病院と薬局の合意に基づく院外処方せんにおける疑義照会簡素化プロトコルとその効果

抄録

Many medical treatments, which were invasive and used to be provided under hospitalization, have been recently performed in the outpatient center. A multidisciplinary approach to the medical care is also required to secure safe and effective pharmacotherapy of the outpatient; therefore, the cooperative care between the hospital and community pharmacy is necessary. In Kyoto University Hospital, a new protocol, which consisted of 8 agreements between our hospital and community pharmacies, was conducted from October 2013. In these agreements, there were concrete examples, which were unrequired inquiries about the prescription to doctors by telephone. In December 2014, the protocol was revised to add 7 agreements, which were also unnecessary inquiries in outpatient prescriptions. The number of prescription changes based on the protocol significantly increased from 13% in September 2014 to 21% in March 2015 of the total changes including those by the phone call in the corresponding periods. Although 20% of the changes in the prescriptions deviated from the protocol in September 2014, the protocol deviations decreased to 7% in March 2015. From July 2014 to June 2015, 829 outpatient prescriptions were changed based on the protocol, and a maximum of 10,940 yen per patient was saved, since the pharmacist found residual drugs in the patient's home and intervened to reduce medication days in the prescription. In conclusion, the protocol for unrequired inquiries about the prescription to doctors in the community pharmacy saved the working times of medical doctors and pharmacists, and possibly contributes to promoting pharmaceutical care to patients.