l
l l 1989~93 l 1985~86 / l 1976~80
l
l 2010~2016
l 2016~2019member of ACPE International Commission() l
2014~2016(ISPOR)
l 2005~(FIP)(WPPF)
l 2003~ //
l 2007~2009
l 2007/ 5
l 20052006
l 19932004
: 1. 2.
l
1.
2.
3.
2013(FIP) l Towards a Future Vision for Complex Patients _
Integrated Care in a Dynamic Continuum
l _ l
l Biological complexities () l Medically complex () –
Pharmacologically complex ( 5) l Socioeconomic factors () l
Cultural factors () l Geographical complexities () 4
Ø
Ø
Ø
X Nitrostat 0.6mg nitroglycerin 1# PRN
X Plavix 75mg clopidogrel 1# QD
X Imdur 60mg isosorbide 5- mononit 1# QD
X Dipyridamole 25mg "standard dipyridamole 1# TID
X Solantin 25mg dipyridamole 1# TID
X Inderal 10mg propranolol 1# TID
X Norvasc 5mg amlodipine 1# QD
X Co-diovan 80/12.5 valsartan 1# QD
X BPH, Doxaben XL 4mg doxazosin 1# HS
X Crestor 10mg Rosuvastatin 1# QD
X Arcoxia 60mg Etoricoxib 1# QD
X Bromarone100mg "H.C" Benzbromarone 1# QD
X Deflam-k F.C. Tablets 50mg Diclofenac potassium 1# TID
X Conicine tablets 0.5mg "H.H" Colchicine 1# TID
X Strocain 5mg Oxethazaine 1# TID
X Tigawet tablets
l 3
l 2 5 15 /
l 8
: Colchicine
l 105 Colchicine 0.5 mg QID 7 Strocaine 1 tab QID 7 101971022
colchicine QID1026 colchicine 0.5 mg QID 14 daysStrocaine 1 tab QID
14 Gascon 40 mg QID 5 Prochlorperazine 5 mg QID 5 Azulene 2 mg 1#
QID 5 Loperamide (Imodium) 2 mg PRN
l 1027~31Imodium 111 26:30 colchicine QID116
l colchicine11 10
9
10
20156 3
l
11
(2010~2016)
2015 1(1021010309)90 2213
190 508 190 7
l
*** 2013~15170 8,000 ***
2010>200 →100
Ø 50%
:53.9±16.2 :44.8±18.2 - 17%
: 60.97±28.72 : 48.54±27.01 -20.4%
61,512±483 52,948±508 - 14% -$42,528,824
56,896±489 47,948±447 - 15.7%
-$71,924,024
-$63,255,767
14,377±16,961 14,024±69,969 -3%
: 13,993±21,136 : 12,483±19,147 -10.8%
( : )
Ø__1,000 ()
16
1. 2. _____ _____ 3. 4.
A1. 2 A2. 2 A3. 5 A4. 8+++
1. 65A1 B2 2. /A1 B2 3. A1 B2
B1. B2. B3. B4. () B5.
2013~2014 l/
l 2 l 2 l 5 l 8( + +)
l
Anticoagulation clinic Asthma-allergy clinic / Cardiac clinic
Cardiovascular risk factor management clinic Diabetic nephropathy
clinic Geriatrics clinic Heart failure clinic Human
immunodeficiency virus (HIV) clinic Inflammatory bowel disease
clinic Lipid clinic Medication management service Medication
therapy management (cardiology) clinic Pediatric epilepsy
ambulatory clinic Pain clinic Percutaneous coronary intervention
clinic Peritoneal dialysis clinic Rheumatology monitoring clinic
Smoking cessation clinic Transplant clinic
()→ ()
06/2016
1. 2. 3. 4. / ()
1.
2.
1. 2. 3. 4.
1
1VIS
broad narrow
Balance specialization with the risk of dis-continuity of care.
Remember to treat the patient not the condition.
