著者

鹿村 恵明 真野 泰成 小茂田 昌代 根岸 健一 佐藤 嗣道 宮崎 智

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.136, no.9, pp.1263-1273, 2016 (Released:2016-09-01)

参考文献数

21

被引用文献数

17 10

---

This nationwide survey aimed to evaluate reduction of drug and medical costs due to prevention of serious adverse drug reactions through pharmaceutical inquires by community pharmacist, and investigate relation with iyaku bungyo (separation of dispensing from medical practice) rates. Using the national list of pharmacies, 10% of pharmacies were randomly selected by prefecture and asked to participate in an Internet-based survey. The survey period was 7 days, from July 21 to July 27, 2015. Of the 5575 pharmacies queried, 818 responded to the survey (response rate: 14.7%). The proportion of inquiries to total prescriptions was 2.6%. Among these, the proportion of prescriptions changed in response to inquiry was 74.9%. An estimated 103 million yen was saved by reducing drug costs, and 133 million yen was saved by reducing medical costs due to prevention of serious adverse drug reactions. Comparison of prescription change rates between pharmacies with high and low iyaku bungyo rates indicated that the proportion of prescriptions changed was significantly higher in pharmacies with high iyaku bungyo rates than in those with low iyaku bungyo rates (78.2% vs. 69.9%, p<0.01). The findings suggest that inquiries about prescriptions are useful in ensuring the safety of pharmacotherapy and reducing the cost of healthcare. They also suggest that iyaku bungyo promotes prescription changes through inquiries, leading to proper use of pharmaceutical products.

著者

鹿村 恵明 田中 愛佳 根岸 健一 下平 秀夫 若林 進 塚原 俊夫 野村 香織 出石 啓治 宮崎 長一郎 望月 眞弓 上村 直樹

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.4, pp.242-250, 2016-02-28 (Released:2017-03-17)

参考文献数

18

---

Objective: For effective use of over-the-counter (OTC) drugs that are provided as relief supplies during a disaster, we aimed to develop a list of OTC drugs that can be used during a disaster.Methods: We obtained information about OTC drugs useful during a disaster by examining results of previous studies and lists of drugs used during a disaster.  We analyzed this information with the expert pharmacist of disaster support and established a rationale for our list and developed “the List of Useful OTC Drugs During a Disaster” and “the Information Card on Useful OTC Drugs During a Disaster.”Results: We developed our list of OTC drugs based on the following parameters: (1) while people with severe disorders (e.g. renal failure) are treated by medical teams, those with minor physical conditions are treated using OTC drugs and (2) those OTC drugs that can be used as substitutes for prescription drugs were preferably selected.  The List of Useful OTC Drugs ()—During a Disaster (containing 56 items) was developed for use mainly by medical professionals.  Further, pharmacists from disaster-relief medical teams may not always be available in disaster-stricken areas; therefore, the Information Card on Useful OTC Drugs During a Disaster was developed to enable disaster victims to independently make a certain level of decision.  The information card contained pictograms to call the attention of the disaster victims.Conclusion: Our results can provide a common tool for drug suppliers, medical professionals engaging in relief works in disaster-stricken areas, and disaster victims.

著者

鹿村 恵明 高橋 淳一 大山 明子 根岸 健一 伊集院 一成 上村 直樹 青山 隆夫

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.131, no.10, pp.1509-1518, 2011 (Released:2011-10-01)

参考文献数

9

被引用文献数

2 4

---

Community pharmacists can provide effective pharmaceutical care by questioning the physicians about their prescriptions. The regulatory authority (Ministry of Health, Labour and Welfare or the like) has been issuing instructions/advice to health insurance-covered pharmacies about the nature of questions to be asked to physicians under the national health insurance system. However, this practice has been facing similar kind of problems almost every year. To identify the reasons for repetition of the problems and facilitate proper application of drug therapy at hospitals, we recently examined the nature of questions asked to physicians by conducting a survey of 165 health insurance-covered pharmacies belonging to 8 district branches of the Japan Pharmaceutical Association. When the pharmacists were asked to express their view whether each of the 18 sample questions included in the past surveys was actually necessary, the most frequent answer from the respondents (n=1980) was “neutral” (42.9%), followed by “unnecessary” (29.0%) and “necessary” (26.6%). Further, 55.5% respondents answered that it is necessary to refer to publications of the concerned fields (guidelines, etc.) when questioning the prescriptions. However, the responses about the possible reasons for judging the necessity of the questions suggested that sometimes the pharmacists failed to understand the details of such publications. The results from this study suggest that a high percentage of community pharmacists believed that there was little need to ask questions about prescriptions if the suggestions made by the regulatory authority about the relevant questions were taken into account. Further, our study findings suggested that pharmacists working at clinics cannot present a clear-cut rationale for their judgment about the necessity of asking questions about prescriptions under the current circumstances where sufficient information collection and the evaluation of need for asking questions about prescriptions are not possible.

著者

鹿村 恵明 大山 明子 高橋 淳一 赤木 祐貴 根岸 健一 伊集院 一成 上村 直樹 青山 隆夫

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.132, no.6, pp.753-761, 2012-06-01 (Released:2012-06-01)

参考文献数

18

被引用文献数

13 8

---

This study examined the impact of pharmaceutical inquiries regarding prescriptions on drug costs by surveying the actual condition of inquiries at 13 pharmacies. The study also investigated the significance of inquiries from a medical economics perspective by calculating the medical cost savings realized by preventing adverse drug reactions (ADRs). As a result, the total change in drug costs for the 13 pharmacies after pharmaceutical inquiries represented an increase of ¥9,018/month. However, upon recalculating the cost of drugs by assuming that those with an “Incomplete entry in the prescription (compared with previous prescription, etc.)” should in fact have been prescribed, and excluding them, the total drug costs for the 13 pharmacies is decreased to ¥154,743/month, translating to a cost-savings of ¥7.2/prescription. The study then undertook a comprehensive assessment based on the Diagnosis Procedure Combination (DPC) system to determine the total medical cost-savings for 5 patients in whom ADRs could have occurred if the prescriptions had not been modified as a result of pharmaceutical inquiries. The obtained figure of ¥1,188,830 suggests that pharmaceutical inquiries contribute to reduced medical costs. The findings of this study indicate that pharmaceutical inquiries regarding prescriptions by staff pharmacists not only ensure the proper delivery of drug therapy to patients, but are also effective from a medical economics perspective.