著者

高井 靖 夏目 優太郎 梶間 勇樹

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.3, pp.64-70, 2023-09-30 (Released:2023-11-01)

参考文献数

17

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We conducted a survey to assess changes in dosage of drugs for treatment of heart failure patients. The survey included all patients admitted to the Mie-Heart Center for heart failure treatment between July 2021 and December 2021. We included 80 patients whose medications could be confirmed after one year. The patients were divided into three groups according to LVEF at baseline: HFrEF, HFmrEF, and HFpEF groups. The endpoint was the change in heart failure medication dose at baseline and after 1 year. Dose changes were classified into “no administration”, “same dose”, “increased dose”, “additional dose”, and “reduced dose”. Statistical analysis was performed by cross-tabulation and chi-square test and residual analysis. There were significant differences in MRA for dose change overall (p<0.001) and dose change overall for RA system inhibitors (p=0.001) and SGLT2 inhibitors (p=0.023), and the adjusted residual ʻno dose’ for all three factors was higher in the HFpEF group. Furthermore, there was a significant difference in dose change overall for β-blockers (p=0.005), and the adjusted residual ʻdose increase’ was higher in the HFrEF group. Our findings suggest that there were many patients in the HFrEF group who continued to take MRA and RA system inhibitors at the induction dose and increased the dose of β-blockers, suggesting a tendency by medical staff to administer additional SGLT2 inhibitors.

著者

高井 靖 梶間 勇樹 西川 英郎

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.43, no.7, pp.388-393, 2017-07-10 (Released:2018-07-10)

参考文献数

11

被引用文献数

1 2

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This study examined the effects of continuous outpatient intervention by pharmacists on medication adherence in patients with heart failure after discharge. Data in the intervention group (n = 25) and non-intervention group (n = 25) were compared on admission (baseline) and after 6 months. Medication adherence was evaluated using the Morisky Medication Adherence Scale (MMAS-4). The number of medications and the medication regimen complexity index (MRCI) were examined as factors influencing such adherence. For statistical processing, the paired t-test was used to clarify differences in the means of dependent variables between before and after intervention in both groups. The significance level was set at 0.05. MMAS-4 scores significantly decreased after intervention in the intervention group, while MRCI scores markedly increased after it in the non-intervention group. In conclusion, regular intervention by pharmacists for outpatients with heart failure may improve medication adherence.

著者

高井 靖 梶間 勇樹

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.46, no.8, pp.446-451, 2020-08-10 (Released:2021-08-10)

参考文献数

7

被引用文献数

1

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This study aims to evaluate the usefulness of the Medication Management Summary, which is a tool of information sharing between hospital pharmacists and pharmacists at insurance pharmacies, based on patient-centered outcomes. Patients whose hospital pharmacists provided the Medication Management Summary to the pharmacists at the insurance pharmacy were assigned to the Medication Management Summary group (Group A), and patients before the introduction of the Medication Management Summary were assigned to the control group (Group B). Each group consisted of 90 patients, among which 30 were cardiac arrest patients, 30 were ischemia heart disease patients, and 30 were arrhythmia patients. The primary endpoint was the number of events, and the secondary endpoints were the presence or absence of readmission, evaluation of medication adherence, and changes in the number of medications in 6 months. The information on the Medication Management Summary in Group A was as follows: medication changes: 20; start of medication: 43; adverse effects: 4; medication management: 29; adjustment of leftover medication: 8; monitoring: 6 (including duplicates). The number of events was significantly lower (P = 0.032) in Group A (2 events) compared to that in Group B (9 events). The number of patients who were readmitted to the hospital was not significantly different between Group A and Group B. The medication adherence was unchanged in Group A but significantly worsened in Group B (P = 0.001). The number of medications did not change significantly in both groups. In conclusion, the provision of the Medication Management Summary by hospital pharmacists to insurance pharmacy pharmacists can help control patient events.

著者

高井 靖 梶間 勇樹

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.46, no.5, pp.279-284, 2020-05-10 (Released:2021-05-10)

参考文献数

8

被引用文献数

1

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In this research, we examined the effects of collaborative intervention by pharmacists in hospitals and insurance pharmacies on the quality of life (QOL) and medication adherence of heart failure patients. Heart failure inpatients were assigned to the collaborative intervention group (Group A) and the control group (Group B), with each group containing 35 subjects. Both groups were examined 12 months after they were admitted to hospital, and the conditions at the time of admission were used as the baseline. The primary endpoint was QOL, which was evaluated by the Minnesota Living with Heart Failure (MLHF) scale, and the secondary endpoints were medication adherence and prescription complexity index, which were assessed using the medication regimen complexity index (MRCI) and the Morisky Medication Adherence Scale (MMAS-4), respectively. The number of target patients that could be analyzed was 31 in group A (18 men and 13 women with an average age of 78.1 ± 9.9 years), and 29 in group B (17 men and 12 women with an average age of 79.6 ± 8.1 years). The QOL at the time of admission and discharge from the hospital was significantly improved in group A and B (P < 0.05). MMAS-4 improved significantly in group A (P < 0.05) but did not change significantly in group B. MRCI was significantly increased in group B (P < 0.05). It is suggested that the intervention by pharmacists in hospitals and insurance pharmacy pharmacists for heart failure patients may have an impact on improving the quality of life.