著者

石渡 涼子 榎木 裕紀 横山 雄太 田口 和明 木津 純子 松元 一明

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.2, no.2, pp.19-26, 2019-09-30 (Released:2019-10-07)

参考文献数

8

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We evaluated heparinoid-containing soft ointments and heparinoid-containing creams to develop information useful to select drugs. Spreadability, consistency and the water content of stratum corneum was measured. A selection table focusing on impression of the use was prepared. Spreadability of the semi-original soft ointment and cream were lower than those of all generic drugs. Regarding hardness, one generic soft ointment was softer than the semi-original drug, but the semi-original cream was harder than all generic creams. Regarding the impression of the use, a significant difference was noted in smell in soft ointments, and 6 items in creams. Correlation was found between the spreadability and consistency test results and impression of the use. A significant difference was noted in the water content of stratum corneum in creams. The selection table prepared based on the impression of the use may provide information that helps selection of preparations in clinical practice.

著者

西村 文宏 牛島 智子 野田 勝生 門脇 大介 宮村 重幸

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.3, no.1, pp.9-14, 2020-03-23 (Released:2020-05-02)

参考文献数

13

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Objective: The aim of this study was to estimate medical economic costs associated with optimizing drugs brought to a cardiology hospital for inpatients with the help of pharmacists and doctors. Methods: We optimized drugs brought to the hospital, compared patient backgrounds, and estimated medical economic costs. Results: Medicine expenditure was 34.36 yen per day per patient post drug optimization with the help of pharmacists and doctors. Estimated glomerular filtration rates were significantly lower and patient ages and the number of prescriptions optimized were significantly higher in patients who regularly used 10 or more drugs than in those who used fewer than 10 drugs.Conclusion: A drug cost reduction effect is expected with the collaboration between doctors and pharmacists, and with prescription optimization of drugs brought to a hospital.

著者

小林 星太 大木 孝弘 徳久 宏子 菅 幸生

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.3, no.3, pp.65-69, 2020-12-31 (Released:2021-01-28)

参考文献数

8

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Serotonin syndrome refers to the adverse events caused by serotonin-based drugs such as antidepressants. Its clinical manifestations include psychiatric and neurovegetative symptoms. In this communication, we report our experience with an 83-year-old woman receiving antidepressants, who developed subjective symptoms such as heavy sweating, dizziness, and tremor after starting treatment with dextromethorphan. Treatment with antidepressants was continued, but five months later, the patient experienced symptoms of heavy sweating, elevated blood pressure, tremor, and anxiety. In her case, serotonin syndrome was suspected by a pharmacist working in a pharmacy, who promptly carried out early intervention and assisted in the prevention of recurrence. In elderly patients who are prescribed dextromethorphan and antidepressants, the possibility of occurrence of serotonin syndrome needs to be taken into consideration in the follow-up of the clinical course.

著者

新井 克明 青木 洋平 雨宮 貴洋 倉田 なおみ

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.59-63, 2023-09-30 (Released:2023-11-01)

参考文献数

10

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The purpose of this study was to evaluate the potential benefits arising from pharmacists accompanying doctors during their rounds in long-term care insured facilities for the elderly. Based on the medical records, the pharmaceutical content provided to physicians, medication history of residents, and residents’ level of care were analyzed. There were 157 interventions related to drug reduction that contributed to polypharmacy decrease. These interventions were maintained for six months and led to a cost reduction of approximately 1.67 million yen. Furthermore, one year after these interventions, a trend toward positive correlation was recorded between the improvement in residents’ level of care and the decrease in the number of medications taken. Overall, this study highlighted that pharmacists attending consultant-led rounds at long-term care insured facilities for the elderly was advantageous with regards to reducing polypharmacy and pharmaceutical costs.

