著者
大嶋 繁 原 彩伽 阿部 卓巳 秋元 勇人 大原 厚祐 根岸 彰生 冲田 光良 大島 新司 井上 直子 沼尻 幸彦 小川 越史 齋木 実 小林 大介
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.137, no.5, pp.623-633, 2017 (Released:2017-05-01)
参考文献数
20
被引用文献数
5

Pharmacists applied deprescribing, which is a process for the rational use of drugs, for 13 at-home patients. The standard used for the rational use of drugs was the “Guidelines for Medical Treatment and Its Safety in the Elderly” (the Guidelines). The results of the deprescribing were discussed with physicians to determine prescriptions. After the prescription change, activities of daily living (ADL) and QOL were assessed using the Barthel Index and SF-36v2, respectively. Potentially inappropriate medications (PIMs) were detected in 10 of the 13 patients (76.9%). This detection rate is higher than previous PIM detection rates of 48.4% and 40.4% reported in prescriptions for home-care patients in Japan under the Beers and STOPP/START criteria. The Guidelines appeared useful as a decision support tool for deprescribing. The patients continuing the changed prescriptions showed no decrease in ADL or QOL after deprescribing, suggesting its rationality. The 10 measurement items of the Barthel Index were all suitable for evaluating the physical conditions of the patients. Meanwhile, SF-36v2 includes many items, but few indexes were directly applicable.
著者
山王丸 靖子 秋山 隆 沼尻 幸彦 寺尾 哲 和田 政裕
出版者
日本食生活学会
雑誌
日本食生活学会誌 (ISSN:13469770)
巻号頁・発行日
vol.26, no.4, pp.197-204, 2016 (Released:2016-04-27)
参考文献数
26
被引用文献数
3

Nowadays, in Japan, there is a high ratio of women who complain of chilliness. In this study, the effects of lifestyle and frequency of certain types of food intake on chilliness among female college students were studied using a questionnaire (n=215). According to the diagnostic criteria for chilliness, 42% of all responders routinely experienced chilliness. The influence of food and lifestyle habits on chilliness was ana lyzed using logistic regression analysis. First, exploratory factor analysis was per formed on 41 items about food and life habits. These items combined into 4 factors with a few items forming their own one-item factor. Using logistic regression analysis, these factors, together with BMI (Body Mass Index), were examined to see whether they predicted the relative risk of respondents for chilliness. The factors “Eating more vegetables”, “Eating more noodles” and “Feeling stress” were shown by the regression analysis to be positively related to experiencing chilli ness (p<0.05). An increase in the consumption of noodles by one level of intensity on a Likert scale of one to five is associated with a 4.75 relative risk of chilliness (given average levels of BMI); an increase in stress by one level (on a one to five Likert scale) is associated with a 3.07 relative risk; an increase in the consumption of vegeta bles by one level (one to five Likert scale) is associated with a 5.56 relative risk. BMI was negatively related to chilliness (p<0.05). These results suggest that to prevent chilliness women should avoid primarily eat ing vegetables and foods like noodles (which are typically eaten by themselves, unlike rice, which is usually part of a balanced meal). Eating a variety of nutritionally-bal anced foods will help with chilliness as well as maintaining a proper weight. The ne cessity of reducing stress is also clear.
著者
堀井 徳光 井上 直子 大嶋 繁 冲田 光良 秋元 勇人 根岸 彰生 大島 新司 沼尻 幸彦 小林 大介
出版者
一般社団法人 日本老年薬学会
雑誌
日本老年薬学会雑誌 (ISSN:24334065)
巻号頁・発行日
vol.1, no.2, pp.28-33, 2018-09-30 (Released:2019-10-07)
参考文献数
19

