著者
佐野 知子 井上 元子 滝澤 理貴 島森 美光 黒澤 菜穂子
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.137, no.5, pp.603-610, 2017 (Released:2017-05-01)
参考文献数
13
被引用文献数
1

The Hakodate Watanabe Hospital has held pharmacist-led multidisciplinary psychiatric pharmacotherapy conferences since September 2013 in order to optimize pharmacotherapy. The effects of holding regular conferences on the correction of high-dose antipsychotic polypharmacy, prevention and reduction of adverse reactions to antipsychotics, and reduction of the drug costs were investigated in psychiatric inpatients prescribed 4 or more antipsychotics. The results revealed that the number of antipsychotics and number of all drugs were significantly reduced by 1, the chlorpromazine (CP)-equivalent dose was significantly reduced by approximately 350 mg, and the drug costs were significantly reduced by 176.5 yen/d. In regard to the effects on the laboratory test data, the blood glucose and hemoglobin A1c (HbA1c) levels were significantly reduced. In addition, 84.8% of the patients were assessed as “unchanged” using the Clinical Global Impression of Change (CGI-C), indicating the absence of any significant changes in the severity of the clinical psychiatric symptoms. The results confirm that psychiatric pharmacotherapy conferences are effective for promoting appropriate use of antipsychotics, reducing the incidence of metabolic adverse reactions, such as elevation of the blood glucose, and also reducing the drug costs. The above results suggest that psychiatric pharmacotherapy conferences encourage psychiatric medical teams to adjust prescriptions while sharing information, and are effective for optimizing pharmacotherapy.
著者
柳本 ひとみ 櫻井 秀彦 古田 精一 黒澤 菜穂子
出版者
一般社団法人 日本在宅薬学会
雑誌
在宅薬学 (ISSN:2188658X)
巻号頁・発行日
vol.6, no.1, pp.11-26, 2019 (Released:2019-05-20)
参考文献数
22

薬剤師の在宅業務において,薬物療法に有益な業務と課題を探索することを目的とし,web アンケート調査を行った.回収数は208 名であった.回答は5 件法とし,属性により層別化し比較を行った.「薬剤師が行う業務確認項目」および「患者/家族あるいは多職種からの情報確認項目」について,因子分析およびクラスター分析により回答群を分類し,属性と関連付けた.結果として,薬剤師は,「薬効」「副作用」などは確認しているが,患者の日常生活動作の確認には「性別」で差が見られ,患者/家族あるいは多職種からの情報収集の頻度は低くかった.分類された5 つのグループと「性別」は関連があった.薬物療法評価に役立つものは,「アセスメントシートを多職種で共有する」であった.今回示した16 項目の業務例の中で必要と思う業務を実施した場合,薬剤師は,「薬物療法の成果」「患者/家族のQOL」が向上し,「医師や看護師など多職種との連携が良くなる」「医師の治療方針に自分の意見が反映される可能性が高くなる」と考えていた.今後,薬剤師は,在宅業務確認ツール作成や,多職種共通尺度により薬物療法の評価を行うことで業務向上を図る必要がある.
著者
千田 泰健 後藤 勝博 黒澤 菜穂子
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.15, no.1, pp.18-28, 2013 (Released:2013-06-06)
参考文献数
17

Objective: In conveying and providing drug information, it is essential to ensure correct understanding of such information at clinical practice sites.  We thus used a hospital’s drug information newsletter (DI News) to analyze factors affecting how well the drug safety information provided is understood by recipients.Methods: Targeting nurses who work at Kushiro Red Cross Hospital, we used the DI News to provide information on changes in insulin preparations, and then implemented Questionnaire Surveys 1 and 2.  An implemented Questionnaire comparison was made among the number of years at work (6 groups), between wards of internal medicine and surgical departments (2 groups), and among various wards (12 groups), and the factors affecting the degree of understanding of information were analyzed.Results: Compared with Survey 1, the degree of understanding improved dramatically in all groups in Survey 2.  However, no significant differences were seen among the groups in the comparison based on the number of years at work, or in the comparison between internal medicine and surgical departments.  The comparison among various hospital wards, however, showed large differences in the scores for Surveys 1 and 2, with significant differences among the groups being documented (p<0.001).Discussion: In providing important pharmaceutical information, it was deemed necessary to gain a deeper understanding of the differences among various wards and to offer individual assistance tailored to each ward.  This study revealed the importance of meticulous, personalized information services provided by ward pharmacists.
著者
斉藤 嘉津彦 清水 瓊子 岡崎 正子 伊林 至洋 端 和夫 前野 康次郎 石井 清二 土橋 和文 島本 和明 戸田 貴大 黒澤 菜穂子 大和田 栄治 加藤 芳伸 大山 徹 梅津 有理 千田 道洋 有吉 範高 鎌滝 哲也 板谷 幸一
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.27, no.3, pp.228-234, 2001-06-10 (Released:2011-03-04)
参考文献数
11
被引用文献数
1 1