著者

早川 裕二 溝神 文博 長谷川 章 天白 宗和 間瀬 広樹 小林 智晴

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.5, no.1, pp.1-6, 2022 (Released:2022-04-21)

参考文献数

17

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Polypharmacy involves problems related to not only the use of many medications but also improper drug administration. The questionnaires used at the time of admission were retrospectively investigated to determine the number of drugs that patients would like to reduce. Most patients wanted to reduce the number of drugs prescribed to them. The target patients were those who visited the National Center for Geriatrics and Gerontology and met the criteria during the hospitalization period from August 1, 2020 to November 30, 2020. In all, we selected 313 patients: 68 in the drug reduction group and 245 in the non-drug reduction group. We investigated the extent of desired reduction and the patient background factors for both groups. Multivariate analysis revealed significant differences between the groups in family management with an adjusted odds ratio of 2.62 (95% CI 1.30-5.29, P < 0.01) and in the number of drugs with an adjusted odds ratio of 1.20 (95% CI 1.09-1.31, P < 0.01). Analysis of the area under the receiver operating characteristic curve(AUC)was carried out for all the cases. The cutoff for self-management was six points (AUC = 0.73, 95% CI 0.64-0.81, P < 0.01). Patients on polypharmacy who are taking more than six drugs, especially family-managed patients, often wish to reduce the number of medications and prescribe it from a pharmaceutical point of view. This aspect needs to be reviewed further.

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

後藤 浩志 武藤 正樹 池田 俊也 百瀬 泰行

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.5, no.2, pp.7-15, 2022-06-30 (Released:2022-07-22)

参考文献数

16

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Objective: This study aimed to clarify the actual prescription status of patients covered through the “Screening Tool for Older Person’s Appropriate Prescriptions for Japanese” (STOPP-J).Methods: Patients aged ≥ 75 years who received oral medications for chronic diseases were classified into two groups: multidrug and non-multidrug groups. The number of drugs according to the drug class and the number of STOPP-J drugs prescribed were examined.Results: This study included 8,192 patients. The average number of medications was 4.1, and its percentage in the multidrug group was 26.4%. The multidrug group presented a higher number of physicians and percentage of STOPP-J prescriptions than the other group. The highest percentage of prescribed multidrug use included antithrombotics (82.5%), digitalis (76.2%), and diuretics (73.2%).Conclusion: The multidrug group presented a higher percentage of STOPP-J prescriptions than the non-multidrug group.

著者

堀井 徳光 井上 直子 大嶋 繁 冲田 光良 秋元 勇人 根岸 彰生 大島 新司 沼尻 幸彦 小林 大介

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.1, no.2, pp.28-33, 2018-09-30 (Released:2019-10-07)

参考文献数

19

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In the Integrated Community Care System, pharmacists are expected to play a central role in addressing patients’ drug problems. Therefore, it is necessary to know the patients’ drug problems as well as the occupations of professionals in solving these problems, and to clarify the problems to be preferentially resolved. Thus, we surveyed care managers working in a district near the Josai University pharmacy about their drug problem recognition and the professionals who solved these problems. Many of the care managers identified “the patient has leftover drugs” and “the patient has declining cognitive abilities” as drug problems. Many of the care managers expected pharmacists to solve the problems of “the patient has leftover drugs” and “the patient does not understand the dosage regimen.” “The patient has leftover drugs,” “the patient needs allotting of drugs to ensure adherence,” “the patient does not understand the significance of the meditation,” and “the patient does not understand the dosage regimen” are drug problems in which pharmacists should preferentially intervene and play a role in the Integrated Community Care System.

著者

金森 未侑 冨澤 登志子 板垣 史郎

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.2, no.1, pp.9-18, 2019-03-31 (Released:2019-10-07)

参考文献数

8

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Purpose: This study aimed to clarify the ratio of inpatients who consume health foods and supplements, determine their awareness of interactions between medicines and health foods or supplements, and confirm that information on the consumption of health foods and supplements by inpatients is collected by medical personnel.Methods: A total of 110 inpatients taking antihypertensive medications completed a questionnaire survey about their medical history, currently prescribed medications, and current diagnoses. Data on the inpatients’ consumption of health foods and supplements were also collected from medical and nursing records by medical staff. The risk of actual drug interactions with health foods or supplements was analyzed using the Natural Medicines Comprehensive Database.Results: Overall, 30% of patients had consumed some health foods or supplements before they were hospitalized. A total of 62 patients were found to have an interaction risk even though most of them were not aware of potential drug interactions with supplements. Few patients knew what medications they were taking. In addition, medical staff and even doctors hardly ever asked patients about their consumption of health foods and supplements.Conclusions: Patients using health food and supplements is 30%. Most patients don’t know interaction risk between health food, supplements, and drugs. Interaction risk between health food, supplements, and drugs is 62 cases. And, in hospital wards, doctors and nurses rarely gather information what health food and supplements patients use.

