保険薬局における心不全療養指導の現状と今後の課題

抄録

The number of patients with heart failure has been steadily increasing in Japan, resembling somewhat of a heart failure pandemic. Since the failure of patient-related factors rather than medical factors results in the exacerbation of heart failure, heart failure education such as preclinical preventive measures and self-care support is important for the patients. This indicates that there is a need to establish a framework for comprehensive heart failure education that involves multidisciplinary teams available for outpatients and those in a home-care setting, in addition to the heart failure teams in hospitals. Therefore, we conducted a questionnaire survey to ascertain the current statuses and future issues concerning heart failure education in community pharmacies. We obtained responses from 444 local community pharmacies in Hokkaido. More than 85％ of community pharmacists understood the exacerbating factors for heart failure. The pharmacists significantly recognize that heart failure education is a better intervention approach for patients in a home-care setting compared to outpatients. However, only 28.4％ of the pharmacies currently performed interventions against heart failure exacerbation even for the patients in a home-care setting, suggesting that the pharmacies found it difficult to provide prescription proposals and self-care support due to the lack of clinical information and medical cooperation with the medical institutions. Recently, certified heart failure educators have been established and this would potentially attract the attention of the pharmacies. Therefore, it would be desirable to develop professional heart failure educators and implement multifaceted healthcare with multidisciplinary heart failure teams in local communities.