharmacy statutes. A 9-member advisory panel reviewed all outputs. Results: Nine design requirements were allocated to a three-tier architecture under the association website. A six-field headword record was specified with hyperlinked cross-references and visible revision history. Search was configured so synonyms, abbreviations, and variant notations retrieve the same headword; unmatched queries route to a proposal form. A six-field report form supports three revision loops—notation correction, subcommittee screening, and annual deliberation—with full review every three years. Provisions for a terminology committee and a four-stage registration pathway to statutory definition were also drafted. Conclusion: The study delivers an implementable specification with institutional arrangements for maintaining authoritative entries. System development and usability testing remain to be conducted.