著者

小倉 史愛 木村 丈司 宇田 篤史 戸田 飛鳥 赤澤 由子 山本 和宏 五百蔵 武士 西岡 達也 久米 学 槇本 博雄 平井 みどり

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.42, no.2, pp.78-86, 2016-02-10 (Released:2017-02-15)

参考文献数

34

被引用文献数

2 5

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Polypharmacy, the co-prescribing of nonessential drugs and inappropriate prescriptions, is a worldwide issue and is a factor affecting the increase in adverse drug reactions, drug-drug and drug-disease state interactions, and the growth in medical spending. In this study, we evaluated the current status of polypharmacy in elderly patients at Kobe University Hospital and the efficacy for screening and intervention against potentially inappropriate medications (PIMs) with the screening tool of older persons' potentially inappropriate prescriptions (STOPP) criteria formulated by a pharmacist. Of 301 study patients, 81 (26.9%) patients with PIMs were identified using the STOPP criteria, and these patients had a significantly higher number of prescribed drugs than other patients. Moreover, there was a correlation between the number of prescribed drugs and the percentage of patients identified using the STOPP criteria. The STOPP criteria identified 125 cases to be PIMs, and the prescriptions were changed for 35 (28%) of them. In 125 cases of PIMs, 61 cases had been strongly recommended prescription changes by pharmacists, of which 32 cases (52.5%) had been changed. Several prescription changes were often associated with the administration of nonsteroidal anti-inflammatory drugs. Based on our findings, we suggest that the STOPP criteria are useful for screening PIMs in Japanese patients and are a helpful tool for managing polypharmacy. The benefits of this approach for pharmacists should be multilaterally evaluated by the assessment of patients and medical economic outcomes in the future.

著者

冨田 猛 山本 和宏 山下 和彦 大本 暢子 槇本 博雄 矢野 育子

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.45, no.12, pp.698-705, 2019-12-10 (Released:2020-12-11)

参考文献数

15

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We began to print the laboratory data of each patient on their in-hospital prescription in April, 2010 and further introduced a prescription checking system associated with laboratory data in December, 2014. This study evaluated the changed prescriptions based on prescription queries and the usefulness of using prescriptions with laboratory data as well as the prescription checking system. We examined the number of changed in-hospital prescriptions after the prescription queries in three periods: before and after using prescriptions with laboratory data (from June, 2009 to November, 2009 and from June, 2010 to November, 2010, respectively), and after the introduction of the prescription checking system (from September, 2016 to August, 2017). Although there were no changed prescriptions based on the laboratory data before using prescriptions with laboratory data, 6.6% of changed prescriptions were based on laboratory data after using prescriptions with laboratory data. In addition, the changed prescription ratio based on laboratory data significantly increased after the introduction of the prescription checking system compared with that after using prescriptions with laboratory data (8.9% versus 6.6%, P = 0.015). In conclusion, using prescriptions with laboratory data and the prescription checking system associated with laboratory data were useful for checking prescriptions effectively in order to avoid adverse drug reactions.

著者

石川 愛子 宇田 篤史 矢野 育子 冨田 猛 阪上 倫行 野崎 晃 西岡 達也 久米 学 槇本 博雄 濱口 常男 岩川 精吾 北河 修治 平井 みどり

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.4, pp.157-164, 2018-04-10 (Released:2019-04-10)