In the Integrated Community Care System, pharmacists are expected to play a central role in addressing patients’ drug problems. Therefore, it is necessary to know the patients’ drug problems as well as the occupations of professionals in solving these problems, and to clarify the problems to be preferentially resolved. Thus, we surveyed care managers working in a district near the Josai University pharmacy about their drug problem recognition and the professionals who solved these problems. Many of the care managers identified “the patient has leftover drugs” and “the patient has declining cognitive abilities” as drug problems. Many of the care managers expected pharmacists to solve the problems of “the patient has leftover drugs” and “the patient does not understand the dosage regimen.” “The patient has leftover drugs,” “the patient needs allotting of drugs to ensure adherence,” “the patient does not understand the significance of the meditation,” and “the patient does not understand the dosage regimen” are drug problems in which pharmacists should preferentially intervene and play a role in the Integrated Community Care System.
著者
山田 沙奈恵 沼尻 幸彦 和田 政裕 山王丸 靖子
出版者
特定非営利活動法人 日本栄養改善学会
雑誌
栄養学雑誌 (ISSN:00215147)
巻号頁・発行日
vol.76, no.5, pp.109-120, 2018-10-01 (Released:2018-11-06)
参考文献数
32
被引用文献数
2

【目的】我が国の健康食品について,医療従事者を含む消費者が持つ知識・認識等について調査し,表示認識およびニーズの実態を明らかにすることを目的とした。【方法】2015年1月~8月に一般消費者,薬剤師,管理栄養士,助産師を対象(合計有効回答数:1,502名)に,健康食品に対するイメージ,知識・認識等に関する無記名自記式質問紙調査を実施し,集団間の違いについて包括検定および対比較(χ2 検定,steel-dwass法)により検討した。本調査における健康食品とは,「健康の維持向上を目的としたすべての食品」と定義した。【結果】健康食品の知識は,一般消費者よりも医療従事者の正答率が高い傾向を示し,一般消費者と管理栄養士との間では有意な差が認められた。一般消費者と比較して医療従事者のポジティブイメージは有意に低い項目が多く,ネガティブイメージは有意に高い項目が多かった。どの集団でも,健康食品の認可機関としては「国」を希望する者が最も多く,機能性表示としてふさわしい段階は「健康増進に効果があること」,「病気のリスクを低減すること」の順となった。安全性に関するニーズは助産師が高い傾向を示した。【結論】一般消費者と医療従事者及び,医療従事者間にも健康食品に対するイメージ,知識・認識等には差が見られ,医療従事者であっても知識は十分ではなかった。表示の認可機関と機能性表示に対する期待の程度は,医療従事者の専門性により異なる傾向を示した。
著者
井上 直子 安田 和誠 森 勇人 秋元 勇人 大原 厚祐 根岸 彰生 冲田 光良 大島 新司 沼尻 幸彦 大嶋 繁 從二 和彦 小林 大介
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.81-90, 2018-12-10 (Released:2019-01-19)
参考文献数
11

Drug dispensing is a statutory and designated duty of a pharmacist. We aimed to examine the changes in the nature of drug dispensing using a text mining method. Our corpus consisted of text documents from “Chozai Shishin”, the most standard manual for dispensing drugs in Japan, Editions 1 to 13 (Japan Pharmaceutical Association), and we used the KH Coder software for text mining. We constructed networks showing the association between frequent word co-occurrence and edition number, and co-occurrence relations for frequent words in each edition. We found that “patient” superseded “dispensing” as a frequent term over time. “Dispensing” was another frequent term with a highly centralized node in each edition. Accordingly, we targeted the term “dispensing” for network analysis to depict its co-occurrence relations. We found that the range of related words for “dispensing” broadened from “preparation” and “compounding” to include “patient adherence instructions”, “assessment”, “medical treatment”, and “information provision”. Accordingly, we concluded that the content of “dispensing”, which is a pharmacist’s duty, has expanded from the duties of “dispensing drugs” to include “responding to patients” within the definition of “dispensing”, and we were able to present this finding as objective data by using the mechanical method known as text mining.
著者
遠藤 敏成 久津間 信明 小林 大介 沼尻 幸彦 上田 秀雄 駒田 冨佐夫 齋藤 侑也 森本 雍憲
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.28, no.6, pp.615-622, 2002-12-10 (Released:2011-03-04)
参考文献数
6

