著者
恩田 光子 宇鷹 瞳 倉山 慎太郎 山下 啓太 庄司 雅紀 荒川 行生
出版者
一般社団法人 日本プライマリ・ケア連合学会
雑誌
日本プライマリ・ケア連合学会誌 (ISSN:21852928)
巻号頁・発行日
vol.42, no.2, pp.98-102, 2019-06-20 (Released:2019-06-26)
参考文献数
13

目的:薬局及びドラッグストアにおける受診勧奨事例を精査し,セルフメディケーション支援の意義を考察する.方法:薬局薬剤師,ドラッグストア薬剤師・登録販売者(薬剤師等)を対象に調査を実施した.主な調査項目は,回答者属性,風邪様症状の相談での受診勧奨の経験,受診勧奨の内容とした.結果:薬局薬剤師300名,ドラッグストア薬剤師57名,登録販売者56名から回答を得た.薬局薬剤師の87.7%,ドラッグストア薬剤師及び登録販売者の100%が受診勧奨の経験を有していた.84の受診勧奨事例で疑われた疾患は,インフルエンザ,副鼻腔炎,胃食道逆流症等で,結核,マイコプラズマ肺炎,脳梗塞の初期症状の事例等も含まれていた.結論:風邪様症状の相談者に対し,薬剤師等が受診勧奨することにより,適正な一般用医薬品等(OTC医薬品等)の選択のみならず,重大な疾患の早期発見に繋がることが示唆された.
著者
上田 昌宏 高垣 伸匡 恩田 光子 荒川 行生 庄司 雅紀 大森 志保 清水 忠
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.140, no.2, pp.301-312, 2020-02-01 (Released:2020-02-01)
参考文献数
21
被引用文献数
3 2

In Japanese pharmaceutical education, the Model Core Curriculum was revised in 2013 to train pharmacists who can appropriately evaluate literature and use evidence-based medicine (EBM). However, in the investigation of EBM education at pharmaceutical universities in 2015, it was found that literature evaluation was hardly performed in the education of undergraduate students. One of the reason is the lack of EBM lecturers at each universities. Therefore, we adopted team-based learning (TBL) to educate more than 50 undergraduate students on the practical evaluation of literatures and the understanding of EBM concepts. The learning outcomes of this strategy were evaluated using the scores of individual tests before and after the class. As a result, the mean scores on the post-test significantly improved from 4.34 to 6.42 out of 10 total points (p<0.001). We further administered a questionnaire survey regarding the understanding of EBM (the mean score was 4.12). In conclusion, it was suggested that TBL for a large number was effective in EBM education for providing knowledge of literature evaluation and the understanding of fundamental concepts.
著者
恩田 光子 今井 博久 春日 美香 安田 実央 下村 真美子 岡本 夏実 高田 百合菜 七海 陽子 田中 有香 荒川 行生
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.17, no.1, pp.21-33, 2015 (Released:2015-06-28)
参考文献数
37

Objective: To examine the effect of pharmacists’ visits to homebound patients on the elimination of unused drugs.Method: We conducted a survey with pharmacies throughout Japan that provided home-visit service, asking them questions regarding their work with up to five patients (the survey period was from January 15 through the end of February, 2013).  Main survey questions were: (1) whether they managed unused drugs since the start of their home-visit, and (2) how they managed the unused drugs.  For (2), we conducted case studies by asking the pharmacists to choose the case that impressed them most and describe the unused drugs involved, actions taken, and the results.Results: Data on 5,447 patients were collected from 1,890 pharmacies throughout Japan (collection rate: 56.9%).  Pharmacists managed unused drugs from 2,484 patients (45.6%). 1,746 patients (3,590 cases) were qualified for analysis.  In 2,332 cases (65.0%), pharmacist intervention eliminated the incidences of unused drugs.  In 782 cases (21.8%), unused drugs were discarded, while the number of drug administration days was adjusted in 2,623 cases (73.1%).  In 21 cases (0.6%), drugs were both discarded and had the number of days adjusted.  There were others for 164 cases (4.5%).  The total price of the eliminated unused drugs was approximately 6,920,000 yen (4,000 yen/person).  Illnesses that benefited most from the elimination of unused drugs were chronic respiratory failure (16,306 yen/person), and Parkinson’s disease (4,803 yen/person).Conclusion: We confirmed the economic effect of eliminating unused drugs by pharmacists’ home visits.
著者
恩田 光子 今井 博久 正野 貴子 高田 百合菜 藤井 真吾 七海 陽子 荒川 行生
出版者
一般社団法人 日本薬剤疫学会
雑誌
薬剤疫学 (ISSN:13420445)
巻号頁・発行日
vol.21, no.1, pp.1-11, 2016-08-31 (Released:2016-09-27)
参考文献数
25
被引用文献数
2

