著者

白髪 恵美 大西 順子 廣本 篤 李 美淑 手嶋 大輔 毎熊 隆誉

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.45, no.3, pp.135-142, 2019-03-10 (Released:2020-03-11)

参考文献数

18

被引用文献数

2

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Pharmaceutical care clinics, wherein hospital pharmacists intervene to resolve the issues of outpatients, have been established in many hospitals in Japan. The purpose of this study was to verify the usefulness of pharmaceutical care clinics in the treatment of diabetes. Between April 2014 - March 2016, among type 2 diabetic outpatients who received pharmaceutical care, 34 patients who had a glycated hemoglobin (HbA1c) value ≥7.5% were included in the pharmacist intervention group and 45 patients who had been consulted only by a nurse or a nutritionist were included in the pharmacist non-intervention group. HbA1c was determined and compared for 9 months among the two patient groups. Although a decrease in HbA1c value was observed in the pharmacist non-intervention group, HbA1c increased gradually from 6 months onwards. After 9 months, a significant difference in HbA1c was found between the pharmacist intervention and non-intervention groups (P = 0.047). With the intervention of nurses and nutritionists alone, it was impossible to suppress the rise in HbA1c value in type 2 diabetic outpatients continuously for 9 months. In the pharmacist intervention group, patients with poor glycemic control and problems of adherence were extracted and instructed more firmly. Because pharmacists spent adequate time identifying patients and improving medication adherence and lifestyle, favorable glycemic control could be achieved for the long term. Therefore, hospital pharmacists play an important role in providing appropriate medication for outpatients.

著者

石川 雅之 横山 威一郎 山口 洪樹 中村 貴子 鈴木 貴明 石井 伊都子

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.45, no.3, pp.143-149, 2019-03-10 (Released:2020-03-11)

参考文献数

10

被引用文献数

1

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PreAVOID (“Prevent and avoid an adverse drug reaction”) is a pharmaceutical intervention that contributes to the improvement of drug safety and efficacy. It is considered important for pharmacists to spend time in the ward and carry out numerous PreAVOID interventions. At present, however, there have been no reports on the relationship between working hours of pharmacists in the ward and the number of PreAVOID interventions performed. Therefore, we investigated this relationship in Chiba University Hospital.The working hours of pharmacists in each ward gradually increased and were 13.5-38.3 h per week from April 2015 to March 2017. The number of PreAVOID interventions also increased from 630 in fiscal year 2015 to 1116 in fiscal year 2016. The number of interventions that prevented adverse drug reactions increased from 402 in fiscal year 2015 to 550 in fiscal year 2016. The number of interventions that improved drug efficacy increased from 188 in fiscal year 2015 to 508 in fiscal year 2016. The working hours of pharmacists in the ward showed a positive and statistically significant correlation with the number of PreAVOID interventions (r = 0.688, P < 0.001). Therefore, our findings indicate that longer working hours of pharmacists in the ward probably result in an improvement in the efficacy as well as safety of drug therapy in association with increased PreAVOID interventions. Thus, it is important to ensure that pharmacists spend sufficient time in the ward in order to contribute to the improvement of drug safety and efficacy through PreAVOID interventions.

著者

佐藤 秀昭 富岡 佳久 中村 哲也 小田 慎 大木 稔也 今井 博久

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.45, no.3, pp.164-170, 2019-03-10 (Released:2020-03-11)

参考文献数

8

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Pharmacists regularly use test values that are either provided by patients or that are recorded in out-patient prescriptions to identify potential adverse reactions to medications, to verify prescription accuracy (e.g., confirm the dose), and to provide patients with guidance on how to take their medications. However, there are no published evaluations of actual submissions from patients to pharmacies of test results that they received from their medical institutions. We administered a questionnaire and found a strong correlation between the submission of test results to pharmacies and test-result requests from both primary-care pharmacies (odds ratio: 2.4; 95% confidence interval: 1.5-3.5; P value < 0.001) and general pharmacies (odds ratio: 2.9; 95% confidence interval: 2.0-4.1; P value < 0.001). Primarycare and general pharmacy requests for test-result reports are useful measures for encouraging patient submission of test-result reports. In the future, non-hospital pharmacists should gain experience in explaining the significance of sharing test values with patients, verifying prescriptions, and helping patients avoid adverse reactions according to their test values, and pharmacists should work hard to change the existing preconceptions of their role in regional medicine. It is important for the patient community to understand that non-hospital pharmacists not only distribute their medicine, but they also play a beneficial role in guiding patientsʼ drug therapies.

