著者

池谷 怜 此村 恵子

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.47, no.9, pp.453-463, 2021-09-10 (Released:2022-09-10)

参考文献数

9

被引用文献数

1

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This retrospective cohort study aimed to evaluate the utility of the family pharmacist system using administrative claims data. The eligible cohort was detected from the JMDC claims database; it was divided into two groups-those using the system (users) and those not using the system but receiving general pharmaceutical management (non-users) in health insurance pharmacies. The calculation of chouhukutouyaku-sougosayoutou-boushi-kasan-which consisted of the calculation other than the adjustment of leftover drugs and the calculation related to the adjustment of leftover drugs-was considered an indicator of the system’s utility. This indicator was compared between the two groups from April 2018 to March 2020, and a generalized linear model (link, identity; distribution, binomial) was developed to estimate the adjusted absolute risk differences (ARDs) and 95% confidence intervals (CIs). A total of 162,340 patients were included in the eligible cohort (users [n = 1,214]; non-users [n = 161,126]). Chouhukutouyaku-sougosayoutou-boushi-kasan was examined among 177 participants (14.6%) of users and 9,052 (5.6%) of non-users (adjusted ARD, 5.1; 95% CI, 3.2 to 7.1). Furthermore, the adjusted ARD was 3.1 (95% CI, 1.6 to 4.7) and 2.4 (95% CI, 1.0 to 3.7), for the calculation other than the adjustment of leftover drugs and the calculation related to the adjustment of leftover drugs, respectively. The current study reported that the family pharmacist system was related to the increase in the calculation of chouhukutouyaku-sougosayoutou-boushi-kasan. Therefore, it is suggested that the system was useful for facilitating pharmaceutical management in health insurance pharmacies.

著者

此村 恵子 森井 康博 赤沢 学

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.142, no.4, pp.413-420, 2022-04-01 (Released:2022-04-01)

参考文献数

17

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Pharmacists play a key role in optimizing the safe and effective use of medicines in the super-aged society in Japan. Recently, community pharmacists' role has been transformed and expanded to provide patient-centered care. This study aimed to simulate a change in the demand for community pharmacists resulting from this shift in their role, from 2019 to 2035. The change in demand was estimated by the number of prescriptions obtained from publicly available sources of information. The number of required community pharmacists was calculated separately for full-time and part-time pharmacists and the pharmacists engaged in home medical care. This number was calculated using the estimated demand, the number of prescriptions dispensed per day, and annual working days. We evaluated the effect of changes in the working conditions, which include changes in the dispensing process time, rate of part-time staff and their work time, and number of home medical care per day, on the number of community pharmacists. When the number of prescriptions dispensed per day was set at 19.8, the demand for community pharmacists was estimated as 188,314 in 2035. Furthermore, due to the changes in the working conditions, the demand is expected to change from 153,362 to 266,944. Although the increasing provision of drug information time leads to an increasing number of pharmacists, combining it with work efficiency services could prevent or decrease it. The optimal supply and demand balance of community pharmacists should be determined by both, promoting pharmaceutical care services and improving work efficiency.

著者

此村 恵子 金井 紀仁 上田 彩 草間 真紀子 赤沢 学

出版者

一般社団法人 日本臨床薬理学会

雑誌

臨床薬理 (ISSN:03881601)

巻号頁・発行日

vol.47, no.5, pp.189-199, 2016-09-30 (Released:2016-12-16)

参考文献数

18

被引用文献数

1

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Objective: A policy survey regarding the development of hospital formulary and promotion of appropriate drug use in hospital settings was conducted.Methods: We have conducted a similar survey every five years since 2000 to monitor hospital policy changes. This year, we selected 500 hospitals with 200 or more beds from a list of 2,583 national hospitals for 2015. A stratified random sampling method was used to identify 250 hospitals that adopted the diagnosis procedure combination (DPC)-based payment system and those that did not (250 non-DPC hospitals). Questionnaires consisting of eight items were posted to individuals who had primary responsibility of drug management, during a study period from November 2015 to January 2016.Results: A total of 175 responses was returned (overall response rate 35%), with response rates of 42% for DPC hospitals and 28% for non-DPC hospitals (including general and mental hospitals). Inclusion of generic drugs in hospital formulary increased by 10 points from 10% in the 2010 survey. Approximately 85% of the hospitals developed their own formulary lists. According to the responses, the most important factors to select formulary drugs were effectiveness, safety, novelty, quality, formulation, price and cost-effectiveness. This trend was almost the same as that reported in the 2010 survey. Eighty-nine percent of DPC hospitals, 73% of general hospitals, and 45% of mental hospitals had specific criteria to select formulary drugs. Many hospitals reported that generic drugs were added to the formulary immediately after they became available in the market.Conclusion: The results of this survey suggested that many hospitals became more cost-conscious due to social pressure of cutting medical expenditure. The findings that many hospitals already developed formulary lists, had standardized formulary review process, and switched to generic drugs showed increased awareness of appropriate drug choices and uses. However, very few hospitals introduced cost-effectiveness analysis in the review process, and it might take time before this analysis becomes commonly used.