Clients' knowledge and satisfaction with outpatient pharmacy services and associated factors at Felege Hiwot comprehensive specialized hospital, Ethiopia: A cross-sectional study.

Objective: This study aimed to assess patient knowledge and satisfaction and associated factors with outpatient pharmacy service at Felege Hiwot comprehensive specialized hospital. Design setting and participants: An institution-based cross-sectional study was conducted at Felege Hiwot comprehensive specialized hospital on patients getting outpatient Pharmacy service from 01 March 2022 to 30 May 2022. The study participants were selected by simple random sampling method. Main outcome measured: Patients' knowledge and satisfaction with pharmacy service was measured by a structured questionnaire and Data were collected, cleared, and coded, then entered into EPI Info (Epidemiological information. version 7.1.5.2) and analyzed using SPSS (version 25). Results: The overall knowledge result of the respondents showed that only 13.3% of individuals have good drug knowledge and 72.01% of respondents were satisfied with the outpatient pharmacy service. Following up on the multivariate analysis of service modality patients by credit (AOR: 5.50 (1.71-17.74), who are with the occupation of merchants (AOR: 0.09 (0.01-0.83)) and labeling (AOR: 3.13 (1.58-6.20) had an association with drug knowledge. Multivariate analysis showed that waiting time, dispensing time and privacy had an association with satisfaction. When we consider waiting time; respondents with 3-6 min, 6.1-9 min and >9 min waiting times are 0.06 times, 0.02 times, and 0.01 less likely satisfied compared with respondents having waiting time <3 min. It shows that as the patient stays without getting serviced for a long time, satisfaction decreases. Conclusions: Overall, around three-fourths of the respondents were satisfied with the outpatient pharmacy services which is approaching the national satisfaction assessment result. Respondents were strongly satisfied with Dose, route, frequency, and duration. However, they were strongly dissatisfied with the name of the drug. After the multivariate analysis privacy, waiting time, and dispensing time had an association with patient satisfaction.

[Evaluation of the Leftover Capecitabine Tablets in Adjuvant CAPOX Chemotherapy for Gastric Cancer].

Since it is important that patients take their oral anticancer therapy as prescribed, pharmacists need to assess adherence. In addition, oral anticancer drugs are expensive, and reuse of leftover drugs at outpatient pharmacy clinics is useful in reducing drug costs. The present study aimed to clarify when and why patients have leftover capecitabine tablets, and the cost of leftover capecitabine tablets reused at an outpatient pharmacy clinic, focusing on adjuvant capecitabine plus oxaliplatin (CAPOX) chemotherapy for gastric cancer. We retrospectively studied patients who received adjuvant CAPOX chemotherapy for gastric cancer between November 1, 2015, and April 30, 2021, at the Cancer Institute Hospital of the Japanese Foundation for Cancer Research. The cost of leftover capecitabine reused by pharmacists was calculated based on the National Health Insurance drug price standard for the study period. This study included 64 patients who received adjuvant CAPOX chemotherapy. Thirty-seven patients had 152 leftover capecitabine tablets. The most common reasons for leftover capecitabine tablets were nausea and vomiting (21.7%), missed doses (18.4%), and diarrhea (13.2%). The leftover capecitabine tablets for 25 patients were reused at the outpatient pharmacy clinic at a cost of JPY 604142.8 (JPY 24165.7 per patient). The study results suggest that evaluating capecitabine adherence and the reasons for leftover capecitabine tablets at outpatient pharmacy clinics as well as reusing leftover medication can contribute to reducing drug costs.