In recent years, genome science has undergone radical changes and numerous advances have led to the development of its use in medical practice. In particular developments in pharmacogenetics have demonstrated that genetic polymorphism is responsible for inter-individual differences in the drug metabolism. This study was conducted to identify the genetic polymorphisms of CYP 2C 9 and CYP 2 C19 using PCR-RFLP, and the application of a gene analysis was investigated in TDM or pharmaceutical management and in counseling services for patients. In a patient with the following pharmacokinetic parameters for phenytoin, for Km=6.69 μg/mL and Vmax = 3.62 mg/day/kg, and a largely decreased metabolic activity of CYP 2 C9 compared to the general population, the genetic differences in CYP 2 C9 could be determined in genomic DNA based on the patient's peripheral blood. Based on this finding, the effective dose for medication was calculated and administered to the patient. In addition, during medical consultations, both written and oral information in an easily comprehensible form could be given to patients with genetic polymorphism. These procedures allow a for the careful matching of the patient to the right medication and dose. This study indicates the possible application of a genetic analysis of CYP to “Evidence-Based Medicine” in the field of pharmaceutical management in order to control the dosage in individuals and to improve patient counseling.
著者
柳本 ひとみ 櫻井 秀彦 古田 精一 黒澤 菜穂子
出版者
日本社会薬学会
雑誌
社会薬学 (ISSN:09110585)
巻号頁・発行日
vol.37, no.2, pp.91-101, 2018-12-10 (Released:2019-01-19)
参考文献数
29

Objective: We search valuable information in home medical care settings that impede smooth collaboration among pharmacists, home care physicians, and home care nurses. Methods: We conducted an online survey on 120 physicians and 118 nurses on “areas perceived as overloaded with tasks,” “quality of life (QOL) evaluation of patients,” and “expectations to pharmacists.” We analyzed data using the Mann-Whitney U test and conducted the customer satisfaction (CS) analysis on “stress.” Results: Physicians answered that they had a significantly higher stress on “at night-time/holidays and weekends works” than nurses (p < 0.05). Nurses experienced significantly more stress during “inter-professional collaboration” than physicians (p < 0.01). CS analysis revealed that nurses experienced more stress for items such as “having patients with dementia self-inject correctly,” etc. Both physicians and nurses evaluated QOL items at a high frequency. Majority of physicians and nurses held high “expectations to pharmacists,” particularly for the eight items related to providing information, managing drugs, and making pharmacological judgments. Nurses had significantly high expectations to pharmacists for “management of supplements taken by the patient” (p < 0.01), “explaining drug effects” (p < 0.001), and “explaining the necessity of prescription revision” (p < 0.01). Discussion: Pharmacists should utilize information on physicians and nurses’ stress as well as understand their expectations to pharmacists to facilitate stronger coordination between both professions and contribute to patient care. In particular, many items were found to cause stress, indicating that support for nurses, who have many expectations to pharmacists, needs to be enhanced.
著者
大野 拓恵 柳本 ひとみ 板倉 宏予 梅田 純代 グレゴリー サムソノー 加藤 隆治 山田 惠 黒澤 菜穂子
出版者
日本社会薬学会
雑誌
社会薬学 (ISSN:09110585)
巻号頁・発行日
vol.36, no.2, pp.62-70, 2017-12-10 (Released:2018-01-05)
参考文献数
8

PEP (the study group of Practical English for Pharmacists) was started by teachers from different fields at Hokkaido Pharmaceutical University, and has been offering English conversation class for local pharmacists. As with its turning point of three years, in January 2016, it conducted an online questionnaire survey for pharmacists all over Japan. The purpose was to find their needs for learning English, as well as to make sure if PEP teaching materials were proper enough for them. The questionnaires consisted of five areas: current working situation in terms of using English; self-evaluation for their attitudes towards English-speaking customers/ patients; their preference in learning English; their foresight into the English-related situation around their job; and evaluation on PEP sample materials. Participants were 220 pharmacists at work who were interested in learning English. They were divided into two groups (Yes-group and No-group) according to the answer to the question of whether they, as a pharmacist, thought it necessary to learn English or not. The groups were compared with each other within each of the five areas mentioned above. The results showed the overall illustrations of the pharmacists today and positive evaluation for a PEP material. Most importantly, however, contrastive difference between Yes-No groups for the type of English needed was revealed (p<0.01). This was interpreted as an evidence that No-group just have a naive intention to learn English, while Yes-group have already been involved in the situations where rather high English proficiency is required for their pharmacy jobs.
著者
佐野 知子 原田 雅史 菅原 隆光 伊坂 直紀 増岡 昭生 三上 昭廣 島森 美光 黒澤 菜穂子
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.133, no.8, pp.897-903, 2013 (Released:2013-08-01)
参考文献数
12
被引用文献数
5 6

As hospitalized patients in psychiatry departments are often prescribed multiple psychotropics depending on their psychiatric symptoms, psychotropics are considered as important factors potentially associated with a high risk of falls. In this study, we attempted to investigate, from the aspect of drug prescription, to what degree the number and doses of psychotropics must be adjusted in order to reduce risk of falls in hospitalized psychiatric patients. The subjects were 526 patients, consisting of a fall group of 313 patients, who had experienced 1 to 5 falls (510 events) and a control group of 213 patients who had never experienced falls. Multiple logistic regression analysis was performed to determine the correlations between the occurrence of falls and the number and doses of psychotropics. The results showed that the risk of falls increased with increasing number of antipsychotics and anxiolytics/hypnotics prescribed, with the risk increasing, by 3.75-fold with the increase in the dose of chlorpromazine (CP)-equivalents to more than 600 mg, by 2.08-fold when the dose of diazepam (DAP)-equivalents to more than 15 mg, and by 7.80-fold with increase in CP-equivalents to more than 600 mg concomitantly with an increase in DAP-equivalents to more than 15 mg. In addition, a tendency towards increase in the frequency of falls was observed when more than 5 psychotropics were prescribed concomitantly. The above results suggested that the risk of falls may be reduced by appropriately adjusting the number of drugs and the doses of psychotropics used in the treatment of psychiatric disorders.