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w wz 16«1y Kor. J. Clin. Pharm., Vol. 16, No. 1. 2006 w w w BÁy CÁ wšdá DÁ DÁ ³D B C û w w w D û w w w Survey Analysis of Familiarity and Willingness of the Use of Auxiliary Label in Community Pharmacists Byung Chul Choi a, Myung Ja Hong b, Han-Gon Choi c, Chul Soon Yong c, Jong Dal Rhee c, and Bong Kyu Yoo c a Pharmacist Education & Research Institute, 604 Hanshin Officetel, Shinchun-dong, Songpa-gu, Seoul 138-733, Korea b Graduate School of Clinical Pharmacy, Yeungnam University, 317-1 Daemyung-dong, Nam-gu, Daegu, 705-802, Korea c College of Pharmacy, Yeungnam University, 214-1 Dae-dong, Gyongsan, 712-749, Korea Patient counseling is emerging as one of the most important roles of community pharmacists because the information on the standard labeling for the prescription drug is not sufficient to ensure the correct use of the drug. However, excessive workload of the community pharmacists in Korea discourages the provision of the effective patient counseling. The use of auxiliary label may be an efficient tool to help patients correctly use the prescription drug in this situation. As a preliminary study to encourage the use of auxiliary label, we have performed a survey analysis of familiarity and willingness of community pharmacists to use the auxiliary label. About three quarters of the participating community pharmacists have heard of the auxiliary label, however, there was not a single pharmacist who uses the label. Furthermore, only one fifth of the participating pharmacists were willing to use the label if they have to purchase. Therefore, it is recommended that governmental and non-profit organizations such as Korean Pharmaceutical Association educate community pharmacists regarding usefulness of the auxiliary label with focus on enhancing patient compliance and constrainment of healthcare expense. Key wordsg Auxiliary label, Community pharmacist, Patient counseling, Patient compliance, Healthcare expense t t y z ù y ƒ» n t» w y w w w w w w. ù x ù š n t» w z» w» w t y w š. w» w xk ƒ w ú x Correspondence to : ³ û w w w 214-1 Tel: +82-53-810-2822, Fax: +82-53-810-4654 E-mail: byoo@yumail.ac.kr w š w.1) w ƒ y š t y n t» w y 2,3) w w ƒ w. w w z e w v w z e ƒ ƒ j.4,5) t w w w š. w yw y w j z ƒ ù ƒ z x 5-8) y j w w. z w» w 9

10 Kor. J. Clin. Pharm., Vol. 16, No. 1, 2006 ƒ w w wš t y» š. ù e wš sw w l wš w wù» w. ù w ƒ š w w w y ƒ ü š ƒ» w» w. p y ƒ ù y» n ¾ ƒ w. w e ƒ xk nù w š. y ƒ w ü» w ƒ w (Fig. 1) ù ƒ y ƒ w» š w w p w. w ù w k» w w ù ƒ y w š w. 2004 9 15 l 2004 9 24 ¾ 10 ew 50 w y mw w. Fig. 1. Typical example of various auxiliary labels used in community pharmacies in US. 5 w, w w 5 w, xy 3 w 13 w (Table 1). w ù š y xk y t w w. w w. Fisher's exact test p z w w m v SPSS (version 7.5) w. m P 0.05 m w q w. š w ù s Table 1. Composition of questionnaire þ (5 w) 1. ù? (20-29 30-39 40-49 50-59 60 ) 2.? (û ) 3.? ( ) 4. j»? (10s 10-19s 20-29s 30-39s 40s ) 5. e? ( ƒ y / x v k ƒ) þ w (5 w) 1. w ¾? ( ) 2. y ƒw ¾? ( ) 3. ƒw ¾? ( ) 4. y w w ƒw ¾? ( ) 5.» w ƒw ¾? ( ) þ xy (3 w) 1. wš ¾? ( ) 2. œ w ¾? ( ) 3. ƒ w w w ¾? ( )

w w 11 40 ƒ 44% ƒ 50, 30, 60, 20 ùkû (Table 2). û ƒ 68% û 32%. ü s ƒ 78% 22% w. j» s 10-19s 54% w 20-29s, 30-39s 40-49s ƒƒ 20%, 12% 6% ùkû. w 10s ³ 8%ù ùk û. w ƒ ew 72% ƒ ùkû ƒ ew, y ù x v k ƒƒ 16%, 8% 4% w ƒ ew ùkû. w w w ¾? 50 74% 37 w w w ùkû. p ù 20 30 40 ƒƒ Table 2. Demographic characteristics of the interviewed population parameters frequency percentage (%) P-value age of pharmacists <0.01 20-29 4 8 30-39 8 16 40-49 22 44 50-59 11 22 60 5 10 sex of pharmacists <0.01 male 16 32 female 34 68 ownership of pharmacists <0.01 owner 39 78 employee 11 22 size of pharmacy <0.01 <10 Pyung* 4 8 10-19 Pyung* 27 54 20-29 Pyung* 10 20 30-39 Pyung* 6 12 40 Pyung* 3 6 in front of org 4 8 central shopping center 8 16 epartment store or 2 4 community shopping area 36 72 *Pyung=Korean traditional measure of area (3.24 m 2 ) Fig. 2. Percentage of community pharmacists who have heard of auxiliary label. ** P<0.01 compared to community pharmacists over fifty or older. 100%, 86% 64%ƒ š w (Fig. 2, P < 0.01). ù 50 60 ƒƒ 18% 20% š w. w w ù ùkû m y. w w y ƒw ¾?,, j» ƒ, y ƒw š w ƒ 90% w (data not shown). w w d w» w w ü s pƒ ƒ w. ù y š ƒw d w» w w y w w ƒw ¾? 20 75%ƒ w 50 55-60%ƒ w (Fig. 3, P < 0.01). w w 62%ƒ w w û 56% w û m ƒ (P < 0.05). j» m ùkü. y š ƒw d w» w w» w ƒw ¾? 50 26.5%ƒ w 50 w ƒ w