ほとんどの在宅療養患者には,複数の薬剤が処方されており,政府は薬剤師による在宅ケアへのさらなる参画を推進している.しかしながら,副作用(副作用の疑い)(Adverse Drug Reactions: 以下 ADRs)の発生に関する情報はほとんど存在しない.本研究の目的は,在宅療養患者における薬物治療に伴う ADRs の発生状況,ADRs との関連要因について明らかにすることである.調査対象は全国の保険薬局とし,当該薬局において訪問サービスを実施している薬剤師に対して,訪問対象患者に関する調査票への記入を依頼した.主な調査項目は,患者属性,内服薬の品目数,ADRs の有無とその具体的内容,訪問サービスに係る薬剤師の業務量とした.1,890薬局から5,447人分の患者データを収集した結果,薬剤師が訪問時に ADRs を発見した患者割合は14.4%であった.10件以上報告された ADRs は12症状分類で全体の85.2%を占め,上位5症状分類は,めまい・ふらつき・立ちくらみ等,消化器障害,臨床検査値異常,意識障害,皮膚症状であった.被疑薬は,上位12症状分類のうち7症状分類において,催眠鎮静剤・抗不安剤,精神神経用剤,その他の中枢神経系用薬のいずれかが被疑薬の上位3項目に含まれていた.また,ADRs との関連要因として,患者の性別,居住形態,内服薬の品目数等が抽出された.日本の在宅医療における ADRs の割合は,諸外国と比較し大差はないが,被疑薬に占める中枢神経系用薬の割合が高いことが示唆された.また,ADRs の発生と多剤併用の関連も実証されたことから,医師と薬剤師の協働による中枢神経系用薬の減薬に取り組む必要がある.
著者
恩田 光子 今井 博久 七海 陽子 平野 章光 藤井 真吾 荒川 行生
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.135, no.3, pp.519-527, 2015 (Released:2015-03-01)
参考文献数
18
被引用文献数
2 8

A nationwide survey was conducted to verify relations between the workload of home-visiting service by community pharmacists and outcomes. Data were collected on 5447 patients from 1890 pharmacies. Most (61.9%) pharmacists visited patients' homes twice monthly, spending there a net average of 20.6 work minutes. At the time of the survey, 29.8% of the patients had improvement of adherence compared with at start of home visits; 65.5% had no change, and 1.4% had gotten worse. Similarly, 41.6% had decreased unused medications, 54.4% had no change, and 2.3% had increased. Home-visiting pharmacists found adverse drug events (ADEs) caused by drug administration in 14.4% of their patients. They dealt with 44.2% of these cases by discontinuing administration of the responsible drug, 24.5% by reducing the dosage, and 18.3% by changing drugs, with a total of 88.1% having been improved. Prescription changes intended to correct problems occurred in 37.1% of the patients. In patients whom the pharmacists visited more often, a higher percent had ADEs, had their prescription changed to correct problems, and had improved adherence and unused medications. The average actual work time was longer in patients whose outcomes improved than in those whose outcomes did not. A higher involvement in homecare by pharmacists was found to improve outcomes of drug treatment.
著者
櫻井 秀彦 恩田 光子 高木 美保 中川 明子 我藤 有香 荒川 行生 早瀬 幸俊
出版者
医療の質・安全学会
雑誌
医療の質・安全学会誌
巻号頁・発行日
vol.6, no.1, pp.3-21, 2011