ü ü ü
ü ü ü ü ü
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Pharmacist-only certification 2012
Ambulatory Care Pharmacy () Board of Pharmacy Specialties
(BPS) Board Certified Ambulatory Care
Pharmacist (BCACS) NCCA*
Nutrition Support Pharmacy () Board of Pharmacy Specialties
(BPS) Board Certified Nutrition Support Pharmacist (BCNSP)
NCCA*
Oncology Pharmacy () Board of Pharmacy Specialties
(BPS) Board Certified Oncology Pharmacist(BCOP) NCCA*
Psychiatric Pharmacy () Board of Pharmacy Specialties
(BPS) Board Certified Psychiatric Pharmacist(BCPP) NCCA*
Pharmacotherapy () Board of Pharmacy Specialties
(BPS) Board Certified Pharmacotherapy
Board Certified Pharmacotherapy Specialist (BCPS) with Added
Qualifications in Cardiology
NCCA*
Board of Pharmacy Specialties (BPS)
Board Certified Pharmacotherapy Specialist (BCPS) with Added
Qualifications in Infectious Diseases
NCCA*
23
Multidisciplinary Certifications - Available to pharmacists
Program Certification Body Credential Earned Certification Body
Accredited By
Anticoagulation Care () National Certification Board for
Anticoagulation
Providers (NCBAP) Certified Anticoagulation Care Provider
(CACP)
Asthma Education () National Asthma Educator
Certification Board (NAECB) Certified Asthma Educator (AE-C)
Cardiovascular/Life Support American Heart Association Advanced
Cardiovascular Life Support (ACLS)
American Heart Association Pediatric Advanced Life Support
(PALS)
Clinical Pharmacology American Board of Clinical
Pharmacology (ABCP) Accredited in Applied Pharmacology (AP)
Diabetes Education () National Certification Board for Diabetes
Educators
(NCBDE) Certified Diabetes Educator (CDE)
Diabetes Management - Advanced
Heath Information Technology Health IT Certification Certified
Professional in Electronic Health Records (CPEHR)
Health IT Certification Certified Professional in Health
Information Technology (CPHIT)
Health IT Certification Certified Professional in Health
Information Exchange (CPHIE)
24
25
()
()
()
()
()
()
()
l
Robert J. Cipolle, Linda M. Strand, Peter C. Morley.,
Pharmaceutical care practice the clinician’s guide. 2nd ED. New
York: McGraw Hill; 2004. 2010;102:S33-S38. 2010;102:S59-S69.
28
l
l
http://www.tpech.gov.tw/lp.asp?ctNode=13750&CtUnit=7952&BaseDSD=7&mp=109011
l l
33
Ø 34
Ø Ø( ) Ø
35
Ø
(1) (2) (3) (4) Ø () Ø ( ) Ø
36
37
1. (GPP) 1.1 (GDP) 2. 2.1
3.
4. 4.1 4.1.1
5.
5.1
5.4
5.5
2015 (I)
8.
9.
10. 10.1 10.2 10.3 10.4 10.5 10.6
11.
17. 18. 19. 20.
21. 22. 23. 24.
(II)
40
1. 32 (24hr+8hr) 2. 3. _8 4. _8 5. _ 8 6. _8 7. _8 8. _3 9. 1_2432
10.2_ 8
l ()
l //TFDA: 1000/ l : : 1200/ l : 600/
l l /TFDA: : 700/ l : : 2000/6 : 200//3
l l : : 100, 8/, , l TFDA: /: 200/ l / : 300/ 600 / l ():
300/
41
ü 42
l 22
l / AABB( )
43
l : (1) [ IC(//) ]
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l
l
l GDP lGPP ü
ü ü
101 03 28 10
101 10 24
7 8 ( )
( )
( )
2
3 6.,1 2,
4 2.
4 5. ,
2+2+2+2/ 4x7 = 8/28 = 0.286
6+6+6+5/ 4x7 = 23/28 = 0.822
2. ()
:53.9±16.2 :44.8±18.2 - 17%
: 60.97±28.72 : 48.54±27.01 -20.39%
61,512±483 52,948±508 - 14% -$42,528,824
56,896±489 47,948±447 - 15.7%
-$71,924,024
-$63,255,767
-$66,366,180
14,377±16,961 14,024±69,969 -3%
: 13,993±21,136 : 12,483±19,147 -10.79%
( : )
5,098,000 12,660,552
= 1 : 2.5
32,255,000 24,441,274
= 1 : 0.8
34,012,000 42,528,824
= 1 : 1.3
49,302,000 71,924,024
= 1 : 1.5
51,362,000 63,255,767
= 1 : 1.2
41,273,340 66,366,180
= 1 : 1.6
3.–
U tility
Fig.4: EQ-5D-5L index values at second and sixth visit indicating
enhancement of HRQoL. *p value < 0.001
. Mean:0.61 (SD:0.25)
0.78 (0.18)*
.55000
.60000
.65000
.70000
.75000
.80000
u 4.3(1~5) u1.4( - 2~+2) u 8.6( 0~10) u 4.2(1~5)
52
53
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–
…
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