Analysis of the current performance of pharmacy outpatient services at grassroots medical institutions at home and abroad / 中华医院管理杂志

Pharmacy services in grassroots medical institutions provide professional pharmacy services for patients. This service not only expanded the scope of primary care delivery, but also meets the residents′need for appropriate medication. At present, the majority of grassroots medical institutions in China provide outpatient pharmacy services by means of pharmacy service alliance, and foreign grassroots medical institutions mainly provide pharmaceutical outpatient services with drug treatment management as the core for patients by granting pharmacists partial prescription rights.In recent years, pharmaceutical outpatient services in grassroots medical institutions had achieved good results in improving patient clinical outcomes, enhancing medication rationality, and enhancing patient compliance. However, there were many unresolved issues, including low public awareness, shortage of pharmaceutical talents, and imperfect guarantee systems. The author suggestted that efforts should be made to increase the publicity of pharmaceutical outpatient services, improve the training mechanism for pharmacists, strengthen cooperation between pharmacists and clinical physicians, include pharmacists in the contracted service team of family doctors, and improve various guarantee systems, in order to provide reference for promoting the sustainable development of pharmaceutical outpatient services in grassroots medical institutions in China.

Establishment and evaluation of “integration of drug storage and dispensing”intelligent drug validity management system in outpatient pharmacy / 中国药房

OBJECTIVE To build an “integration of drug storage and dispensing” intelligent drug validity management system in outpatient pharmacy， and to evaluate the effect of this system. METHODS The information technology was used to connect the drug information in the primary storage， the intelligent secondary storage and the rapid dispensing machine； an “integration of drug storage and dispensing” intelligent drug validity management system was constructed. At the same time， the implementation effects of drug validity management system in outpatient pharmacy of our hospital were evaluated one year before and after the construction of the system. RESULTS By using information technology， intelligent closed-loop management of batch number and expiration date information throughout the entire process of drug circulation in outpatient pharmacy of our hospital had been achieved， making it easy to track and trace drug information. After the establishment of the intelligent system， the time spent on managing drug validity every month was reduced from 103 people·h to 8 people·h； the number of near-expired drugs per month had decreased from （30.67±1.10）types to （17.67±1.17）types（P＜0.05）. CONCLUSIONS The intelligent drug validity management system in outpatient pharmacy based on the mode of “integration of drug storage and dispensing” makes the drug validity management in the outpatient pharmacy more scientific， reasonable and efficient.

Design and application of auxiliary system for drug distribution in outpatient pharmacy / 药学实践杂志

Objective To construct the auxiliary system of outpatient drug distribution, reduce errors and improve the quality of outpatient pharmaceutical service. Methods The bar code technology was used to independently develop outpatient pharmacy dispensing assistant system. The system design and function are introduced. The practical application effect of the system was evaluated on dispensing errors, efficiency and pharmacist evaluation. Results Based on the special network environment of the hospital, the system integrated the functions of drug check, prescription right management, expiration date management and medication instruction. After using the system, the number of dispensing errors decreased from 84 to 25. The waiting time for patients to receive medicine decreased by 151 seconds. All pharmacists surveyed agreed that auxiliary system was helpful to pharmacists’ work. Conclusion The system reduced the medication dispensing error in outpatient pharmacy, improved work efficiency and the quality of pharmaceutical care.

Patient Satisfaction of Ambulatory Care Pharmacy Services.

The Ministry of Health (MOH) recently developed the Health Sector Transformation Program (HTSP) to focus on patient satisfaction, safety, and care. This study explored patient satisfaction with outpatient care services. A semi-structured questionnaire was designed to collect the data of patient satisfaction with pharmacy care services through face-to face interviews of participants and over the internet using an electronic format of the same questionnaire (web-based survey). A total of 508 participants responded of whom, 51.8% were male and 83% were below 46 years old. The average scores of domains 1, 2, 3, 4, 5, 6, 7, and 8 were 4.51, 4.11, 4.30, 3.70, 3.57, 3.82, 3.63, and 4.15, respectively. The general evaluation of pharmacy services demonstrated that respondents were very satisfied (245; 48.2%), satisfied (143; 28%), and willing to recommend the pharmacy to their families (380; 76.4%). There was no statistically significant difference in the overall satisfaction with pharmacy services among the 2 hospitals (P > .05). Most respondents were satisfied with outpatient care pharmacy services. More efforts are needed to improve the service of following up on patients' adherence by the pharmacists.

Applying Simulation Optimization to Minimize Drug Inventory Costs: A Study of a Case Outpatient Pharmacy.