著者

佐古 有紀 桐林 東一郎 河野 弥生 花輪 剛久 宮川 信明

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.41, no.10, pp.750-756, 2015-10-10 (Released:2016-10-10)

参考文献数

8

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Osteoporosis is more common in elderly people and oral bisphosphonates are widely used for the treatment of osteoporosis throughout the world. It is generally considered that elderly people decline in physical function with age and find the taking of drugs to be problematic. We conducted this survey to clarify potential problems in osteoporotic patients during treatment with oral bisphosphonates. The survey of an 8-item questionnaire was performed in 32 pharmacies in Hiroshima prefecture. A total of 684 patients were enrolled in the survey, 637 patients were analyzed and 47 patients with protocol violation were excluded from the survey. Baseline characteristics were as follows: gender (female, 581; male, 56), age (< 70 years old, 26%; 70 years old ≤, 74%), administration interval (daily, 42; weekly, 313; monthly, 282). The patients with dry mouth accounted for 14% of total patients and those with experience of discomfort during swallowing accounted for 11%. Moreover, 40% of total patients had experience of forgetting to take bisphosphonates. Our survey demonstrated that osteoporotic patients taking bisphosphonates experienced several hurdles and did not complain directly to pharmacists about it. We need to communicate better with osteoporotic patients and collaborate closely with physicians, nurses and others.

著者

小林 美沙樹 小田中 みのり 鈴木 真也 船崎 秀樹 高橋 秀明 大野 泉 清水 怜 光永 修一 池田 公史 市田 泰彦 高橋 邦雄 齊藤 真一郎

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.41, no.1, pp.18-23, 2015-01-10 (Released:2016-01-15)

参考文献数

9

被引用文献数

1 2

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Hand-foot skin reaction (HFSR) is one of the major adverse effects of sorafenib necessitating discontinuation of the drug, however, no standard interventions for HFSR have been established yet. At our hospital, we are using a urea-containing cream prophylactically for HFSR associated with sorafenib. We carried out this study in 74 hepatocellular carcinoma patients receiving treatment with sorafenib at our hospital between June 2009 and January 2011 to assess the benefit of prophylactic use of urea-containing cream against sorafenib-induced HFSR. Patients with a history of previous use of tyrosine kinase inhibitors or insufficient data in respect of the dose of urea-containing cream were excluded. The patients were divided into a high-dose group (38 patients) and a low-dose group (36 patients) according to the median dose (2.9 g per day) of urea-containing cream used within the first 2 weeks after the start of sorafenib treatment. The frequency of grade 2 or 3 HFSR was 42.1% in the high-dose group and 61.1% in the low-dose group(P = 0.105). The relative dose intensity of sorafenib was 71.1% in the high-dose group and 59.6% in the low-dose group (P = 0.043). No significant difference was observed in the response rate or time to progression between the two groups. In conclusion, prophylactic use of a urea-containing cream might enhance the relative dose intensity of sorafenib, but further prospective studies are warranted to elucidate its usefulness.

著者

荒木 美輝 半谷 眞七子 亀井 浩行

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.45, no.2, pp.63-75, 2019-02-10 (Released:2020-02-10)

