へき地における災害対策移動薬局車両の平時活用による出張調剤の実証的検討：実装と運用評価

抄録

Pharmaceutical access remains a major challenge in Japan’s remote and underserved areas, driven by aging, pharmacist shortages, and inadequate infrastructure. To forge a practical solution, we conducted a pilot study deploying a disaster-response mobile pharmacy vehicle (MPV) for routine, non-disaster use within a pharmacy-less community in Gifu Prefecture. The MPV was operational twice per week for 6 months (October 2022–March 2023), receiving outpatient prescriptions, dispensing medications, and providing essential counseling and adherence support. Over 49 days of operation, 96 patients were served with 97 prescriptions. Pharmacists conducted 13 prescriber clarifications (13.4％), which included leftover-medication adjustments, regimen simplification, and a re-examination referral. One-dose packaging was provided to 15 patients (15.6％). Generic drug use increased from 60.8％ during prepilot in-clinic dispensing to an average of 79.2％ during the pilot. Furthermore, medication notebook presentation increased to 93.8％. The patient reported an enhanced understanding of drug effects and adverse reactions despite a decrease in satisfaction regarding the waiting time. The clinic staff reported substantial benefits, including reduced dispensing workload, relief from inventory management, and increased prescribing flexibility. Even with existing legal and operational limitations, routine MPV deployment was deemed feasible, successfully enhancing pharmaceutical access, improving medication safety, and boosting the quality of care. The findings indicate that MPV is valuable beyond disaster response, establishing it as a sustainable model for enhancing health system resilience and promoting the separation of prescribing and dispensing in remote and medically underserved areas. Additional multisite, controlled studies are required to validate its effectiveness and long-term sustainability.