Drug inventory management is an important part of hospital management. The large amounts of drug data in hospitals bring challenges to optimizing the setting values for the safety stock and the maximum inventory of each drug. This study combined a two-stage clustering method with an inventory policy (s, S) and established a simulation optimization model for the case hospital's outpatient pharmacy. This research used the simulation optimization software Arena OptQuest, developed by Rockwell Automation Inc (Rockwell Automation, Coraopolis, PA, USA), in order to determine the minimum and maximum values (s, S) of the best stock amounts for each drug under the considerations of cost and related inventory constraints. The research results showed that the minimum and maximum inventory settings for each drug in the simulation model were better than those set by the case outpatient pharmacy system. The average inventory cost was reduced by 55%, while the average inventory volume was reduced by 68%. The proposed method can improve management efficiency and inventory costs of hospital pharmacies without affecting patient services and increasing the inventory turnover rate of the drugs.

Evaluation of Academic Detailing to Impact Pharmacists' Compliance with an Outpatient Pharmacy Partial Fill Policy.

BACKGROUND: Pharmacists' compliance with a medication partial fill policy at a Veterans Affairs healthcare system has been underwhelming. Academic detailing, an educational outreach approach conducted by trained health care professionals to improve patient care, is an attractive method for improving pharmacists' compliance with the policy. OBJECTIVE: To evaluate the impact of academic detailing on pharmacists' compliance with the partial fill policy. METHODS: A pre-post analysis was performed to evaluate the impact of academic detailing outreach visits on pharmacists' compliance with the partial fill policy. Data collection included all partial fill medication orders verified during the study duration. Student's t-test was used to analyze the change in the day supply of partial fills following the academic detailing intervention. Total partial fill drug expense during the pre- and post-intervention phases was calculated as drug cost plus material cost for each partial fill. RESULTS: A total of 36 (97.3%) pharmacists received an academic detailing outreach visit. Total percentage of partial fills limited to a 7-day supply was significantly increased following academic detailing outreach visits (49.2% pre-intervention vs. 84.2% post-intervention, p-value <0.001). Total partial fill drug expense decreased from $12,144.42 to $9,713.50. Percentage of partial fills limited to a 7-day supply remained significant during the 6-month follow-up period (p-value = 0.03). CONCLUSIONS: Academic detailing is an effective method for improving pharmacists' compliance with an outpatient pharmacy partial fill policy and decreasing total partial fill drug expense for the pharmacy department.

Systematic analysis of drug dispensing errors and preventive measures in outpatient pharmacies / 药学实践杂志

Objective To understand the current situation of dispensing errors and effective prevention and control measures in outpatient pharmacies in domestic hospitals, in order to further improve the quality of drug dispensing. Methods The Chinese journal database was retrieved from 2015 to 2020 for the literature on the dispensing errors of outpatient pharmacies and the continuous improvement of the quality after the measures were taken in secondary and tertiary hospitals. Results Of the 146 literatures retrieved, 13 were included in the analysis (11 in tertiary hospitals and 2 in secondary hospitals). Before the improvement, the median of the drug dispensing error rate was 5.1‰, and after the improvement it was 1.1‰. Before and after the improvement, the types of drug dispensing errors were mainly quantity errors (52.5% vs. 51.3%), variety errors (28.3% vs. 28.7%), specifications and dosage forms errors (6.2% vs. 6.7%), and labeling errors (2.1% vs. 2.9%). The improvement measures taken for the reasons of dispensing errors have a high overlap rate, and they are concentrated in two aspects: personnel factors and drug factors. Conclusion The use of continuous quality improvement tools in hospital outpatient pharmacy to control and prevent dispensing errors is still a hotspot of current research. The composition of the types of errors after improvement has basically not changed. The implemen-tation of standardized operating procedures and other continuous improvement comprehensive measures can effectively reduce the incidence of dispensing errors, and contribute to the implementation of the “Expert Consensus on Medication Error Management in China”.

Exit-Knowledge About Dispensed Medications and Associated Factors Among Patients Attending the Outpatient Pharmacy of Ambo General Hospital, Western Ethiopia.