参考文献数

36

被引用文献数

6

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Despite the demand for pharmacists' active participation in home medical care and cooperation with other professionals, their role in home medical care is not properly understood by other professionals. This study qualitatively analyzed the opinions of other professionals about their perceived need to cooperate with pharmacists.A semi-structured interview was conducted involving 4 visiting nurses and 2 certified care workers providing home medical care services in Aichi Prefecture, and the obtained data were qualitatively analyzed using a grounded theory approach.As medication management of patients at home was difficult due to not only patients' physical factors, but also emotional and social factors, as well as living, environmental, and institutional factors, the ability to care for such patients is essential. Home medication management was performed mainly by care workers, nurses, and pharmacists; however, a difference in the attitude of sharing information with pharmacists was observed between care workers and nurses. Thus, pharmacists must consider emotional barriers, such as concerns and hesitations towards pharmaceutical knowledge among other professionals, as well as emotional conflicts over the overlap of professional domains in the management of medications. Also, since home medical care is provided in the patient's personal domain, excessive emphasis is often placed on the patient's and family's intentions. It is, therefore, important that pharmacists acquire the ability to endure emotional difficulties and dissonance caused by the patient's rejection of professional involvement, and learn and develop an attitude to accept the feelings of patients and their families.

著者

治田 匡平 市田 裕之 石樋 康浩 宇髙 歩 日笠 真一 尾崎 淳子 大槻 真央 矢倉 裕輝 吉野 宗宏 古西 満 杉山 幸正

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.45, no.1, pp.44-53, 2019-01-10 (Released:2020-01-10)

参考文献数

18

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Pharmacists' interventions are considered to be important at the time of starting anti-HIV therapy or changing treatment in outpatient care for HIV infection. We conducted a questionnaire survey to clarify patients' assessments of pharmacists' interventions in outpatient care for HIV infection. The survey was conducted at seven AIDS treatment center hospitals in the Kinki region, and the analysis was performed on 112 patients receiving the initial treatment and 79 patients experiencing treatment change. Pharmacists' interventions were found to be helpful by 97.3% of the initial treatment patients and 96.2% of the treatment change patients; the former often found it helpful in understanding the “necessity of receiving drugs” and “failure in taking drugs and acquisition of resistance”, while the latter often found it helpful in understanding the “difference of the new drug from the previous one” and “side effects”. Pharmacists' interventions relieved anxiety in 89.3% of the initial treatment patients and 89.9% of the treatment change patients, and produced good overall effects such as “relieving anxiety as regards receiving drugs”, “facilitating communication with doctors”, and “reducing questions for doctors”. The survey results showed that pharmacists' interventions at the time of starting anti-HIV therapy or changing treatment met patients' needs and contributed to improving the quality of medical care, such as reducing patient anxiety and the burden on doctors.

著者

松尾 泰佑 富田 隆 工藤 賢三 佐塚 泰之

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.45, no.1, pp.54-60, 2019-01-10 (Released:2020-01-10)

参考文献数

9

被引用文献数

1

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Magnesium oxide tablets are sometimes crushed prior to administration to patients having difficulties in swallowing tablets. However, the quality of magnesium oxide formulations may decrease when stored for a long time as a one-dose package, owing to the absorption of high amounts of moisture by magnesium oxide. Additionally, as magnesium oxide solution is alkaline, it can interact with other medicines, making it incompatible for one-dose packaging. There are three types of magnesium oxide powder formulations: crushed magnesium oxide tablets, magnesium oxide bulk powder, and magnesium oxide granules. However, the appropriate formulation of magnesium oxide for one-dose packages is unknown. The stability of powder formulations stored as one-dose packages at 75% RH for 3 months was evaluated by analyzing the change in weight change and dissolution. The dissolution of the three powder formulations did not change for 3 months. Although the weight had increased in all the formulations, the change in the weight of magnesium oxide granules was the lowest among the three formulations. Isoniazid and levodopa tablets have been reported to interact with magnesium oxide tablets. The incompatibility between the crushed powder of these medicines and magnesium oxide powder formulations was analyzed when stored as one-dose packages. Among the three formulations, incompatibility was the lowest for granule. In conclusion, preserving magnesium oxide and other formulations that causes incompatibility should basically be avoided. However, magnesium oxide granules can be used for storing with the other formulations that interact with magnesium oxide within a term to circumvent incompatibility.