<B>目的</B>:保険薬局に勤務する薬剤師と事務職の組織や職務に対する意識と安全意識を調査し,それらの関連性を職種や他の属性で比較検討した.<br><B>対象と方法</B>:関西圏に基盤を置くチェーン薬局41店舗でアンケート調査を実施した.非管理職の薬剤師(n=180)と事務職(n =127)を対象とし,組織や職務に関する30の質問項目とミス対策などに関する38の質問項目を設定,それぞれ5件法で回答を求めた.職種別に因子分析を行い,抽出された因子を比較検討した後,共分散構造分析と重回帰分析で組織や職務に対する意識と安全意識の関連性について検討した.重回帰分析では,過誤対策委員経験の有無や雇用形態による影響を,ダミー変数を用いて確認した.<br><B>結果</B>:因子分析では,組織や職務に関する設問から5因子が,安全意識に関する設問から5因子が抽出された.薬剤師と事務職では因子の構成項目が若干異なった.共分散構造分析では,薬剤師と事務職ともに組織や職務に対する意識が安全意識に影響を与えていることが明らかとなった.重回帰分析では個々の因子およびダミー変数で影響に違いがあることが明らかとなった.<br><B>考察</B>:安全意識を高めるためには,まず良好な職場風土を醸成し,組織への評価を高めること,次いで職種,雇用形態,過誤対策委員の経験の有無などの違いを考慮した組織管理姿勢を検討する必要性が裏付けられた.
著者
櫻井 秀彦 恩田 光子 中川 明子 藤本 佳乃子 奥田 勅子 岡山 浩之 荒川 行生 早瀬 幸俊
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.3, pp.118-123, 2013 (Released:2013-12-27)
参考文献数
15

Objective: This study quantitatively analyzes the factors causing dispensing errors in community pharmacies and explores the characteristics of these factors and their order of importance.Design and Methods: We collected data records on the contents and causes of dispensing errors as reported between April and July 2009 by a total of 320 pharmacists at 56 stores of two pharmacy chains (15 stores in Hokkaido and 41 stores in the Kansai area).  We focused on the following three types of dispensing error: 1) “measurement error”, 2) “wrong drug dispensing error” and 3) “wrong dosage form specification error”.  We conducted multiple regression analyses and discriminant analyses with occurrence frequency of each type of error as dependent variables and count frequency of each causal factor as independent variables.Results: The result of the multiple regression analyses indicated that the primary causes of the three types of errors in order of strength of the regression coefficients were as follows.  For “measurement error”: 1) pharmacist’s wrong assumption and 2) calculation error; for “wrong dosage form specification error”: 1) insufficient confirmation of prescription and 2) pharmacist’s wrong assumption; for “wrong drug dispensing error”: 1) pharmacist’s wrong assumption and 2) insufficient confirmation of prescription.  The results of the discriminant analysis indicated that only for the discriminant coefficient between “wrong dosage form specification error” and “wrong drug dispensing error” no significant difference in the mean was found (p=0.539).Conclusions: Results show that partly different factors cause “measurement error” as compared with the two other types of dispensing errors.  In addition, while basically the same factors were found to cause “wrong drug dispensing error” and “wrong dosage form specification error,” there was a difference in the order of importance of these factors.  This study uncovered differences in terms of causal factors affecting each dispensing error type.
著者
恩田 光子 兼松 美和 北村 朋子 酒井 隆浩 阪上 久美子 田中 景子 濱畑 有記美 廣岡 輝子 藤井 貴和子 松田 雅史 三木 春奈 真下 博孝 羽田 理恵 荒川 行生
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.127, no.7, pp.1159-1166, 2007 (Released:2007-07-01)
参考文献数
10
被引用文献数
8 8

Access to drug information (DI) needed to evaluate generic product bioequivalence was studied to identify problems with the current status of DI availability and encourage proper use of DI. Ten items were chosen from among the stock of branded products at the University Pharmacy, and five corresponding generics were selected for each item. Conditions of access to information on pharmacokinetic tests and dissolution tests were rated and the assigned ratings compared. In the case of pharmacokinetic parameters obtainable from makers of generic drugs, we also performed Welch's t-test to compare the difference between values reported for branded and generic products. From the standpoint of individual tests, the pharmacokinetic tests yielded higher scores on the whole than did the dissolution tests, and low scores were obtained for the half-life of blood drug concentration (T1/2). We observed a tendency for the adequacy of information to depend more upon the drug item itself than upon the nature of the test. The percentage of tests allowing for comparison with branded products varied from 0%-75% (average 49%). Parameter by parameter, the range of variation was from 35% of Tmax to 63% of Cmax. Factors precluding comparison included insufficient data on branded products, mismatch in assayed chemical species between branded and generic, mismatch between final sampling time in AUCt measurement, dosage inconsistency, and insufficient data on generic products. DI should be provided in a manner that facilitates comparison of information supplied by generic drug makers with data released by makers of branded products.
著者
中 雄介 恩田 光子 山根 有香子 川口 祐司 中野 翔太 荒川 行生
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.18, no.2, pp.81-86, 2016 (Released:2016-09-27)
参考文献数
14