BACKGROUND: Insufficient knowledge of patients about their dispensed medications may result in inappropriate use of medication which can lead to treatment failure and poor therapeutic outcome. PURPOSE: This study aimed to determine the exit-knowledge level and its determinants among patients attending outpatient pharmacy of the Ambo General Hospital. PATIENTS AND METHODS: Hospital-based cross-sectional study was conducted on 400 study participants who visited the outpatient pharmacy in Ambo General Hospital from October to December 2019. Face-to-face interview was conducted using structured questionnaires to assess the exit-knowledge of the patients about their dispensed medication at the pharmacy exit. A binary logistic regression was employed to determine factors associated with the exit-knowledge. The association was statistically significant at 95% of confidence interval with a p-value less than 0.05. RESULTS: A total of 400 patients participated in the study with a 100% response rate. Of the total, 222 (55.5%) patients had sufficient exit-knowledge about their dispensed medication. Patients in the age group of 19-29 (AOR=3.1; 95% CI (1.7-5.6) and 49 -59 (AOR = 3.7; 95% CI (2.3-6.0)) had greater exit-knowledge than the elderly participants (>60 years). Participants who reported the comfort of the waiting area was not suitable had lower odds of sufficient exit-knowledge (AOR= 0.7; 95% CI (0.2-3.0)) in comparison to those who reported a suitable waiting area. Lower odds of sufficient exit-knowledge (AOR=0.4; 95% CI (0.3-0.7)) was determined among those who responded fairly clarity of the dispensers guidance in comparison with those reported clear guidance. The gender and the residence of the participants were also had a significant association with the exit-knowledge level. CONCLUSION: Modest number of the patients had sufficient exit-knowledge of their dispensed medication. Age, gender, residence, perceived comfort of the waiting area and perceived clarity of the pharmacists' guidances were significantly associated with the exit-knowledge.

Bidirectional information sharing between Nagoya Memorial Hospital and health insurance pharmacies using a communication sheet for pharmaceutical cooperation.

BACKGROUND: We collaborated with the regional pharmaceutical associations near Nagoya Memorial Hospital and created a communication sheet for pharmaceutical cooperation between the hospital and health insurance pharmacies. METHODS: The communication sheet for pharmaceutical cooperation was issued in October 2014. We conducted a questionnaire survey of both cancer patients and community pharmacists 1 year after the implementation of the use of this sheet. Based on the results of the survey, we modified our communication sheet and added a unified reply form in October 2016. We examined the number of replies from community pharmacists from October 2014 to April 2019. We then analyzed how community pharmacists instructed and communicated with cancer patients using the results of both the questionnaire survey and the reply form, which were compared before and after introducing the modified version of the communication sheet. RESULTS: During the 5 years of observation, 743 communication sheets were sent from Nagoya Memorial Hospital to community pharmacists. As a result of pharmaceutical cooperation in using the communication sheet, 96.4% of prescribed medication were immediately prepared in health insurance pharmacies on that day. The communication sheet also enhanced the conversations between cancer patients and pharmacists. The introduction of the unified reply form increased the response rate of community pharmacists from 1.7 to 69.5% (p < 0.001). The communication between community pharmacists and cancer patients was significantly hindered by prescriptions without an oral cancer drug and patient age < 65 years old (p < 0.05). However, this hindrance was reduced by the use of the modified form. CONCLUSIONS: The communication sheet for pharmaceutical cooperation is useful for bidirectional information sharing between hospitals and health insurance pharmacies, which may enable pharmacists to provide cancer patients with medication instructions in coordination with hospitals and increase the quality of outpatient pharmacy services.

Studying the Efficiency of Waiting Time in Outpatient Pharmacy.

In general, the pharmacy is the last department to be visited for outpatient in the hospitals, and therefore its efficiency is directly linked to patients' satisfactions and more important the reputation of the entire hospital. The study here is based on Medical City that is located in Riyadh, Saudi Arabia. It serves patients from all over Saudi Arabia. The aim of the study is to improve the efficiency of waiting time of outpatient pharmacy based on the problems that have been observed using management quality tools and techniques. After analyzing the data for the current situation, then trying to propose changes for improvement in system efficiency. Results showed that by proposing automated waiting system with automated prescriptions, patient categorization, reduce the unclaimed prescriptions, and modify the pharmacy's layout. All of that will help in reducing the waiting time as well as increasing the patients' satisfaction which will lead to improve the pharmacy's efficiency. From reviewing the literature, it concludes that applying management quality tools and techniques will tremendously improve the quality of services in healthcare systems. The statistical analysis presented shows some outliers points when serving patients which were studied and recommendations were proposed. This is new approach to enhance the quality of healthcare management and leads to increase in the efficiency of the outpatient pharmacies.

