의약분업 이후 병원약국 업무 변화 : 골수이식병동약국(Satellite Pharmacy)의 운영 현황

박애령 한국병원약사회 2000 병원약사회지 Vol.17 No.4

국내 의료기관에서 종양약료서비스 현황과 전문약사의 역할

박애령,문진영,서정애,고종희,이윤선,천주향,홍소연,이정현,김경임 한국병원약사회 2019 병원약사회지 Vol.36 No.4

Background : The Korean Society of Health-System Pharmacists conducted the first certified oncology pharmacist examination in 2010. Currently, there are more than 180 certified oncology pharmacists in Korea. The purpose of this study was to investigate the current status of oncology pharmacy service and the role of pharmacists and suggest future paths for certified oncology pharmacists in Korea. Methods : The survey was conducted on pharmacists working at oncology pharmacies, as well as doctors and nurses with oncology pharmacy services experience. Additionally, the focus group interview was conducted with certified oncology pharmacists to evaluate pharmacists’needs regarding improving the certified pharmacist system. Results : The survey was completed by 99 pharmacists, 33 doctors, and 65 nurses in 33 hospitals. Among the certified oncology pharmacists currently working, the percentage of those who work specifically in oncology pharmacies was 24.9%. Oncology pharmacy services comprise prescription review and intervention, medication history management, attending round and conference, education, quality improvement activity and research activity. When asked about the services provided by oncology pharmacists, the medical staff responded with prescription review and intervention, providing drug information, patient education, therapeutic drug monitoring consulting, adverse drug reaction monitoring, and medication history management. And the medical staff showed more than average satisfaction in each service field. In the focus group interview, similar findings were confirmed. Meanwhile, dissatisfactory factors included the combination of clinical and dispensing tasks, discontinuity of work due to department circulation, and difficulties caused by lack of manpower. Conclusions : The results show that certified oncology pharmacists were performing more advanced services than general pharmacists. Also, the medical staffs were fully aware of the oncology pharmacy services and satisfied with such services. However, the current certified pharmacist system has a limitation in that it lacks laws as well as a compensation system.

암통증 관리에 대한 환자 만족도 조사

박애령,박지원,강진숙,김옥녀 한국병원약사회 1998 병원약사회지 Vol.15 No.2

Pain management of cancer patients should be considered as important as treatment disease in the aspect of raising the quality of the patients' life. Generally, pain control is based on the WHO 3-step analgesic ladder, and includes nerve block, radiation therapy, and physical therapy. To assess the adequacy of pain control in terminal cancer patients in this hospital, we investigated patients' charts and gave out questionnaires to patients to observe the degree of pain, compliance, and the patients' satisfaction. On the cancer pain intensity, 80 percent of patients experienced severe to worst possible pain. 40 percent of patients always complained cancer-related pain. The list of common side effects associated with analgesic drugs includes nausea and vomiting (45%), constipation (15%), and GI trouble (5%). Prescription pattern followed by the WHO 3-step analgesic ladder occupied 33%. The results showed most patients received inadequate pain management, and the use of analgesics was not properly carried out by stages. For adequate pain management, accurate assessment of pain and proper prescription about the patients' disease state and condition should be considered.

