著者

櫻井 秀彦 恩田 光子 野呂瀬 崇彦 柳本 ひとみ 古田 精一

出版者

日本社会薬学会

雑誌

社会薬学 (ISSN:09110585)

巻号頁・発行日

vol.35, no.1, pp.23-33, 2016-06-10 (Released:2016-07-06)

参考文献数

51

被引用文献数

2

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In addition to the notion of promoting generic drugs to lower pharmaceutical costs, another approach that has gained attention as vital to policy reform is that of utilizing health insurance pharmacies to decrease over-prescription and surplus of drugs. Such a move would perforce require separating medical and dispensary practices. There is increased need for more efficient provision of pharmaceuticals, including proper inventory control, outpatient clinics that function as family pharmacies, and support of home-bound patients’ medication regimens. However, chronic ailments in particular tend to lack subjective symptoms, and decreased intake of medication and surplus medication compound to make these larger policy issues difficult to solve. This has led to the Revised Dispensing Service Fee changes in 2012 and 2014 putting stricter controls on medication regimens and checks of surplus medication. This research examines in parallel the issues of patient satisfaction and loyalty alongside adherence to medication regimens, issues that have been previously treated in isolation in the existing literature. By comparing their respective inter-relationships and influencing factors, we conducted a re-analysis of the relationship between insurance pharmacies and patients. We collected data from patients with diabetes and high blood pressure via an Internet survey. Responses on loyalty, patient satisfaction, overall perceived quality, and degree of medication adherence were obtained, as well as responses on the factors believed in a cross-sectional sense across research disciplines to contribute to the above, and the results measured on a quantitative scale. Path analysis was then used, with a model defined using overall perceived quality as a parameter and measuring the degree of satisfaction, loyalty, and medication adherence. In addition, a multiple-group analysis was simultaneously performed. Although there was variance by ailment in terms of patient satisfaction and loyalty, factors contributing to perceived quality were the strongest, followed by the rating of the prescribing doctor. However, for adherence, only self-efficacy and prescribing doctor rating contributed. Ultimately, no correlation was found between patient satisfaction, loyalty, and adherence, and the contributing causes were found to vary, so improving these various vectors would seem to require respectively differing strategies. In terms of medication adherence, the results suggested the need for strategies to increase patients’ self-efficacy, partner with prescribing doctors, and improve the perceived rating of prescribing doctors; different quality improvements are needed by medical area, whether medicine or dispensary practice.

著者

櫻井 秀彦 古田 精一

出版者

生活経済学会

雑誌

生活経済学研究 (ISSN:13417347)

巻号頁・発行日

vol.43, pp.1-12, 2016 (Released:2016-09-30)

参考文献数

33

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Improving patient satisfaction is a goal of many pharmacies in Japan. However, it has been shown that in the case of chronic diseases, the outcomes of medical treatment are not always clearly perceivable, and may not necessarily lead to patient satisfaction. Issues such as reduced medication adherence and unused drugs have been indicated. In this study, we simultaneously measured the degree of patient satisfaction and medication adherence, issues which have been handled separately in previous studies. We then investigated influential factors. A questionnaire survey was conducted on out-patients in pharmacy. Patient satisfaction and medication adherence as well as factors considered to affect these parameters were measured with quantitative scales. Path analysis was performed to examine differences in degrees of influence on satisfaction and medication adherence with multiple group analysis of each patient attribute and disease group. The patient satisfaction level was affected by understanding of effect and medical staff. The adherence scale was most affected by burden followed by understanding of effect. Ultimately, in most cases, no correlation was found between patient satisfaction and adherence, and the contributing causes were found to vary, so improving these various vectors would seem to require respectively differing strategies.

