著者

郷 真貴子 川地 志緒里 宇佐美 英績 木村 美智男 吉村 知哲

出版者

一般社団法人日本医療薬学会

雑誌

医療薬学 (ISSN:1346342X)

巻号頁・発行日

vol.44, no.6, pp.280-287, 2018-06-10 (Released:2019-06-10)

参考文献数

18

被引用文献数

3

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A pharmacist outpatient service for patients receiving monotherapy with oral anticancer drugs aims to improve safety and medication continuation through pre-examination interviews. We assess medication adherence and monitor chemotherapy-induced adverse events by referring to patientsʼ complaints of symptoms and their medical diaries. In addition, “unused prescribed medicines” can also be a useful information resource. However, unused medicines are becoming a large-scale problem in Japan, thus leading to lower therapeutic effects and higher healthcare costs. In this study, we interviewed 270 patients (cumulative total: 1,385, monthly average: 153.9) from January 1 to October 31, 2017. Adjusted numbers of unused anticancer drugs were 96 and those of unused medicines for supportive care were 420, including moisturizing creams and steroidal ointments (23.1%), antidiarrheal drugs (18.1%), and antiemetic drugs (8.1%). We calculated the reduction in healthcare costs as JPY 5,045,585.5 (monthly average: JPY 560,621) for all unused medicines and as JPY 4,699,791.6 (monthly average: JPY 522,199) for only unused anticancer drugs. Anticancer drugs went unused because of chemotherapy-induced adverse events (grade 1: 37.3%, grade 2: 60.8%, grade 3: 2.0%) and failure to take them as prescribed. However, the chemotherapy discontinuation rate caused by adverse events was only 6.8% through our continuous interventions. Chemotherapy with oral anticancer drugs needed to be discontinued appropriately in cases of developing grade≧2 adverse events; therefore, unused medicines exist. This pharmacist outpatient service can also lead to major reductions in healthcare costs through management of unused medicines.

著者

松岡 知子 宇佐美 英績 吉村 知哲 高田 裕子 安田 忠司

出版者

一般社団法人日本医療薬学会

雑誌

医療薬学 (ISSN:1346342X)

巻号頁・発行日

vol.37, no.8, pp.487-493, 2011 (Released:2012-08-30)

参考文献数

13

被引用文献数

2 3

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Liposomal-Amphotericin B (L-AMB) may cause hypokalemia. This study was carried out to examine the occurrence of hypokalemia and its primary causes in 74 patients who were administered L-AMB. They were divided into 2 groups regarding the severity of hypokalemia that occurred: Grade 0-2 group: 35 patients (47.3%), and Grade 3-4 group: 39 patients (52.7%). The results of a comparison of the Grade 0-2 group and Grade 3-4 group showed that causes for the Grade 3-4 group were significantly different from those in the Grade 0-2 group, which were a serum albumin level of more than 2.82 mg/dL at the start of the L-AMB administration (p=0.004, OR: 8.711, 95%CI: 2.273-45.823), and a history of hypokalemia before L-AMB administration (p=0.009, OR: 7.859, 95%CI: 1.844-44.109) in the Grade 3-4 group.While combination with trimethoprim-sulfamethoxazole resulted in significant avoidance of Grade 3-4 hypokalemia (p=0.019, OR: 0.233, 95%CI: 0.063-0.750), administration of potassium for preventive or maintenance purposes did not affect the occurrence of hypokalemia (p=0.137, p=0.198). However, for 20 patients with an abnormal serum potassium level (Grade 1 and more) at the start of L-AMB administration, our findings suggested that the preventive/maintenance administration of potassium was indeed effective (p=0.011).It has been proven that L-AMB causes hypokalemia frequently and the primary causes have been clarified. In this regard, it is important to regularly monitor serum potassium levels and adjust them depending on the situation of patients with hypokalemia.

著者

川口 実希 木村 美智男 宇佐美 英績 川地 志緒里 郷 真貴子 池田 義明 吉村 知哲

出版者

公益社団法人 日本薬学会

雑誌

YAKUGAKU ZASSHI (ISSN:00316903)

巻号頁・発行日

vol.139, no.3, pp.483-490, 2019-03-01 (Released:2019-03-01)

参考文献数

22

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This study aimed to clarify the situation of use of health foods by patients and the level of satisfaction of patients in order to make use of information on cases where patients undergoing cancer medication therapy use health foods. Between May 7, 2018 and June 29, 2018, we conducted a questionnaire survey of patients with progressive cancer who were undergoing cancer chemotherapy at Ogaki Municipal Hospital. In addition, we conducted a multivariate analysis of patients who were using health foods and those who were not. The questionnaire items included the objectives of use, product effectiveness and satisfaction, and QOL. The rate of health food use was 81/281 (29.5%). The primary objectives of use were, “to maintain health” (29.8%) and “to alleviate symptoms” (24.0%). The primary sources of information about health foods were “a friend” (50.6%) and “TV” (13.5%). The satisfaction level was 0-3 points in 8.3% of patients, 4-6 points in 38.1% of patients, and 7-10 points in 53.6% of patients. For “stage of illness (recurrence),” the odds ratio was 1.810 (95% CI, 1.040-3.150; p=0.035), and for “QOL value,” the odds ratio was 2.210 (95% CI, 1.220-4.020; p=0.009), indicating that these factors had a significant influence on health food use. Health foods tended to be used in patients who had recurring cancer with low QOL and various symptoms, and friends and other people close to the patient had a large influence on the patient's decision. It was clear that the patients' satisfaction level was high.