著者

徳山 尚吾 中本 賀寿夫

出版者

Japanese Society of Pharmaceutical Health Care and Sciences

雑誌

医療薬学 (ISSN:1346342X)

巻号頁・発行日

vol.39, no.9, pp.511-520, 2013-09-10 (Released:2014-09-10)

参考文献数

70

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Fatty acids are an important source of energy and an essential component of cell membranes. They also function as signal transduction molecules in a range of biological phenomena. There are several reports on the transport mechanisms of fatty acids including fatty acid transport proteins, and lipid chaperones fatty acid-binding proteins. Furthermore, fatty acids can signal through G-protein-coupled receptors or toll-like receptors.The recent westernization of dietary habits and food satiation is becoming a problem. Accordingly, the dietary intake ratio of n-3 fatty acids has dramatically decreased over several decades. Although the health influence in the change of these food habits has received little attention, in a recent study, the functional relationship between n-3 fatty acids and psychiatric disease or neurodegenerative disease has been the focus of many studies. Also, it has become apparent that the functional properties of fatty acids are modulated by factors such as the amount of individual fatty acid intake and their distribution among organs.In particular, it is reported that, in patients with depression, n-3 fatty acid contents in the brain decrease and the intake of the n-3 fatty acids can relieve psychiatric symptoms of depression. Therefore, it is thought that a fatty acid signal in the central nervous system relates to nerve activity and modulation of the synapse plasticity. However, the detailed mechanisms of these disorders have not been fully elucidated.In this mini review, we summarize a number of basic and clinical studies on n-3 fatty acids and psychiatric diseases and neurodegenerative disorders.

著者

小林 貴志 福本 恭子 土下 喜正 楠本 正明 上野 和行

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.32, no.8, pp.772-775, 2006-08-10 (Released:2007-11-09)

参考文献数

11

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It has been reported that the pharmacokinetics and pharmacodynamics of carvedilol vary between the S- and R- enantiomers. The aim of this study was to evaluate the pharmacokinetic characteristics of carvedilol for each enantiomer and apply this in clinical practice. Serum stereoselective concentrations of carvedilol were monitored in 60 Japanese inpatients who received a fixed dose of carvedilol. The concentrations were determined by high performance liquid chromatography (HPLC). Serum carvedilol concentration/dose of administered carvedilol ratios were determined for each enantiomer (R/D, S/D). The means±SD for R/D and S/D were 85.8±264.0 (10-3kg/L) and 29.0±78.2 (10-3kg/L), respectively. The mean for R/D tended to be larger than that for S/D (p=0.11), and the dispersion of R/D was significantly greater than that of S/D (p<0.01). Although a significant positive correlation was observed between R/D and S/D, a remarkable difference was observed in a few inpatients. These results suggest that the pharmacokinetics of carvedilol are different for each enantiomer. The monitoring of the stereoselective pharmacokinetics of carvedilol is therefore necessary to ensure proper use.

著者

岩尾 一生 小林 道也 及川 孝司 中駄 優作 藤崎 博子 室谷 光治 伊藤 昭英 辻 昌宏 井出 肇 遠藤 泰 関川 彬 齊藤 浩司

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.34, no.2, pp.112-117, 2008 (Released:2009-09-04)

参考文献数

14

被引用文献数

4 1

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A questionnaire survey was conducted to investigate the use of health foods among outpatients with diabetes mellitus (DM) at the Health Sciences University of Hokkaido Hospital.Responses were obtained from 69.2% of the patients (180 out of 260).The proportions of patients who had used health foods previously or were using them at the time of the survey were 16.7 and 37.2%,respectively,indicating that more than half of the patients had experience of taking health foods and this was irrespective of sex and age.The most frequently consumed health foods were Aojiru (n=25)followed by Kurozu (n=24)and blueberry extract (n=17).Among the health foods taken,those that influence blood sugar considerably were guava leaves polyphenol (n=16),Gymnema sylvestre extract (n=1),Gymnema sylvestre tea (n=1),and Aloe Vera (n=1).One patient was taking a Chinese health food that contained glibenclamide.Many patients took health foods to keep healthy and as a nutritional supplement,and most of them had not consulted their doctors or pharmacists about the use of health foods.More than 70% of the patients targeted by this study had complications such as hypertension.Since there is a possibility of health foods aggravating DM and its complications and of interactions between them and drugs used to treat DM,doctors,pharmacists and other co-medical workers should provide patients with information on the ingredients of health foods as well the adverse effects that they could have.