Objective: The subjects of this study were consumers with cold-like symptoms who visited drugstores to purchase OTC drugs.  The purpose was to elucidate the factors that influence the intention of these consumers to consult pharmacists or sellers.Design: Analytic observational studyMethod: We conducted a survey of consumers who visited pharmacies or drugstores for cold-like symptoms.  Pharmacists and registered sellers (hereafter “pharmacists or sellers”) utilized tools to serve them, entering details in customer records.  We handed postcards to these consumers asking them to respond to questions about the prognosis and the degree of satisfaction about the service they had received.  We then used the customer records and follow-up results to perform linear regression analysis with “I would like to consult the pharmacist or seller again” (hereafter “desire for consultation”) as the dependent variable, and the usefulness of the advice and degree of satisfaction about the explanation and service as the independent variables.Results: We analyzed the data of 81 consumers for whom we were able to match the customer records and postcards.  The linear regression analysis indicated that “the usefulness of the advice (coefficient of standardization: 0.73)” affected the desire for consultation most, followed by “the degree of satisfaction about the service (coefficient of standardization: 0.24).Conclusion: We verified that, in self-medication assistance, advice that lets consumers feel the consultation was actually “helpful” by focusing on individual needs, and good customer service were necessary to increase the desire for consultation with pharmacists or sellers, and to encourage actual consultation.
著者
寺田 久仁子 岩本 佳代子 小林 睦 辻野 政司 寺岡 文雄 荒川 行生 恩田 光子 前田 頼伸
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.35, no.2, pp.96-102, 2009 (Released:2010-02-07)
参考文献数
21

Bone cements have been widely used to fill the dead space of bone tissues in orthopaedic surgeries.Loaded with antibiotics,these materials are also administered for the prevention and treatment of infections,infectious osteomyelitis for example.We made polymethylmethacrylate cement preparations of five commercial vancomycin (VCM) products and compared the in vitro dissolution profiles of the VCM in them and mechanical strengths of the cements.When immersed in phosphate buffer (PB) for 30 days,dissolved amounts of VCM ranged between just 5 and 19% of the calculated contents and after immersion in PB for 40 days mechanical strengths were significantly decreased (50-75% of the control without VCM).Further,on testing a cement preparation containing pharmaceutical additives as well as VCM,the amount of antibiotic released was significantly larger than that for other preparations and the release was more rapid as well.This cement preparation also had the lowest strength among those studied.By doing this,we showed that pharmaceutical additives could have marked effect on the dissolution of the antibiotic and mechanical strength for antibiotic-laden bone cements for the first time,though these were in vitro findings.The present study clearly demonstrated that the antibiotic products used can cause functional differences in antibioticladen bone cements and also suggested that pharmaceutical additives influence cement functions.It is therefore necessary to pay attention to both the antibiotic content of commercial VCM products and types of pharmaceutical additive in the preparation of such cements.
著者
七海 陽子 恩田 光子 坪田 賢一 田中 理恵 向井 裕亮 的場 俊哉 田中 有香 荒川 行生
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.135, no.9, pp.1057-1067, 2015 (Released:2015-09-01)
参考文献数
24
被引用文献数
5

In Japan the prevalence of dementia has increased considerably, and pharmacists are involved in addressing these patients' medication-related problems. Here, we determined whether pharmacists' comprehensive assessment of medication profiles could reduce the burden of dementia patients' medication-related problems. In this historical cohort study 120 community pharmacies were randomly selected, and participating pharmacists completed questionnaires concerning comprehensive assessment of patient medication profiles, using a “start” questionnaire for patients prescribed medication prior to or during the study period and a “follow-up” questionnaire for patients who subsequently visited pharmacies for prescriptions. Numbers and details of problems and solutions implemented by pharmacists and identified in the start and follow-up questionnaires were compared. Changes in start and follow-up scores were also compared between patients whose problems were identified by pharmacists (identified group) and those whose problems were not (non-identified group). Data were collected for 349 patients issued medication by 60 pharmacies. The most common medication-related problems identified in the start survey were key person's understanding of donepezil (60 cases) and other dementia treatments (60 cases), and adherence to treatment (53 cases). Solutions implemented by pharmacists included gathering information regarding drug administration and dementia awareness from the key person and providing pharmaceutical counseling and instruction. Subsequently, problems related to understanding of dementia treatment, understanding donepezil, and adherence were resolved by 70.0%, 65.0%, and 58.5%, respectively. Pharmacists' comprehensive assessment of medication profiles could effectively solve dementia patients' medication-related problems.