著者

神保 美紗子 市原 千花 内海 貴大 谷口 誠哉 北川 英俊 溝神 文博

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.2, pp.21-28, 2023-06-30 (Released:2023-07-22)

参考文献数

14

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In recent years, there have been many reports on how polypharmacy is addressed in hospitals through multidisciplinary collaboration; however, there are few reports on how pharmacies are addressing polypharmacy among outpatients in collaboration with physicians and hospital pharmacists. In September 2020, physicians, hospital pharmacists, and pharmacy pharmacists collaborated to establish a model for dealing with polypharmacy in community pharmacies (creating a polypharmacy assessment tool and conducting regular joint conferences between hospitals and pharmacies). In this study, the actual state of polypharmacy intervention by pharmacy pharmacists after the introduction of this model was investigated. The study was conducted at three community pharmacies over a 6-month period. A tool-based polypharmacy assessment of patients aged 65 years or older taking six or more prescription drugs revealed that 97% (65/67 patients) experienced polypharmacy issues and in 44.8% (30/67 patients), the pharmacist considered it necessary to report the patient’s condition to the physician. Of the 35 informational letters reported to physicians, 28 were prescription suggestions, with a prescription change rate of 46.4% (13/28). The improvement rate of adverse drug events after pharmacist intervention was 54.0% (27/50), and the improvement rate of adherence was 66.7% (24/36). These results indicate that the model for dealing with polypharmacy in community pharmacies contributed to the improved ability of pharmacy pharmacists to intervene, because of the establishment of criteria for evaluating polypharmacy and because hospital-pharmacy joint conferences, which are key to community collaboration, were continuously held.

著者

皆元 文恵 梅田 勇一 冨永 麻衣子 上西 真理子 鵜木 友都 松本 弥一郎

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.5, no.4, pp.33-40, 2022-12-31 (Released:2023-01-27)

参考文献数

17

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At Iizuka Hospital, we organized a polypharmacy team to engage in multidisciplinary collaboration and we began interventions aimed at prescription optimization for inpatients. During the interventions, we confirmed the patient’s willingness for pharmacotherapy. After that, we evaluated the merits and demerits of continuation or discontinuation of the drugs considering the patient’s condition, life prognosis, and time to benefit. In this study, we considered the investigated results of 100 patients who experienced intervention by the polypharmacy team. Of the 49 patients who reduced their medications after the polypharmacy team intervened, the most common reason for medicine reduction was long-term administration, and the most common pharmacological category of medicine reduction was gastrointestinal medication. The polypharmacy team at Iizuka Hospital intervenes for the Departments of General Internal Medicine, Transitional and Palliative Care, and Orthopedic Surgery, and we hope polypharmacy team interventions will be expanded to more departments to optimize prescribing in the future.

著者

石坂 優奈 柳 奈津代 佐藤 宏樹 三木 晶子 馬来 秀行 小西 ゆかり 雨宮 潤美 澤田 康文

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.5, no.3, pp.24-31, 2022-09-30 (Released:2022-11-10)

参考文献数

10

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Pharmacists attended an interprofessional team meeting that included nurses and care workers at fee-based homes for the elderly to assess the association between medication, health status, and living conditions provided by care workers. A visually based comparative worksheet on a timeline was used. This study aimed to clarify the role of pharmacists in interprofessional collaboration. A total of 47 residents at 13 facilities were assessed, and drug deprescription or prescription changes were provided in 39 cases. The cases were classified according to the reason for the change, e.g., discontinuation of unnecessary medication, the possibility of a harmful event, examination of therapeutic effect, and improving drug adherence. The participation of pharmacists helped clarify information about medication and health status and contributed to reducing drug-related problems in many cases.