著者

鈴木 裕之 中村 達也 宮浦 誠治 猪岡 京子 八木 朋美 我妻 恭行 鈴木 常義 髙村 千津子 鈴木 幹子 村井 ユリ子 中村 仁

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.44, no.10, pp.503-509, 2018-10-10 (Released:2019-10-10)

参考文献数

17

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Panvitan® powder for prescription (PP) administrated in combination with pemetrexed sodium hydrate (PEM) for the purposes of folic acid supplementation is significantly degraded by exposure to humidity or light. Hence, we investigated the influence of humidity and light on the color of the powder and concentration of folic acid in PP. We prepared samples by placing 1 g of PP into separate bags and stored them for 28 d under normal delivery conditions, intermediate humidity, high humidity, and light exposure. The amount of folic acid was quantified by high-performance liquid chromatography, where the percentage was calculated assuming the initial amount was 100%. Under normal delivery conditions (room temperature, 50% RH, shielded light) and intermediate humidity conditions (25℃, 75% RH, shielded light), no significant changes in appearance or folic acid content were observed. The sample stored under high humidity conditions (25℃, 91% RH, shielded light) changed in color from yellow to brown. The decrease in folic acid content was time dependent, and decreased to 47.1% after 28 d. Under light exposure (room temperature, 50% RH, 5,000 lux, 0.56 W/m2), the yellow color of PP becomes thin with time, while the folic acid content decreased to 73.2% after 28 d. The amount of folic acid may have decreased without any concomitant visible changes in the powder. The results of this study are expected to facilitate the management of adverse effects of PEM.

著者

河添 仁

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.44, no.7, pp.323-332, 2018-07-10 (Released:2019-07-10)

参考文献数

48

被引用文献数

3

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This review describes the clinical outcomes of pharmaceutical interventions and bidirectional sharing of patient information between a hospital and community pharmacies in outpatient chemotherapy. First, we retrospectively evaluated the clinical outcomes of 56 pharmaceutical interventions relating to chemotherapy-induced adverse events and estimated their associated economic impact. Twenty-nine of the pharmaceutical interventions significantly decreased the grade of adverse events compared with before pharmaceutical interventions. The number of reductions in grade 1, 2, and 3 was 14, 11, and 4, respectively. In accordance with the potential economic costs associated with the Adverse Drug Reaction Relief System of the Pharmaceuticals and Medical Devices Agency and reduction of grade, we estimated that the total cost saving associated with the clinical outcomes of pharmaceutical interventions was JPY11,360,000. Second, we developed a system for bidirectional sharing of patient information between a hospital and community pharmacies, which comprised a modified prescription format and a monitoring sheet for tegafur/gimeracil/oteracil potassium (S-1). Questionnaire surveys showed that community pharmacies significantly understood patient information compared with before the sharing system. We also retrospectively investigated the discovery rate of adverse events in outpatients who had received S-1. The proportion of patients who developed all grades of an eye symptom and grade ≥ 2 nausea significantly increased after implementation of the sharing system, showing that the system was able to track adverse events. In addition, the proportion of patients in which clinicians managed the adverse events slightly increased. These results suggest that our interventions contribute to the quality and safety of outpatient chemotherapy.

著者

今村 牧夫 松井 裕典 片山 健太郎 武本 千恵 上原 孝

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.41, no.4, pp.254-265, 2015-04-10 (Released:2016-04-10)

参考文献数

12

被引用文献数

5 8

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Team medical care needs to be improved at the outpatient clinic to manage highly complex cancer chemotherapy. In May 2008, Kurashiki Medical Center was the first medical institution in Japan to start a pharmaceutical outpatient clinic called a “support clinic.” At the support clinic, oncology pharmacy specialists interview patients and propose several suitable options of drug regimens to the physicians to ensure safe and effective treatment. We evaluated the functions expected of the support clinic and the appropriateness of health insurance application to the clinic's services.Physicians and nurses highly evaluated the work of the oncology pharmacy specialists at the support clinic. The function that they expected most of the support clinic was the design of supportive therapies followed by the design of treatment strategies. All 93 patients surveyed said that the support clinic was beneficial to them. Ninety-six percent of the patients considered that the support clinic services were worth paying.The support clinic has been providing oncology pharmacy specialists with great opportunities to fulfill their potential. Its services are needed by medical professionals and patients who want improved outpatient cancer treatment.