When a pharmacist informs a patient of premonitory symptoms to prevent any adverse effects of each prescribed medicine, such instructions are often to complicated to be understood by the patients, mainly due to the fact that numerous medicines have a wide range of adverse effects, and furthermore, an such adverse effects have many premonitory symptoms. We attempted to make a computer aided adverse effect informing program to assist pharmacists. This program arranges the symptoms according to their order of importance, and gives the probable information of adverse effect, which is not mentioned in the package leaflet. The most frequent and common premonitory symptoms of adverse effect were suggested to be fever and fatigue as a result of running the program when many individual patient prescription data were inputted.The incorporation of this program into the computer system that manages the patient's medicine history will be useful for pharmacists to inform patients of understandable premonitory symptoms and to monitor any potential adverse effect.
著者
小林 大介 久津間 信明 中山 惠 鵜近 篤史 鈴木 暢之 佐次田 優子 遠藤 敏成 上田 秀雄 沼尻 幸彦 駒田 富佐夫 齋藤 侑也 森本 雍憲
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.28, no.6, pp.571-575, 2002-12-10 (Released:2011-03-04)
参考文献数
10
被引用文献数
2 1

When a novel additional adverse effect is reported for a marketed medicine, the medical information leaflet has to be revised to inform physicians and pharmacists of this. Pharmacists are responsible for informing patients of early warning symptoms to avoid the subsequent appearance of severe adverse effects. However, at present, patients may suffer from severe adverse events because such symptoms may remain unrecognized until the medicine is on the market. As a result, investigations to predict and prevent novel additional adverse effects of medicines are required. In this study, we investigated a novel additional adverse effect classified as a pharmacological effect based on the drug safety update (DSU). As a result, skin disorders including toxic epidermal necrolysis and Stevens Johnson syndrome, and pseudomembranous colitis have become evident as additional adverse effects of antibiotics, with a high incidence. In addition, neuroleptic malignant syndrome and aplastic anemia have also been reported as adverse effects of central nervous system agents.Therefore, it is important to provide patients with information about the early warning symptoms related to such adverse effects, even though such adverse effects are not contained in the patient information leaflet.
著者
井上 裕 森田 夕貴 斉藤 麗美 天野 留美子 沼尻 幸彦 金本 郁男 杉林 堅次
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.33, no.1, pp.30-35, 2014-06-10 (Released:2015-08-11)
参考文献数
17

In 2012, the external prescription rate was 66.1% of the national average. A dispensing doctor is recognized by the escape clauses of Article 22 of the Medical Law, Article 21 of the Dentist Medical Law, and Article 19 of the Pharmacists Act. In this study, the medicine inventories of dispensing doctors and pharmacies were compared. The medicine supplies of 7 dispensing doctors and 11 pharmacies in Saitama were classified according to the medicinal effects. We also investigated the conditions in which high-risk medicines, poisons, or drugs were stored. The average number of medicines in the medicine inventory of a dispensing doctor was 262.3 (range : 99, 439), whereas the average number of medicines in the medicine inventory of a pharmacy was 1179.7 (minimum, 275 ; maximum, 1980). Further, among these medicines, there were an average of 41.0 high-risk medicines (minimum, 18 ; maximum, 76) in the inventory of a dispensing doctor and an average of 176.7 high-risk medicines (minimum, 5 ; maximum, 299) in the inventory of a pharmacy. In addition, poisons (average, 0.3) and narcotics (average, 0.9) were found to be stored by dispensing doctors. The study results revealed that pharmacies as well as dispensing doctors stored high-risk medicines. The dispensing doctor may be indirectly associated with critical medical accidents to need cross-check by pharmacist exceedingly high-risk medicine. Thus, for patients to use medicines appropriately and for them to be reassured of the safety of medicines, only professionals such as pharmacists, rather than doctors, should dispense medicines.