12 Kor. J. Clin. Pharm., Vol. 16, No. 1, 2006 Fig. 3. Percentage of community pharmacists who responded auxiliary label would increase patient compliance. *P<0.05 compared to male community pharmacists, **P<0.01 compared to community pharmacists over 50 or older. Table 3. Percentage of pharmacists who responded that auxiliary label would constrain healthcare expense* parameters percentage (%) P-value age of pharmacists <0.001 <50 26.5 50 0 sex of pharmacists 0.241 male 18.8 female 17.6 ownership of pharmacists <0.01 owner 15.4 employee 27.3 size of pharmacy 0.205 <30 Pyung** 17.1 30 Pyung** 22.2 in front of or 25.0 central shopping center 12.5 department store or 0 community shopping area 19.4 *overall percentage was 20%, and it was 94% if the auxiliary label were available at no charge, **Pyung=Korean traditional measure of area (3.24 m 2 ) (Table 3, P < 0.001). j» ƒ. ù ƒ eƒ w œ w ùkû (P < 0.01). y ƒw 90% wš, y w jš z ƒ š ƒw 20 w. w y z ƒ w y ƒ. 20, y w z ƒ ƒw ƒƒ 75% 50% w ùkù ew w w w w w w e. xy w x wš w 50 w œ w ÿ 94%ƒ w. ù w w ƒ 20% w w 50 26.5%, 50 6.3% m ùkû (Table 4, P < 0.001). j» e ƒ ùkû ³ ƒ j 40s w ƒ ùkû. ùkü. w y ƒ e k ƒ û z» l jš w w l w y w «wš. 9-12) ù z ƒ w w y w y yw» w ƒ» š. w z w ù x y

w w 13 Table 4. Percentage of pharmacists who responded they would purchase auxiliary label parameters percentage (%) P-value age of pharmacists <0.001 <40 26.5 40 6.3 sex of pharmacists 0.105 male 18.8 female 20.6 ownership of pharmacists 0.232 owner 20.5 employee 18.2 size of pharmacy <0.001 <30 Pyung* 17.1 30 Pyung* 33.3 in front of org 50.0 central shopping center 12.5 department store or 0 community shopping area 19.4 *Pyung=Korean traditional measure of area (3.24 m 2 ) wš w xr. 13) w w 20% w w ƒ ùkû. w z w z ƒ z w w «w y w v ƒ. ù w ùkû y w y. w z z y wš v mw w v ƒ. š x 1. Fontaine AL. Current Requirements and Emerging Trends for Labelling as a Tool for Communicating Pharmacovigilance Findings. Drug Safety 2004; 27: 579-89. 2. McKenney J. Efficacy and safety of rosuvastatin in treatment of dyslipidemia. Am J Health-System Pharm 2005; 62: 1033-47. 3. Aschenbrenner DS. Changes to trazodone label. Am J Nursing 2004104: 33-4. 4. Chisholm MA, Mulloy LL, Jagadeesan M et al. Impact of clinical pharmacy services on renal transplant patients' compliance with immunosuppressive medications. Clin Transplant 2001; 15: 330-6. 5. Lindstrom E, Bingefors K. Patient compliancewith drug therapy in schizophrenia: economic and clinical issues. Pharmacoeconomics 2000; 18: 105-24. 6. Al-Eidan FA, McElnay JC, Scott MG et al. Management of Helicobacter pylori eradication- the influence of structured counselling and follow-up. Br J Clin Pharmacol 2002; 53: 163-71. 7. Elewski BE. Onychomycosis: Treatment, Quality of Life, and Economic Issues. Am J Clin Dermatol 2000; 1: 19-26. 8. Hope CJ, Jingwei W, Wanzhu T et al. Association of medication adherence, knowledge, and skills with emergency department visits by adults 50 years or older with congestive heart failure. Am J Health-Syst Pharm 2004; 61: 2043-9 9. Krantz MJ, Havranek EF, Mehler PS et al. Impact of a Cardiac Risk Reduction Program in Vulnerable Patients Hospitalized with Coronary Artery Disease. Pharmacotherapy 2004; 24: 768-75. 10. Bartlett EE. Effective Approaches to Patient Education for the Busy Pediatrician. Pediatrics 1994; 94: 920-3. 11. Kansanaho H, Cordina M, Puumalainen I et al. Practicing pharmacists' patient counseling skills in the context of reflectivity. Pharmacy Education 2005; 5: 19-26. 12. Kerzman H, Baron-Epel O, Toren O. What do discharged patients know about their medication? Patient Educ Counsel 2005; 56: 276-82. 13. Brown C, Solovitz B, Bryant S et al. Short- and longterm effects of auxiliary labels on patient knowledge of precautionary drug information. Drug Intell Clin Pharm. 1988 Jun; 22: 470-4.