著者

中山 季昭 内田 礼人 片山 明香 嶋崎 幸也

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.44, no.11, pp.575-581, 2018-11-10 (Released:2019-11-10)

参考文献数

9

被引用文献数

2

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Recently, drug vial optimization (DVO) for anti-cancer drugs has been recommended as one of the concrete measures to decrease medical costs. DVO enables us to use single-dose vials for more than one patient to minimize unused drug waste to save on medical costs. Multiple needle punctures of the rubber stopper of the vial, however, could potentially increase the leakage of anti-cancer drugs raising concerns for worker exposure risk during the dose formulation preparation. Thus, we evaluated the relationship between the preparation procedure and leakage of anti-cancer drugs to determine an adequate preparation procedure for multiple use with a low risk of worker exposure.No significant increase in leakage of anti-cancer drugs was observed with the adequate preparation procedure following the preparation manual of each anti-cancer drug together with replacing the device between preparation intervals for multiple use, irrespective of the presence or absence of a closed system drug transfer device (CSTD). In contrast, the preparation procedure with deviations from the preparation manual resulted in a significant increase in drug leakage. These results indicate that CSTD is not mandatory to reduce the risk of worker exposure during the preparation for multiple use although it has been generally recommended. To perform the adequate preparation for multiple use without CSTD, however, replacing the syringe and needle for every single preparation should be mandatory in addition to adequate procedures consistent with the preparation manual such as creating a slight negative pressure and adequate needle puncture (including adequate location and direction).

著者

菅原 拓也 荒井 浩一 倉本 敬二 東海林 徹 浅倉 聖岳 白石 正

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.42, no.10, pp.678-686, 2016-10-10 (Released:2017-10-10)

参考文献数

18

被引用文献数

1

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We previously reported that insoluble particulate matter formed during the mixing of injectable drugs. We considered that the contamination derived from the disposable injection syringe used for the mixture as one of the causes. Therefore, in the present study, we evaluated the amount of insoluble particulate matter caused by using a 50-mL syringe of each manufacturer, using syringes of various capacities and number of piston times (suction and expulsion) of the syringe. Furthermore, we were able to identify the components of the insoluble particulate matter that formed. As a result, we found that a lot of insoluble particulate matter was expelled from the 50-mL syringes of each manufacturer that increased with the capacity of the syringe and the number of piston times. In addition, we found that the insoluble particulate matter was from the silicone oil coating on the inner surfaces of the syringes.

著者

福井 愛子 半谷 眞七子 吉見 陽 野田 幸裕 亀井 浩行

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.44, no.10, pp.516-525, 2018-10-10 (Released:2019-10-10)

参考文献数

14

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We investigated the educational effects of fourth-year pharmacy studentsʼ participation in the case presentation performed by senior students during clinical practice. Two hundred eight fourth-year students participated in the case presentation using Meijo Distance Education System (MDES), and a total number of 509 fourth-year students was administered questionnaires. Of the total number of students, 93.7% answered “watching the case presentation was useful,” 91.2% answered “question-and-answer was useful,” 86.6% answered “I gained useful knowledge,” and 79.7% answered “I was satisfied with the content.” Joining the case presentation is an opportunity for fourth-year students to think about how to apply basic knowledge and appropriate interventions for individual patients. It is useful for junior students to consider senior students as role models to gain further understanding of clinical practice and to improve their motivation to study.