Construction and Practice of Automatic Drug Delivery System in Outpatient Pharmacy of Our Hospital / 中国药房

OBJECTIVE：To investigate the problem s and improvement measures in the application of automatic drug delivery system in outpatient pharmacy of our hospital ，and to provide reference for the construction of automatic drug delivery system in outpatient pharmacy. METHODS ：Combined with the pharmacy module function of HIS system in our hospital and the actual needs of the pharmacist in drug delivery process ，the automatic delivery system of our hospital （including automatic delivery machine ， prescription dispensing and delivery mode ，intelligent medicine basket ）was established for operation and optimization. RESULTS ： After six months of running period ，the hardware of the automatic dispensing machine had been stabilized ，and the software functions had been optimized ，including the mode of pre-dispensing ，drug storage ，system prompt ，quantity of dispensing ， management of the drug period of validity ，and the mode of dispensing at the peak of drug taking. At the same time ，the emergency plan was formulated for automatic dispensing system. The application of the automatic dispensing machine shared 80％ of pharmacists ’prescription dispensing on an average day ，saved labor cost （reduce the labor cost of about 2 pharmacists）， shortened patients ’waiting time for drug-taking （down from 7.45 min to 6.61 min on average ，P＜0.01），reduced prescription dispensing error rate （down from 0.040 9％ to 0.019 5％ on average ，P＜0.01）. CONCLUSIONS ：The establishment of automatic drug delivery system in our hospital has reduced the workload of pharmacists ，improved the work efficiency ，decreased prescription dispensing error and promoted the quality of pharmaceutical care.

Exploration and Practice of Closed-loop Management of Drug Valid Date in the Intelligent Outpatient Pharmacy / 中国药房

OBJECTIVE：To explore the closed-loop management mode of drug valid date in the intelligent outpatient pharmacy，and to provide reference to improve the management level of drug valid date and ensure the safety of drug use in patients. METHODS ：The model and practice of closed-loop management of drug valid date in the intelligent outpatient pharmacy were summzired from the aspects of dispensing system ， logistics system ， temperature and humidity monitoring system ， management of drugs to be about to expired ，internal quality control and performance evaluation. The patients ’satisfaction degree of the indicators were compared between the new and old hospital districts. RESULTS ：The intelligent drug dispensing system ， logistics and information flow system ，temperature and humidity monitoring system were established in the new district of our hospital，and management system of drugs to be about to expire ，internal quality control and performance evaluation system were established. The workflow of drug validity management was optimized ，the pharmacy working environment was improved ，and the pharmaceutical service quality and pharmacy management level were improved. The results of satisfaction survey of outpatients in new and old distrcts showed that the indicators of patients ’satisfaction（service attitude ，work quality ，drug consultation ，waiting time）in new distrct were improved to different extents ，compared with old district. The satisfaction of special storage tips and waiting time in new district were all significantly higher than old district ，with statistical significance （P＜0.05）. CONCLUSIONS ： The design and management concept of intelligent outpatient pharmacy in our hospital has been significantly improved ，the drug valid date management is more scientific and reasonable than before ，and the patient satisfaction is improved.

ClotAssist: A program to treat cancer-associated thrombosis in an outpatient pharmacy setting.

