著者

早川 裕二 溝神 文博 長谷川 章 天白 宗和 間瀬 広樹 小林 智晴

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.5, no.1, pp.1-6, 2022 (Released:2022-04-21)

参考文献数

17

---

Polypharmacy involves problems related to not only the use of many medications but also improper drug administration. The questionnaires used at the time of admission were retrospectively investigated to determine the number of drugs that patients would like to reduce. Most patients wanted to reduce the number of drugs prescribed to them. The target patients were those who visited the National Center for Geriatrics and Gerontology and met the criteria during the hospitalization period from August 1, 2020 to November 30, 2020. In all, we selected 313 patients: 68 in the drug reduction group and 245 in the non-drug reduction group. We investigated the extent of desired reduction and the patient background factors for both groups. Multivariate analysis revealed significant differences between the groups in family management with an adjusted odds ratio of 2.62 (95% CI 1.30-5.29, P < 0.01) and in the number of drugs with an adjusted odds ratio of 1.20 (95% CI 1.09-1.31, P < 0.01). Analysis of the area under the receiver operating characteristic curve(AUC)was carried out for all the cases. The cutoff for self-management was six points (AUC = 0.73, 95% CI 0.64-0.81, P < 0.01). Patients on polypharmacy who are taking more than six drugs, especially family-managed patients, often wish to reduce the number of medications and prescribe it from a pharmaceutical point of view. This aspect needs to be reviewed further.

著者

古田 勝経 溝神 文博 宮川 哲也 森川 拓 永田 治 永田 実 福澤 悦子 油座 マミ 櫻井 淳二 庄司 理恵 藤井 聡

出版者

一般社団法人 日本医療・病院管理学会

雑誌

日本医療・病院管理学会誌 (ISSN:1882594X)

巻号頁・発行日

vol.50, no.3, pp.199-207, 2013 (Released:2013-09-10)

参考文献数

15

---

褥瘡は寝たきり高齢者に多い慢性創傷であり,難治であり医療費や患者の生活の質に影響を与える。チーム医療で治療を行うことが治癒促進につながるが薬剤師の積極的な関与が少なく本来のチーム医療の有用性は示されていない。そこで,本研究では,薬剤師の積極的関与のある褥瘡チーム医療治療群と褥瘡ハイリスクケア加算群とで,褥瘡治癒に関する費用対効果を検討した。患者数は(褥瘡チーム医療治療群 / ハイリスクケア加算群) 295名/80名,DESIGN点数の減少を用いた費用対効果の比較では総費用(円/点) 6,709 / 24,549で,褥瘡チーム医療治療群はハイリスクケア加算群に比べ約4分の1におさえられていた(p<0.001)。

著者

神保 美紗子 市原 千花 内海 貴大 谷口 誠哉 北川 英俊 溝神 文博

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.6, no.2, pp.21-28, 2023-06-30 (Released:2023-07-22)

参考文献数

14

---

In recent years, there have been many reports on how polypharmacy is addressed in hospitals through multidisciplinary collaboration; however, there are few reports on how pharmacies are addressing polypharmacy among outpatients in collaboration with physicians and hospital pharmacists. In September 2020, physicians, hospital pharmacists, and pharmacy pharmacists collaborated to establish a model for dealing with polypharmacy in community pharmacies (creating a polypharmacy assessment tool and conducting regular joint conferences between hospitals and pharmacies). In this study, the actual state of polypharmacy intervention by pharmacy pharmacists after the introduction of this model was investigated. The study was conducted at three community pharmacies over a 6-month period. A tool-based polypharmacy assessment of patients aged 65 years or older taking six or more prescription drugs revealed that 97% (65/67 patients) experienced polypharmacy issues and in 44.8% (30/67 patients), the pharmacist considered it necessary to report the patient’s condition to the physician. Of the 35 informational letters reported to physicians, 28 were prescription suggestions, with a prescription change rate of 46.4% (13/28). The improvement rate of adverse drug events after pharmacist intervention was 54.0% (27/50), and the improvement rate of adherence was 66.7% (24/36). These results indicate that the model for dealing with polypharmacy in community pharmacies contributed to the improved ability of pharmacy pharmacists to intervene, because of the establishment of criteria for evaluating polypharmacy and because hospital-pharmacy joint conferences, which are key to community collaboration, were continuously held.