著者
赤沢 学
出版者
一般社団法人 日本臨床薬理学会
雑誌
臨床薬理 (ISSN:03881601)
巻号頁・発行日
vol.41, no.5, pp.245-252, 2010 (Released:2010-11-25)
参考文献数
18
被引用文献数
1 1

A number of new vaccines for preventable diseases such as meningitis and cervical cancer are getting available for Japanese children. However, those vaccines are categorized as voluntary vaccination and their costs should be paid by recipients. Therefore, high cost is a barrier for access to the preventive care. In addition, subsidiary by local governments causes their regional disparities. On the other hand, the Advisory Committee on Immunization Practices (ACIP) in the United States recognizes importance of economic analyses in establishing policy for addition of new vaccines to routine immunization schedules. The ACIP publishes guidance for health economic studies to ensure that high quality economic data are presented in a standard format. In this study, a critical review of economic analyses for childhood vaccine programs in Japan was conducted. Six original studies that included varicella, mumps, Hib (haemophilus influenza type B), pneumococcal disease and human papillomavirus vaccines were identified by a systematic literature review. The results of all studies suggested that these new vaccines should be included to routine immunization schedules because expected benefits would outweigh additional costs of vaccines. However, according to the check lists recommended by ACIP guideline, these studies utilized various sources of cost information and calculated opportunity costs differently. Some studies did not consider discounting of future costs. Therefore, direct comparisons between studies were very difficult. Economic analyses to evaluate the priority of vaccine programs should follow a standard method to increase comparability and quality of studies.

49 0 0 0 OA 5.CONSORT声明

著者
津谷 喜一郎
出版者
一般社団法人 日本臨床薬理学会
雑誌
臨床薬理 (ISSN:03881601)
巻号頁・発行日
vol.40, no.3, pp.105-110, 2009 (Released:2009-08-12)
参考文献数
7

24 0 0 0 OA 4.JIKEI HEART研究

著者
三輪 宜一
出版者
一般社団法人 日本臨床薬理学会
雑誌
臨床薬理 (ISSN:03881601)
巻号頁・発行日
vol.39, no.5, pp.157-161, 2008 (Released:2009-02-05)
参考文献数
18

6 0 0 0 OA 3. 片頭痛

著者
中島 健二 竹島 多賀夫
出版者
一般社団法人 日本臨床薬理学会
雑誌
臨床薬理 (ISSN:03881601)
巻号頁・発行日
vol.36, no.6, pp.277-283, 2005-11-30 (Released:2010-06-28)
参考文献数
24
著者
永井 恒司
出版者
一般社団法人 日本臨床薬理学会
雑誌
臨床薬理 (ISSN:03881601)
巻号頁・発行日
vol.2, no.2, pp.189-195, 1971-04-30 (Released:2010-06-28)
参考文献数
22
著者
安藤 利奈 山崎 知恵子 岩城 寛尚 辻井 智明 矢部 勇人 西川 典子 永井 将弘 野元 正弘
出版者
一般社団法人 日本臨床薬理学会
雑誌
臨床薬理 (ISSN:03881601)
巻号頁・発行日
vol.48, no.5, pp.167-171, 2017-09-30 (Released:2017-10-28)
参考文献数
11
被引用文献数
2

Parkinson's disease (PD) causes motor impairment, but motor dysfunction can be improved by treatment. However, the package inserts of PD therapeutic drugs state “do not drive a car” as an important precaution in Japan. In addition, the package insert of non-ergot dopamine agonist (DA) states specifically “do not drive a car or operate a machine” as a warning because non-ergot DA causes sudden sleepiness and somnolence. On the other hand, driving is a very important means of transportation for daily living and work. Even though doctors explain at the clinic that the patients should not drive while on medications, many patients are forced to drive in everyday life. In addition, somnolence and sudden sleepiness differ among individuals. Therefore, doctors are confused about instructing patients to refrain from driving. We investigated the relation between non-ergot DA and driving situation in PD patients, which is a serious issue in the clinical setting. All 362 PD patients who visited our offices were interviewed regarding their driving situation, and detailed medications and car accidents were examine in 154 patients who continued driving a car or stopped driving after the onset of disease. In the investigation of medications, 51 patients were taking non-ergot DA, 36 patients (70.6%) of whom continued to drive. In addition, 20 of 154 patients had serious car accidents, but only six of the accidents were associated with somnolence and sudden sleepiness. In the examination of medications at the time of accident, there was no difference between non-ergot DA and other medications. These results suggest that upon receiving instructions from healthcare professionals, PD patients drive while making appropriate judgment about medication-induced somnolence. However, in this study, the number of patients who experienced serious car accidents was small, and the numbers of patients taking ergot DA and non-ergot DA were limited. Further larger scale study is required to confirm the findings. Preparation of guidelines related to instructions on taking PD medications is necessary, which include medication taking during holidays, consideration of the occurrence of sudden sleepiness and somnolence, and judgement of whether to continue driving.
著者
三輪 英人
出版者
一般社団法人 日本臨床薬理学会
雑誌
臨床薬理 (ISSN:03881601)
巻号頁・発行日
vol.40, no.4, pp.145-150, 2009 (Released:2009-10-15)
参考文献数
17

The placebo effect can be observed in various medical conditions, and has been documented by randomized placebo-controlled drug studies. One of the best examples is the placebo effect in Parkinson's disease (PD). The placebo effect is observable not only in drug trials but also with surgical therapies, such as deep brain stimulation, fetal tissue transplantation, and infusion therapy of a neurotrophic factor. A recent study using positron emission tomography (PET) with raclopride demonstrated that the release of endogeneous dopamine in the dorsal striatum mediates the placebo effect in PD, suggesting that the placebo effectiveness is achieved by endogenous dopamine supplementation. Although the detailed pathophysiological mechanism underlying the placebo effect is unclear, the placebo effect has been explained by two mechanisms: the conditioning theory (pavlovian conditioning) and the cognitive or expectancy theory (expectation of clinical improvement). Speculatively, it may be that the placebo effect in PD is related more to cognitive mechanisms. Numerous studies have suggested a functional relationship between dopamine and the reward system. Understanding the placebo effect is important for designing clinical trials and interpreting their results.
著者
景山 茂
出版者
一般社団法人 日本臨床薬理学会
雑誌
臨床薬理 (ISSN:03881601)
巻号頁・発行日
vol.34, no.6, pp.297-300, 2003-11-30 (Released:2010-06-28)
参考文献数
9