著者

柳本 ひとみ 櫻井 秀彦 古田 精一 黒澤 菜穂子

出版者

一般社団法人 日本在宅薬学会

雑誌

在宅薬学 (ISSN:2188658X)

巻号頁・発行日

vol.6, no.1, pp.11-26, 2019 (Released:2019-05-20)

参考文献数

22

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薬剤師の在宅業務において,薬物療法に有益な業務と課題を探索することを目的とし,web アンケート調査を行った.回収数は208 名であった.回答は5 件法とし,属性により層別化し比較を行った.「薬剤師が行う業務確認項目」および「患者/家族あるいは多職種からの情報確認項目」について,因子分析およびクラスター分析により回答群を分類し,属性と関連付けた.結果として,薬剤師は,「薬効」「副作用」などは確認しているが,患者の日常生活動作の確認には「性別」で差が見られ,患者/家族あるいは多職種からの情報収集の頻度は低くかった.分類された5 つのグループと「性別」は関連があった.薬物療法評価に役立つものは,「アセスメントシートを多職種で共有する」であった.今回示した16 項目の業務例の中で必要と思う業務を実施した場合,薬剤師は,「薬物療法の成果」「患者/家族のQOL」が向上し,「医師や看護師など多職種との連携が良くなる」「医師の治療方針に自分の意見が反映される可能性が高くなる」と考えていた.今後,薬剤師は,在宅業務確認ツール作成や,多職種共通尺度により薬物療法の評価を行うことで業務向上を図る必要がある.

著者

櫻井 秀彦 古田 精一

出版者

生活経済学会

雑誌

生活経済学研究 (ISSN:13417347)

巻号頁・発行日

vol.43, pp.1-12, 2016

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Improving patient satisfaction is a goal of many pharmacies in Japan. However, it has been shown that in the case of chronic diseases, the outcomes of medical treatment are not always clearly perceivable, and may not necessarily lead to patient satisfaction. Issues such as reduced medication adherence and unused drugs have been indicated. In this study, we simultaneously measured the degree of patient satisfaction and medication adherence, issues which have been handled separately in previous studies. We then investigated influential factors.A questionnaire survey was conducted on out-patients in pharmacy. Patient satisfaction and medication adherence as well as factors considered to affect these parameters were measured with quantitative scales. Path analysis was performed to examine differences in degrees of influence on satisfaction and medication adherence with multiple group analysis of each patient attribute and disease group.The patient satisfaction level was affected by understanding of effect and medical staff. The adherence scale was most affected by burden followed by understanding of effect. Ultimately, in most cases, no correlation was found between patient satisfaction and adherence, and the contributing causes were found to vary, so improving these various vectors would seem to require respectively differing strategies.

著者

柳本 ひとみ 櫻井 秀彦 古田 精一 黒澤 菜穂子

出版者

日本社会薬学会

雑誌

社会薬学 (ISSN:09110585)

巻号頁・発行日

vol.37, no.2, pp.91-101, 2018-12-10 (Released:2019-01-19)

参考文献数

29

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Objective: We search valuable information in home medical care settings that impede smooth collaboration among pharmacists, home care physicians, and home care nurses. Methods: We conducted an online survey on 120 physicians and 118 nurses on “areas perceived as overloaded with tasks,” “quality of life (QOL) evaluation of patients,” and “expectations to pharmacists.” We analyzed data using the Mann-Whitney U test and conducted the customer satisfaction (CS) analysis on “stress.” Results: Physicians answered that they had a significantly higher stress on “at night-time/holidays and weekends works” than nurses (p < 0.05). Nurses experienced significantly more stress during “inter-professional collaboration” than physicians (p < 0.01). CS analysis revealed that nurses experienced more stress for items such as “having patients with dementia self-inject correctly,” etc. Both physicians and nurses evaluated QOL items at a high frequency. Majority of physicians and nurses held high “expectations to pharmacists,” particularly for the eight items related to providing information, managing drugs, and making pharmacological judgments. Nurses had significantly high expectations to pharmacists for “management of supplements taken by the patient” (p < 0.01), “explaining drug effects” (p < 0.001), and “explaining the necessity of prescription revision” (p < 0.01). Discussion: Pharmacists should utilize information on physicians and nurses’ stress as well as understand their expectations to pharmacists to facilitate stronger coordination between both professions and contribute to patient care. In particular, many items were found to cause stress, indicating that support for nurses, who have many expectations to pharmacists, needs to be enhanced.