院外処方箋疑義照会簡素化プロトコールの運用状況の評価および医師・保険薬局へのアンケートに基づいた有用性と問題点の検討

抄録

In March 2021, Yamagata University Hospital created a protocol based on a simplified out-of-hospital prescription questionnaire to improve work efficiency. To confirm the effect of the protocol on work efficiency and identify its limitations, we examined the number and content of prescriptions changed by community pharmacies and the economic effect 4 months before and 6 months after introducing the protocol. In addition, we conducted a survey among the community pharmacists and doctors working in Yamagata University Hospital, using a questionnaire. The protocol was applied to 52.3％ of all the prescription changes within 6 months of introduction. Compared to the period before introduction, the number of prescription changes based on the protocol increased from 43.3 ± 15.6 to 176.0 ± 27.1 per month (P < 0.001). However, inappropriate use of the protocol was observed in 1.1％ of the prescription changes applied according to the protocol. The protocol implementation significantly increased the amount of monthly drug cost reduction due to residual medicine adjustments from JPY 76,990 ± 56,255 to 221,846 ± 85,036 (P = 0.018). The questionnaire showed that work efficiency was improved in 52.2％ and 75.4％ of the doctors and community pharmacists, respectively. Moreover, 43.3％ of the doctors and 52.9％ of the community pharmacists who were not enlisted to implement the protocol stated that they were not aware of such a protocol. Thus, the present study revealed that the protocol improved work efficiency. Our results also suggest that the protocol encourages community pharmacists to optimize prescriptions. Further awareness of the protocol is necessary for its spread and appropriate use.