Stable cancer patients diagnosed with a pulmonary embolus or deep vein thrombosis are commonly referred to the emergency department for management. This practice strains an already overburdened emergency department and is associated with long wait times and poor disease/injection education for patients. This pilot study sought to determine if stable cancer patients with newly diagnosed cancer-associated thrombosis could be effectively managed by community-based pharmacists who followed an evidence-based protocol to prescribe and initiate low-molecular weight heparin therapy. We hypothesized that this novel care pathway could provide faster patient care with more comprehensive disease education, self-injection training, and follow-up. Fifty-five patients with various cancers, including gastroesophageal, urogenital, breast, brain, and lung were enrolled into this pilot study. We observed that this alternative first-dose treatment pathway provided safe and effective treatment of venous thromboembolism combined with excellent patient satisfaction. Following their interaction with the pharmacist, patients felt confident about their ability to self-inject and about their venous thromboembolism management overall. No occurrences of bleeding or other side-effects were observed. This pilot study demonstrates that community-based pharmacists are capable of delivering complex care services in the outpatient environment, particularly in the management of venous thromboembolism.

Surface contamination of counting tools after mock dispensing of cyclophosphamide in a simulated outpatient pharmacy.

PURPOSE: The primary aim was to determine if dispensing of cyclophosphamide tablets resulted in accumulated residue on pharmacy counting tools during a simulated outpatient dispensing process. Secondary objectives included determining if cyclophosphamide contamination exceeded a defined threshold level of 1 ng/cm2 and if a larger number of prescriptions dispensed resulted in increased contamination. METHODS: Mock prescriptions of 40 cyclophosphamide 50 mg tablets were counted on clean trays in three scenarios using a simulated outpatient pharmacy after assaying five cleaned trays as controls. The three scenarios consisted of five simulated dispensings of one, three, or six prescriptions dispensed per scenario. Wipe samples of trays and spatulas were collected and assayed for all trays, including the five clean trays used as controls. Contamination was defined as an assayed cyclophosphamide level at or above 0.001 ng/cm2 and levels above 1 ng/cm2 were considered sufficient to cause risk of human uptake. Mean contamination for each scenario was calculated and compared using one-way analysis of variance. P-values of < 0.05 implied significance. RESULTS: Mean cyclophosphamide contamination on trays used to count one, three, and six cyclophosphamide prescriptions was 0.51 ± 0.10 (p=0.0003), 1.02 ± 0.10 (p < 0.0001), and 1.82 ± 0.10 ng/cm2 (p < 0.0001), respectively. Control trays did not show detectable cyclophosphamide contamination. Increasing the number of prescriptions dispensed from 1 to 3, 1 to 6, and 3 to 6 counts increased contamination by 0.51 ± 0.15 (p = 0.0140), 1.31 + 0.15 (p < 0.0001), and 0.80 ± 0.15 ng/cm2 (p = 0.0004), respectively. CONCLUSION: Dispensing one or more prescriptions of 40 cyclophosphamide 50 mg tablets contaminates pharmacy counting tools, and an increased number of prescriptions dispensed correlates with increased level of contamination. Counting out three or more prescriptions leads to trays having contamination that surpasses the threshold at which worker exposure may be increased. Pharmacies should consider devoting a separate tray to cyclophosphamide tablets, as cross-contamination could occur with other drugs and the efficacy of decontamination methods is unclear. Employee exposure could be minimized with the use of personal protective equipment, environmental controls, and cleaning trays between uses. Future investigation should assess the extent of drug powder dispersion, the effects of various cleaning methods, and the potential extent of contamination with different oral cytotoxic drugs.

Application of FMEA regulated drug supply chain collaborative service platform for drug-receiving in outpatient pharmacy / 药学实践杂志

Objective To strengthen the system of drug supply chain collaborative service platform in drug supply, decrease drug inventory backlog, and improve the outpatient pharmacy management capacity in outpatient pharmacy.Methods Failure mode and effects analysis (FMEA) method was used to discover the potential risks in the drug supply chain collaborative service platform and formulate the corresponding improvement measures.Results The number of drug-receiving errors dropped from 137times to 32times and the risk reduction rate was 76.64％after improving the procurement process of the supply chain service platform, which significantly reduced the risk of contracting errors.Conclusion FMEA method could help to figure out the loopholes and hidden dangers of the pharmacy system, which made the outpatient pharmacy more reasonable and accurate by constantly improving the measures of the drug supply chain collaborative service platform.

