The ability to communicate effectively is an essential skill for a pharmacist. However, the curricula of most pharmacy schools in South Korea do not include communication skills training (CST). This study aims to evaluate the effects of CST in pharmacy education. This study was a comparison of pre- and post-intervention surveys completed by sixty fifth-year pharmacy students who participated in communication skills and patient counseling training during the spring 2017 semester. The students were asked to respond to 49 questions addressing 4 self-assessment categories: communication skills (24), attitudes (19), and confidence levels (2) at the beginning and end of the CST, and their perception of CST (4) after completing the course. The training session included lectures, small group work, role play, videos, and performance feedback by a tutor. Data were analyzed using the paired t-test with Bonferroni’s correction for multiple comparisons. The open-ended questions were analyzed using inductive content analysis. The pharmacy students’ self-assessment of their communication skills, attitudes toward the communication course, and confidence levels showed significant improvement after the CST. Most students (96.7%) indicated the necessity of a pharmacy communication curriculum. They responded that CST is helpful for effective communication with patients (33.3%) and other healthcare professionals (31.7%). Role-playing was reported as the most preferred learning method (58.3%). CST significantly impacted pharmacy students’ skills, attitudes, and confidence levels related to communication skills and patient counseling. These findings indicate that communications training should be included in the regular curriculum of pharmacy schools.

Antimicrobial stewardship program (ASP) is one of the most important strategies for managing infectious disease treatment and preventing antimicrobial resistance. The successful implementation of ASP in the community health system (CHS) has been challenging. We evaluated perceptions of current ASP, potential setbacks of ASP implementation, and future demands on ASP services among physicians and pharmacists in the CHS. The qualitative research was conducted through in-depth individual interviews and focus group discussions with 11 physicians and 11 pharmacists. In addition, a quantitative gap analysis was conducted to assess the different awareness and demands on services of ASP and preferred antimicrobial-related problems (ARP). In overall, perceptions of ASP varied by profession. The identified setbacks were unorganized institutional leadership, the undefined roles of healthcare professionals, a lack of reimbursement, the hierarchical structure of the health system, and the labor-intensive working environment of pharmacy services. Although demands for ASP improvement were similar among professionals, they had different preferences in prioritizing each service item of ASP/ARP development and the profession responsible for each service. Continuous administrative and financial investments, understanding ASP contents, ASP-specific information technology, and interdisciplinary collaboration with good communication among healthcare professions are needed to continue the progression of ASP.

Antibiotic-induced dysbiosis may affect the efficacy of immune checkpoint inhibitors. We investigated the impact of antibiotics on the clinical outcomes of nivolumab in patients with non-small cell lung cancer (NSCLC). Patients who received nivolumab for NSCLC between July 2015 and June 2018 and who were followed up until June 2020 were included in a retrospective cohort analysis. Of 140 eligible patients, 70 were on antibiotics. Overall survival (OS) was shorter in patients on antibiotics (ABX) compared to those not on antibiotics (NoABX) (p = 0.014). OS was negatively associated with piperacillin/tazobactam (PTZ) (HR = 3.31, 95% CI: 1.77–6.18), days of therapy (DOT) ≥ 2 weeks (HR = 2.56, 95% CI: 1.30–5.22) and DOT of PTZ. The defined daily dose (DDD) in PTZ (r = 0.27) and glycopeptides (r = 0.21) showed weak correlations with mortality. There was no difference in progression-free survival (PFS) between ABX and NoABX; however, PFS was negatively associated with the antibiotic class PTZ and DOT of PTZ. Therefore, the use of a broad-spectrum antibiotic, such as PTZ, the long-term use of antibiotics more than 2 weeks in total and the large amount of defined daily dose of specific antibiotics were associated with decreased survival in patients receiving nivolumab for NSCLC.

What is known and Objective Understanding investigational medications is important. Many older drugs are being investigated for repurposing against COVID‐19. We comment on various drugs currently undergoing such trials to optimize their safe use. Comment We describe medications used during early COVID‐19 outbreaks in South Korea, focusing on practice aspects including the method of drug administration, drug formulation, patient‐monitoring for adverse reactions and drug interactions informed by our experience during the 2015 outbreak of Middle East respiratory syndrome (MERS). We comment on hydroxychloroquine, chloroquine, lopinavir/ritonavir with zinc supplement, remdesivir, tocilizumab, ciclesonide, niclosamide and high‐dose intravenous immunoglobulin (IVIG). What is new and conclusion Effective therapies are urgently needed to manage COVID‐19, and existing drugs such as antivirals and antimalarials are under investigation for repurposing to meet this need. This process requires up‐to‐date drug information to ensure optimum use, particularly safety and efficacy profiles of the medications, until convincing evidence is reported.

Doxorubicin and cyclophosphamide (AC)-based chemotherapy has been a standard regimen for early-stage breast cancer (ESBC) with an intermediate risk (10–20%) of febrile neutropenia (FN). Secondary prophylaxis of granulocyte colony-stimulating factor (G-CSF) is considered in patients receiving AC-based chemotherapy; however, relevant studies are limited. Here, we retrospectively reviewed the electronic medical records of 320 patients who completed adjuvant AC-based chemotherapy from September 2016 to September 2020. Approximately 46.6% of the patients developed severe neutropenic events (SNE) during AC-based chemotherapy. Secondary prophylaxis of G-CSF reduced the risk of recurrent SNE (p < 0.01) and the relative dose intensity (RDI) < 85% (p = 0.03) in patients who had experienced SNE during AC-based chemotherapy. Age ≥ 65 years (p = 0.02) and alanine aminotransferase (ALT) or aspartate aminotransferase (AST) > 60 IU/L (p = 0.04) were significant risk factors for RDI < 85%. The incidences of FN, grade 4 neutropenia, unscheduled hospitalization, and interruption to the dosing regimen were reduced in patients administered secondary prophylaxis with G-CSF (before vs. after administration: FN, 19.4% vs. 4.6%; grade 4 neutropenia, 86.1% vs. 14.8%; unscheduled hospitalization, 75.9% vs. 11.1%; interruption to the dosing regimen, 18.5% vs. 8.3%). This study indicated the importance of active intervention of G-CSF use to prevent recurrent SNE and improve clinical outcomes in patients with breast cancer who receive AC-based chemotherapy.

Na Yeon Kim, Sohyun Park, Eun Joo Jeong, Hyun Kyung Sohn, Da Som Kim and Ji Eun Kang. J. Kor. Soc. Health-syst. Pharm. 2022;39:57-68. https://doi.org/10.32429/jkshp.2022.39.1.004