백혈병의 약물 치료2

박애령 韓國病院藥師會 2009 병원약사회지 Vol.26 No.1

백혈병의 약물치료

박애령 한국병원약사회 2009 병원약사회지 Vol.26 No.1

종양약료 전문약사 제도에 대한 국내외 현황 조사와 비교

박애령,문진영,서정애,고종희,이윤선,천주향,홍소연,강예슬,김경임 한국병원약사회 2019 병원약사회지 Vol.36 No.2

Background : Due to the increasing number of patients with cancer and the complexity of anti-cancer drug therapies, it has become important for the pharmacists to develop specialized knowledge and skills to provide enhanced pharmaceutical care for these patients. The concept of certified oncology pharmacist, however, is relatively new in Korea. The objective of this study was to review the certified oncology pharmacist systems in Korea and two advanced countries (the US and Japan) and provide a comparative analysis. Methods : The information related to certified oncology pharmacist system was obtained through the official websites of related organizations in each country. For obtaining the outcomes of pharmaceutical care services provided by certified oncology pharmacists, we explored the related domestic journals and PubMed database. Results : The Korean Society of Health-system Pharmacists (KSHP) conducted the first certified oncology pharmacist examination in 2010 in Korea. To take this examination, completion of a related education course (at least a total of 360 hours) administered by the KSHP is essential. In the United States, the Board Certified Oncology Pharmacist (BCOP) was approved by the board of pharmacy specialty in 1996. In Japan, there are four types of the specialized pharmacist in oncology depending on the organization; Board Certified Pharmacist in Oncology Pharmacy, Japanese Society of Pharmaceutical Health Care and Sciences (JSPHCS)-certified Senior Oncology Pharmacist, JSPHCS-certified Oncology Pharmacist, and Accredited Pharmacist of Ambulatory Cancer Chemotherapy. In the US and Japan, a specialist is required to possess rigorous practical experience as well as academic training. Conclusions : This study provides a deeper understanding of some of the practical issues that need to be addressed for improving the systems of certified oncology pharmacists in Korea.

진행성 또는 전이성 위암 환자에 있어서 Oxaliplatin 투여로 인한 말초신경통증 분석

박애령,김순주,방준석,나현오 한국임상약학회 2009 한국임상약학회지 Vol.19 No.1

Oxaliplatin is a tolerable and effective drug of choice in the treatment of advanced or metastatic gastric cancer. However, it has many dose-limiting neurotoxicities. This study was performed to assess the incidence and types of oxaliplatin-related neurotoxicities. Sixty-four patients receiving oxaliplatin-involved regimen as salvage therapy on metastatic gastric cancer or as the first-line therapy on advanced gastric cancer were evaluated during the period between September 1, 2006 and February 29, 2008. The patients were treated with oxaliplatin 100 mg/m2 and leucovorin 100 mg/m2 simultaneously as 2-hour-lasting infusion on Day-1 followed by 5-FU 1200 mg/m2 as a 22-hour-lasting continuous infusion both on Day-1 and Day-2 by every other week. We developed questionnaires to evaluate patient-recognized neurotoxic symptoms rather than the observer-described events. Surveys were completed at bedside or via telephone interview. Acute and chronic neurotoxicities were graded according to the National Cancer Institute Common Toxicity Criteria (NCI-CTC, version 3) as well as the Oxaliplatin-specific Neurotoxicity Scale. The Grade-3 neuropathy was reported in 19% of the patients (n=12) and grade-1/2 neuropathy occurred in 70% (n=45). The most common symptom was cold-related dysesthesia (83%) regarded as nociperception by the patients. Some patients (19%) experienced functional impairment affecting activities of daily living such as writing, buttoning, and walking. Even though 74% of the patients (42/57) were prescribed with gabapentin to reduce these peripheral symptoms, it did not appear to derive any benefit from this medication. It is suggested that notify the patients about their oxaliplatin-associated, debilitating symptoms, and educate them any self-care strategy at the initiating phase of the chemotherapy. Moreover, it needs to design the intervention studies regarding the prevention and management of the peripheral neuropathy.

음주운전자의 심리적 특성에 관한 연구

박애령 ( Park Ae-ryung ) 한국도로교통공단 2015 교통안전연구 Vol.34 No.-

본 연구는 음주운전 행동에 영향을 미치는 심리적 특성을 분석하여 음주운전자 교육의 효과성을 높이는 데 목적이 있으며, 연구 대상자는 도로교통공단 부산지부의 음주운전으로 인한 특별 교통안전교육 교육생 333명이다. 본 연구의 분석결과, 음주운전자의 적발횟수에 따른 심리적 특성에서 유의미한 차이가 나타나지 않았다. 또한 음주결과 기대를 긍정적으로 가지고 있는 운전자와 부정적으로 가지고 있는 운전자는 음주운전 행동에 대한 방어기제, 죄의식, 수치심 등의 심리적 특성에서 다른 결과가 나타났고, 음주운전자의 알코올의존 정도에 따라 방어기제도 다르게 상관관계가 있는 것으로 나타났다. 마지막으로 음주운전자의 수치심, 죄의식, 곤혹감의 심리적 특성이 음주운전처벌 생각의 정도에 영향을 미치는 것으로 나타났다. 이와 같은 연구 분석 결과로 볼 때, 음주운전은 한 가지의 요인만으로 나타나는 우발적인 행동이 아닌 개인의 심리, 인지적 측면이 복합적으로 작용하여 나타난 것임을 알 수 있다. 따라서 이러한 음주운전자의 심리적 특성과 인지적 요인을 다양한 측면에서 정확하게 파악하여 보다 깊이 있는 사례별 접근이 가능한 심리 상담교육의 활성화가 요구된다고 할 수 있는 결과이다. The purpose of this study was to examine influential psychological characteristics and congnitive factors for drunken driving. The subjects in this study were 333 people who received special safety education due to drunken driving in the region of Busan. Four research questions were posed: First, What are the differences in the psychological characteristics among two different groups of drivers? Second, What influences do the psychological characteristics of the drunk drivers have on the expectation of their feelings after the drunk alcohols? Third, What is the relationship between the psychological characteristics and alcohol dependence of drunken drivers? Fourth, What is the relationship between the sychological characteristics of drunken drivers and their thought of drunken-driving punishment? The above-mentioned finding suggest that drunken driving is not an accidental behavior or mistake but has something to do with psychological characteristics and cognitive factors.