Exit-Knowledge of Ambulatory Patients About Medications Dispensed in Government Hospital in Eastern Ethiopia: The Need for Focused Patient Counseling.

Background: In the counseling process, a multi-cultural competence of dispenser is among the key factors affecting his/her successful communication with patients for achieving optimal use of medications. For patients to use dispensed drugs appropriately, it is a must for them to understand the medication related information provided by the dispenser. Hence, the objective of this study was to identify parameters that likely affect ambulatory patients' knowledge of medication(s) provided at the exit of outpatient pharmacy of Federal Harar Police Hospital, Eastern Ethiopia. Methods: Cross-sectional study design was employed to conduct this study. An interview of patients was made at the exit of hospital pharmacy using a semi-structured questionnaire. The interview tool primarily assessed the knowledge of the patients for a maximum of three medications provided. Statistical Package for Social Sciences (SPSS), Version 20.0, was employed for analysis of the data. Chi-squared test was done to retain parameters with potential to have association; and the retained parameters were adjusted by performing bivariate and multivariate logistic regression analyses. Results: The result showed that only 37.2, 33.4 and 28.7% of the patients were able to recall the name of the drug(s), common side effects, and actions to be taken for missed doses, respectively. The likelihood of patients' knowledge for dispensed medications was high among patients aged 19-39 years (adjusted odds ratio [AOR]: 5.0; 95% CI: 1.04-24.2) and who thought their communication with dispenser had been polite (AOR: 4.62; 95% CI: 1.48-14.4). However, the knowledge status was found low among patients who were Afan Oromo speakers (AOR: 0.58; 95% CI: 0.35-0.95) and who came from rural residence (AOR: 0.48; 95% CI: 0.25-0.90). Conclusion: A high proportion of patients were unable to recall the drug (s) name, associated common toxicities, and actions to be taken in case of missed dose. In addition, patients who were at early adulthood and who were positive for the politeness of dispenser had better exit-knowledge of their medication. Therefore, for the patients' clear understanding of medications provided, it is mandatory to optimize patient-dispenser communication possibly by adapting multi-cultural communication skills and by providing focused training for dispensers to address factors that likely affect patient-dispenser interactions.

Projection of future pharmacy service fees using the dispensing claims in hospital and clinic outpatient pharmacies: national health insurance database between 2006 and 2012.

BACKGROUND: Predicting pharmacy service fees is crucial to sustain the health insurance budget and maintain pharmacy management. However, there is no evidence on how to predict pharmacy service fees at the population level. This study compares the status of pharmacy services and constructs regression model to project annual pharmacy service fees in Korea. METHODS: We conducted a time-series analysis by using sample data from the national health insurance database from 2006 and 2012. To reflect the latest trend, we categorized pharmacies into general hospital, special hospital, and clinic outpatient pharmacies based on the major source of service fees, using a 1% sample of the 2012 data. We estimated the daily number of prescriptions, pharmacy service fees, and drugs costs according to these three types of pharmacy services. To forecast pharmacy service fees, a regression model was constructed to estimate annual fees in the following year (2013). The dependent variable was pharmacy service fees and the independent variables were the number of prescriptions and service fees per pharmacy, ratio of patients (≥ 65 years), conversion factor, change of policy, and types of pharmacy services. RESULTS: Among the 21,283 pharmacies identified, 5.0% (1064), 4.6% (974), and 77.5% (16,340) were general hospital, special hospital, and clinic outpatient pharmacies, respectively, in 2012. General hospital pharmacies showed a higher daily number of prescriptions (111.9), higher pharmacy service fees ($25,546,342), and higher annual drugs costs ($215,728,000) per pharmacy than any other pharmacy (p <  0.05). The regression model to project found the ratio of patients aged 65 years and older and the conversion factor to be associated with an increase in pharmacy service fees. It also estimated the future rate of increase in pharmacy service fees to be between 3.1% and 7.8%. CONCLUSIONS: General hospital outpatient pharmacies spent more on annual pharmacy service fees than any other type of pharmacy. The forecast of annual pharmacy service fees in Korea was similar to that of Australia, but not that of the United Kingdom.