著者

Yusaku Matsumoto Hayato Kizaki Yuki Ikeda Shohei Nakamura Shinya Kina Takanori Nagai Takafumi Nasu Koji Miyamoto Satoko Hori

出版者

International Research and Cooperation Association for Bio & Socio-Sciences Advancement

雑誌

Drug Discoveries & Therapeutics (ISSN:18817831)

巻号頁・発行日

pp.2021.01102, (Released:2021-12-30)

参考文献数

7

被引用文献数

4

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Japan has an ageing population and geographical impediments to healthcare access, so an experimental trial of telepharmacy has recently been implemented in remote islands or remote areas of Japan prior to the formal implementation. This exploratory study was conducted to understand patients’ perspectives on telepharmacy in a mountainous depopulated area away from urban areas of Japan. Semi-structured interviews were conducted with four elderly patients, who were all of the patients receiving telepharmacy in Toyone village, Japan, at the time of the survey. The transcribed interview data were qualitatively analyzed by coding and categorization. The subjects thought telepharmacy would be advantageous to overcome poor access to a clinic and to improve convenience in processes ranging from medical examination to obtaining prescribed medicines. However, they pointed out the low digital literacy of the elderly. Also, they had low expectations for pharmacists, because they had previously had no relationship with pharmacists due to lack of pharmacies in the area. To promote telepharmacy, efforts to eliminate resistance to smartphones and to provide support for smartphone operations are needed among the elderly. Work is also needed to establish how pharmacists should best be involved in patient care and health support in remote areas. Our findings suggest that telepharmacy is useful in remote areas of Japan, but in locations where there is no existing relationship with pharmacists, it would be desirable for pharmacists to be actively involved with the community to maximize its effectiveness.

著者

Keisuke Ikegami Megumi Saito Shungo Imai Hayato Kizaki Osamu Yasumuro Ryohkan Funakoshi Satoko Hori

出版者

The Pharmaceutical Society of Japan

雑誌

Biological and Pharmaceutical Bulletin (ISSN:09186158)

巻号頁・発行日

vol.46, no.1, pp.95-101, 2023-01-01 (Released:2023-01-01)

参考文献数

15

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To prevent denosumab-induced hypocalcemia in patients with renal dysfunction, combination therapy with 1α,25-dihydroxy-vitamin D3 (active vitamin D) is recommended. We previously developed a risk prediction model for hypocalcemia in patients with cholecalciferol/calcium (natural vitamin D). However, the prescription status and the risk factors of patients with active vitamin D have not been identified, so we designed this retrospective observational study using a large practice database covering June 2013 to May 2020 to analyze prescription status and risk factors. Patients were classified according to vitamin D type. After that, factors associated with development of hypocalcemia in patients with active vitamin D were explored. Univariate analysis was conducted to compare patient backgrounds between the hypocalcemia and non-hypocalcemia groups. Receiver operating characteristic analysis was conducted to evaluate the predictive potential of the extracted factors. Of the 33442 patients who received denosumab, 22347 and 3560 patients were co-administered natural and active vitamin D, respectively. Patients with active vitamin D had significantly lower renal function (estimated glomerular filtration rate (eGFR) median: 74.0 vs. 69.7 mL/min/1.73 m2), but some patients (23.6%) with sufficient renal function (eGFR ≥90) were also receiving active vitamin D. Of the 3560 patients with active vitamin D, non-hypocalcemia (n = 166) and hypocalcemia (n = 17) groups who met the study criteria were analyzed. Renal function was lower in the hypocalcemia group, and alkaline phosphatase gave the best discrimination. High aspartate aminotransferase (AST), renal dysfunction, high alkaline phosphatase (ALP), and low hemoglobin may be significant factors in risk prediction for hypocalcemia in patients with active vitamin D.