著者
面谷 幸子 石坂 敏彦 井上 美樹 安井 友佳子 長井 克仁 初田 泰敏 向井 淳治 名徳 倫明
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.20, no.1, pp.12-19, 2018 (Released:2018-06-16)
参考文献数
11

Objective: In conjunction with the introduction of medical fees for pharmaceutical practices in hospital wards, the pharmacy department at Sakai City Medical Center has solely managed PREAVOID and reported the results to the Japan Society of Hospital Pharmacists (JSHP) since 2012.  We investigated the pharmacological management being performed by pharmacists and what knowledge is necessary for the super-aged society according to our PREAVOID reports.Methods: We totaled and analyzed the PREAVOID preventive reports (pattern 2) that were reported to JSHP from April 2014 to March 2016.Results: Elderly people had the highest number of PREAVOID reports (p<0.001).  “Transcription error and incorrect prescription” was the most common cause, followed by “special condition (impaired renal function, etc.)” and “overdose.”  Regarding the elderly generation, the number of reports in the 2-year period was the highest for “special condition” (173 cases, 5.30% ?? ), which was 3.69-times the number for adults (p<0.001).  These results demonstrate that involvement of pharmacists is indispensable for pharmacotherapeutics in generations with greatly differing drug metabolic functions.Conclusion: This survey revealed that adverse effects were caused by inadequate medication.  As “pharmaceutical management” was involved in most reports, these results indicate that it is important to manage pharmaceuticals in hospital wards.  It is possible to improve pharmacological knowledge by sharing and utilizing the analysis results of these PREAVOID reports in order to appropriately medicate elderly patients.  According to this study, pharmacists play a crucial role in medication of the elderly.
著者
井上 美樹 面谷 幸子 安井 友佳子 初田 泰敏 名徳 倫明 石坂 敏彦
出版者
一般社団法人 日本医薬品情報学会
雑誌
医薬品情報学 (ISSN:13451464)
巻号頁・発行日
vol.23, no.1, pp.47-54, 2021-05-31 (Released:2021-06-25)
参考文献数
8

Objective: The prescription-related inquiry process is being simplified in an increasing number of facilities, wherein doctors and pharmacists discuss ambiguous points concerning prescriptions before creating protocols. For making this process more efficient and further promoting appropriate drug use, the doctors and the Department of Pharmacy of our center discussed the permissible range for prescription change reports and determined the prescription items that pharmacists can change based on their own judgment. We analyzed data related to the simplification of the prescription-related inquiry process to verify the effects and issues associated with simplifying this process. Then, we examined the countermeasures that should be taken as a prescription issuer in response to the issue.Methods: The center concluded an agreement with 147 insurance-covered pharmacies in or around Sakai City. We analyzed data related to simplification of the prescription-related process between March 1, 2017, and February 28, 2018.Results: Permissible prescription change reports were classified into eight categories. The total number of out-of-hospital prescriptions issued by the center was 94,785. Among the 147 insurance-covered pharmacies under the agreement, 79 (53.7%) reported prescription changes by fax. In total, 895 prescription changes were reported. The number of reports belonging to each category was as follows: change of dosage/additional descriptions: 312 (33.1%); change to other brands with the same ingredients: 208 (22.0%); and change of the medication duration to reduce unused medications: 168 (17.8%). Calculating based on drug prices, change of the medication duration to reduce unused medications consequently reduced medication costs by 709,452 yen.Conclusion: It is thought that the simplification of inquiry will result in shortening the waiting time for patients and reducing the time burden of prescribing doctors and pharmacists. Also, by analyzing the contents of the inquiries, it was evident that improvements could be made to improve efficiency by devising an electronic medical record system, which can help avoid similar reports in the future. Furthermore, regularly reviewing the simplifications will contribute to providing higher quality medical care. Cooperation and information sharing between pharmacy pharmacists and hospital pharmacists are indispensable and vital in advancing side effects and risk aversion, polypharmacy measures, and improvement of adherence.
著者
向井 淳治 石坂 敏彦
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.15, no.1, pp.37-40, 2013 (Released:2013-06-06)
参考文献数
7

Objective: The number needed to treat (NNT) is an index for determining the number of patients who need to be treated in order to prevent the occurrence of an adverse event when a new treatment instead of the standard one is used.Methods: The properties of NNT were examined by using the geometric distribution formula as the probability for preventing the occurrence of an adverse event in the NNT.Results: When the NNT was enlarged infinitely, the probability for the prevention of an adverse event by NNT was found to be 63.2% (=1−e−1), and the number of patients who needed to show adverse event prevention at the probability of 95% was about 3 times as that of the NNT (Rule of Three).Conclusion: When the effect of new treatment needs to be evaluated based on NNT, one should take these properties of NNT into consideration.