著者

小久江 伸介 大野 能之 折山 豊仁 山口 諒 徳田 篤志 長瀬 幸恵 鈴木 洋史

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.42, no.10, pp.694-700, 2016-10-10 (Released:2017-10-10)

参考文献数

7

被引用文献数

1 4

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At the University of Tokyo hospital, we began allocation of ward pharmacists to some wards in August 2012 and to all wards in August 2014. In this study, we qualitatively and quantitatively reviewed cases reported by ward pharmacists to evaluate the effects of this allocation on intervention and consultation that required positive participation.We retrospectively reviewed the pharmaceutical interventions' record from April 2012 through March 2015. We also analyzed cases for three months after the allocation of pharmacists to every ward. We found a highly positive correlation (R2 = 0.928, P < 0.0001) between the number of wards and pharmaceutical interventions. Intervention cases per month increased by 21.5 after allocating a pharmacist to a ward. There were a total of 2,438 intervention cases over three months. Active and passive approaches were employed in 1,833 cases and 605 cases, respectively. High-risk medicines were associated with 39.3% of cases. The prescription change rate was 86.2% for active interventions and 50.9% for passive interventions.Results showed that the allocation of a ward pharmacist could assist pharmaceutical approaches through the evaluation of patient complaints and clinical conditions, participation in the treatment plan, and consultation from medical staff. There were also reports that an active approach led to critical adverse event avoidance and pharmacotherapy effect improvement. These findings suggest that the allocation of ward pharmacists results in the promotion of healthcare services and medical safety.

著者

加藤 隆寛 岩澤 瞳 甚目 陽子 加藤 顕子 築山 郁人 斎藤 寛子

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.12, pp.680-690, 2017-12-10 (Released:2018-12-10)

参考文献数

34

被引用文献数

1 2

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The efficacy of pharmaceutical interventions for patients with cardiovascular disease has been reported in several countries. However, the interventions especially for patients with cardiovascular disease have not been evaluated for safety, efficacy and economy. To evaluate pharmaceutical interventions in the cardiovascular ward, we evaluated the economic benefit of pharmaceutical interventions retrospectively. We classified pharmaceutical interventions into 3 items, which included type of intervention, intervention that influences patients' outcome, and intervention according to guidelines. Moreover, we evaluated for economic benefit regarding the prevention of serious adverse drug reactions, and avoidance of drug interaction. We also collected interventions for initiating drugs, and the estimated cost savings by decreasing the risk of hospital readmission by initiating drugs.One hundred and thirteen interventions were accepted and 27 interventions were rejected. It was considered that 48 interventions led to safety. The cost saving associated with pharmaceutical interventions that include the prevention of serious ADRs, avoidance of drug interaction and others was estimated to be about 13 million-yen of financial benefit.In addition, 33 interventions were those for changing medications according to several guidelines. The interventions (drug initiation) cut the medical care cost by about one million yen per year by the decreased risk of hospital readmissions.This is the first study to estimate the economic impact directly associated with various pharmaceutical interventions of pharmacists in cardiovascular disease in Japan. Evaluating the economic impact in relation to the pharmaceutical interventions is an important method for assessing the role of pharmacists.

著者

松尾 泰佑 富田 隆 工藤 賢三 佐塚 泰之

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.44, no.9, pp.464-470, 2018-09-10 (Released:2019-09-10)

参考文献数

8

被引用文献数

6

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Tablet splitting, an important task of the pharmacist, is performed at hospitals and health insurance pharmacies. Although magnesium oxide tablets have no score line, the accuracy of their division is not assured. Furthermore, as magnesium oxide strongly absorbs moisture, the stability of half-tablets is unknown when stored in one-dose packages. The variation and loss when splitting magnesium oxide 500 mg tablets by using a tablet-divider were evaluated. The stabilities of split tablets after storage in one-dose packages at 75%RH were evaluated through the analysis of weight change, disintegration, and dissolution. The variation in half-tablets of magnesium oxide 500 mg tablets was 5.5 ± 4.4% and the loss of almost all tablets was below 1%. Although the weight of the half-tablets increased when preserved in one-dose packages, this was related to the quantity of magnesium oxide stored in one-dose packages and not on the splitting of tablets. The disintegration time of half-tablets was prolonged by increased moisture absorption, but the disintegration time of split tablets was shorter than that of whole tablets when the same quantity of moisture was absorbed. The dissolution rate was similar among split tablets and whole tablets. Magnesium oxide tablets can be administrated as a split tablet, but caution should be exercised regarding prolonged disintegration time. Pharmacists should be careful when using half-tablets in prescriptions.