소아 급성림프구성백혈병 치료에서 L-asparaginase의skin test 시행 방법의 적절성 평가

김경덕,박애령,김순주,황보신이,나현오 한국병원약사회 2018 병원약사회지 Vol.35 No.1

Background and Objective : L-asparaginase is the chemotherapeutic agent for the treatment of acute lymphoblastic leukemia and is associated with hypersensitivity reactions. Because of the high rates of hypersensitivity reactions, skin test has been proposed. However, the method of skin test not standardized, and false-positive and false-negative results have been documented. We have conducted skin tests prior to every dose of L-asparaginase. In consideration of the convenience of administration, the skin test is changed to be conducted prior to the first dose of L-asparaginase and prior to restarting therapy after an interval of a week or more has elapsed between doses by intervention of a pediatric oncology pharmacist. The objective of this study was to evaluate the sensitivity and specificity of skin tests. Methods : From July-December 2012, patients that received skin tests prior to every dose of Lasparaginase were classified A group. From July-December 2013, patients that received skin tests prior to the first dose of L-asparaginase and prior to restarting therapy after an interval of a week or more has elapsed between doses were classified B group. Results : 63 patients were included in the A group and received 402 cases of skin tests. 65 patients were included in the B group and received 126 cases of skin tests. The sensitivity of skin tests in the B group (52.2%) was superior to the A group (20%). This result showed statistically significant difference (p=0.047). The specificity of skin tests in the A group (96.1%) was superior to the B group (90.3%). This result showed statistically significant difference (p=0.017). Conclusion : In conclusion, reducing the number of skin tests by intervention of a pediatric oncology pharmacist improved convenience of administration and enhanced clinical safety of chemotherapy.

Rituximab 항암화학요법에 대한 약사의 환자 교육 개선 및 적용 효과

한영현,박애령,김순주,이병구,나현오 한국병원약사회 2014 병원약사회지 Vol.31 No.2

Rituximab is a monoclonal antibody approved for the treatment of non-Hodgkin’slymphoma. Infusion-related reactions have been reported in 50% of the patients within 1-2 hoursof starting the infusion. The patient education had been performed after the administration ofrituximab, due to heavy work-load during the morning shift at Seoul St. Mary’s Hospital. Therefore, an improvement in education method for rituximab-containing chemotherapy wasrequired. The purpose of this study was to evaluate the improved education method and theresult of the application of new method. The patients in this study were over 19 years of age, who received the first combination chemotherapy including rituximab, at Seoul St. Mary’s Hospital from May 2011 to January 2012. The patients who received the education previous to improvement were the control group (n=20),and patients who received the improved education were the study group (n=20). The improvededucation was performed on the patients before and during the rituximab administration,respectively. The contents of the education were the same before and after the improvement. In the control group, 13 patients experienced subjective side effects, and 6 of those patientsimmediately reported their conditions (6/13, 46.2%). In the study group, 9 patients out of 11immediately reported their subjective side effects (9/11, 81.8%), and this result was not statisticallysignificant (p=0.270). The points of the recognition for hypersensitivity were shown to be50.0±25.6 and 67.2±22.6 in the control and study groups, respectively, and this was significantlyhigher in the study group (p=0.031). The patient’s understanding, needs, and satisfaction fromthe education were shown to be 68.9±14.0 and 65.0±20.6 (p=0.612), 74.3±14.0 and 75.0±19.4(p=0.904), and 80.6±14.4 and 81.3±13.1 (p=0.943), in the control and study groups, respectively. The new education methods focusing on hypersensitivity to rituximab improved on the recognitionand the management of hypersensitivity reactions.