参考文献数

9

被引用文献数

3 3

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Kobe University Hospital created a simplified 14-item protocol for resolving out-of-hospital prescription queries. The protocol was implemented in September 2016 in nine community pharmacies. If prescriptions were changed as per the new protocol or via typical query procedures, we asked community pharmacies to fax the changed prescriptions, and the hospital pharmacists, rather than medical doctors, modified the prescription history. To evaluate the effects of this simplified protocol, we examined the number of changed outpatient prescriptions and administered questionnaire surveys to community pharmacists and hospital-based medical doctors. The ratio of changed to total outpatient prescriptions decreased in January 2017 (4.1%) compared with those in September 2016 (6.4%). Ultimately, more than half of all outpatient prescriptions were changed by the protocol. Drug brand name changes accounted for 52% of the total changes during both September 2016 and January 2017, but the proportion of residual medicine adjustment increased from 12% in September 2016 to 26% in January 2017. Due to the questionnaire survey, 33% of surveyed medical doctors indicated that they knew or had heard of the protocol, and 54% responded that the protocol decreased the burden of addressing outpatient prescription queries. The community pharmacies reported that the burden of clarifying outpatient prescription queries decreased. In conclusion, implementation of the simplified protocol for outpatient prescription queries improved medical efficiency and may help promote cooperative streamlining of community patient pharmaceutical care services.

著者

冨田 猛 野崎 晃 宇田 篤史 山本 和宏 西岡 達也 久米 学 槇本 博雄 矢野 育子 平井 みどり

出版者

Japanese Society of Drug Informatics

雑誌

医薬品情報学 (ISSN:13451464)

巻号頁・発行日

vol.19, no.1, pp.1-7, 2017-05-31 (Released:2017-06-16)

参考文献数

10

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Objective: When responding to questions regarding drug-drug interaction by the medical staff of our hospital, pharmacists previously collected information using some drug databases from Japan and the United States.  The aim of this study was to construct a search system for interaction information using drug databases from both Japan and the United States for streamlining questions and answers regarding drug-drug interaction.Methods: Using the drug databases from Japan and the United States, we collected information on the interaction pertaining to drugs prescribed at Kobe University Hospital.  This information was further assessed for consistency.  Furthermore, we constructed an original search system for interaction information for streamlining questions and answers regarding drug-drug interaction.Results: The difference between information obtained from the databases from Japan and the United States was apparent.  Thus, we concluded that it was necessary to obtain interaction information via a database search that included information from both the countries.  Therefore, our original interaction search system was reconstructed with interaction information collected using databases from both the countries.  We compared the response to questions regarding the previous and present methods using our original search system for interaction information; the time required to obtain the responses was 5.89 and 3.09 min, respectively, and it took lesser time for providing responses than the previous method.Conclusion: We evaluated the usefulness of the original search system for interaction information.  We found that the original system provides a more rapid response to questions compared with the previous method.  We are considering a further upgrade and update for the original system by adding information on drugs not prescribed by our hospital.

著者

伊藤 雄大 髙田 麻季 飯田 真之 宇田 篤史 住吉 霞美 秋山 恵里 丸上 奈穂 丹田 雅明 野間 千尋 山本 和宏 五百蔵 武士 木村 丈司 西岡 達也 久米 学 槇本 博雄 矢野 育子

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.5, pp.236-243, 2018-05-10 (Released:2019-05-10)

参考文献数

18

被引用文献数

2

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Team-based learning (TBL) is an active learning method which has been designed to help students solve problems both by themselves and as a team. In this study, TBL was introduced in the journal club (gathering to read and discuss medical papers) for pharmacists, and its effectiveness was compared with that of a traditional lecture. The subjects, 29 pharmacists at Kobe University Hospital, were randomly allocated to the lecture group and TBL group. The pre-test was conducted two months before the journal club, and the post-tests were conducted immediately and one month after the journal club. There was no significant difference in the background data of the pharmacists between the lecture group and the TBL group. The score differences between the pre-test and the post-test immediately after the journal club were not significant (11.4 ± 2.3 points (mean ± SD) in the TBL group, 8.8 ± 4.2 points in the lecture group, P = 0.14). The post-test scores immediately after the journal club in the TBL group (19.6 ± 0.5 points) were significantly higher compared with those in the lecture group (17.8 ± 1.5 points) (P < 0.01), and the learning effect provided by TBL tended to be maintained one month after the TBL. In conclusion, TBL was an alternative method of the ordinal lecture and may be a useful learning method for pharmacists to read medical papers critically compared with the ordinal lecture.