Patients' impressions of pharmacists at the time of consultations are important for building a relationship of trust between the cancer patient and the pharmacist. In this survey conducted using an adjective-pair questionnaire, we investigated changes in patients' impressions about pharmacists and associated factors because of continuous consultations with pharmacists. The subjects were outpatients with cancer at the Tsushima City Hospital who received their first cancer chemotherapy regimen from August 2018 to August 2020. Board Certified Pharmacist in Oncology Pharmacy consulted with the subjects at each treatment, and the subjects' impressions about these pharmacists were investigated using the questionnaire twice, during the first and the fifth treatment sessions. The survey was aimed at evaluating adjective-pairs on a 7-tier scale. The data obtained from the patients' medical records were date of birth, gender, cancer type and stage, regimen, and adverse events and their responses. We also calculated the predicted 5-year survival rate and analyzed the changes in each adjective-pairs for each patient attribute. As a result of 14 people, after 5 times each in 3-4 months, the score related to the sense of stability changed significantly to a negative impression as a whole. However, when changes in impressions were compared using the patient attributes of age, gender, predicted 5-year survival rate, and whether or not the patient complained of adverse events, the impressions of female patients and patients who complained of adverse events were found to tend toward a change to "pleasant" (p = 0.031 and p = 0.027, respectively). We found no significant changes in the cancer patients' impressions about pharmacists after five pharmacist consultation sessions. However, patient gender and adverse events were the factors that affected the patients' impressions. Overall, our findings suggest that sufficient consideration should be given to building a relationship of trust between cancer patients and oncology pharmacists.

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encouragement to 76 individuals. Risk factor measurements showOsteoporosis in older adults can lead to bone fracture, which can aggravate not only the quality of life but also life convalescence. Previous studies have shown that fewer patients receive treatment than the estimated total number. Studies have demonstrated that changes in bone density are associated with age, sex hormones, environmental factors, genetic factors, and medication. Thus, the Toyoake Pharmaceutical Association conducted an investigation that targeted people without osteoporosis, which was confirmed through bone density measurement using supersonic wave bone mass measuring equipment, via an interview on remedy medication. The study recruited 209 individuals (female: 87.1%; median age: 70.0 years; interquartile range: 57.0–76.0 years). Female respondents demonstrated a higher enforcement rate of fracture precaution (53.8%) than male respondents (29.6%). Further, we provided lifestyle guidance to 12 individuals and consultation ed that the condition of the elderly and women are the worst. The risk of bone beam area fracture was <23.9% in the elderly and those who have already had fracture in addition to the possibility of taking fall-related medicines. The present study found that bone density measurement and survey interview of locals on remedy medication enabled the prediction of fracture risk. The results can serve as reference for various types of interventions, such as lifestyle guidance and consultation encouragement.

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Insurance pharmacies are required to centrally and continuously record patient medication information, manage and instruct patients, and treat patients utilizing Information and Communications Technology (ICT). Therefore, we investigated the use of information on the regional cooperation system "Kinshachi-medinet" (KM) in the pharmacies of Nagoya Medical Center. Ten patients, who visited the hospital from September 2015 to July 2016 and agreed to share information on KM, were included in this study. The most-viewed items on KM were records of doctors and pharmacists. The use of information was significantly higher on days other than the prescription-issue date (P=0.019). The number of patient visits was correlated with the number for views of consultations on KM, and the views of consultations was found to increase proportionally (r= 0.82) with the number of visiting patients. It was suggested that availability of patient information on KM was related to the way medication guidance was practiced. After the disclosure of electronic medical record (EMR) on KM, it was found that the EMRs were browsed on days other than the patient-visit day also. This implies a change in the way medication guidance is done. It was recommended that using ICT for sharing medical information between different stakeholders is essential for business efficiency and continuous care of patients, and sharing information through KM is one of the means for insurance pharmacies to play a part in community comprehensive care by more robust cooperation with various stakeholders and multiple institutions.

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We conducted a web-based survey of pharmacists in hospital and community pharmacies in the Kingdom of Thailand to clarify issues related to non-communicable disease medication in elderly patients. The survey asked about the respondents’ background and drug sales for non-communicable diseases. Furthermore, the survey asked pharmacists about their ability to recognize drug-related issues in elderly patients with chronic conditions, the types of medication support provided at the pharmacy, and whether polypharmacy measures were implemented. We performed chi-square tests to compare the responses of hospital and community pharmacists. In total, 209 pharmacists responded. In the Kingdom of Thailand, drugs for non-communicable diseases requiring a doctor’s diagnosis and pharmacist guidance in other countries were sold without a prescription at more than half of the community pharmacies, such as glibenclamide, glipizide, metformin, simvastatin, amlodipine, enalapril, hydralazine, amiloride hydrochloride/hydrochlorothiazide, metoprolol, propranolol, and atenolol. Community pharmacists were less aware of drug treatment issues for elderly patients with non-communicable diseases than hospital pharmacists (p<0.001). Hospital pharmacists also provided more medication support than community pharmacists (p<0.001). These results emphasize the importance of sharing information between hospital and community pharmacies regarding drug treatment for elderly patients with non-communicable diseases.

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As the community-based integrated care system is advanced in Japan, we can expect an increase in the number of patients receiving medication via tubing at their homes. Under such a trend, it will become increasingly important to provide guidance and support about the simple suspension method to patients receiving medication via tubing and to their caregivers at home. The present study was undertaken to investigate the current status of the calculation of the amount to be billed to the insurer under the recently started tube medication support fee reimbursement system and the method of drug administration to patients receiving tube medication, using a questionnaire addressed to administrative pharmacists at insurance pharmacies. Responses to the questionnaire were collected from 384 insurance pharmacies (53.5%). The percentage of insurance pharmacies practicing the calculation of the tube medication support fee was as low as 2.1% (6/283 pharmacies), and the percentage of pharmacists having experience with guidance about the simple suspension method was also low (13.8%, 47/341 pharmacies). The percentage of insurance pharmacies having made a counter-proposal to physicians prescribing drugs unsuitable for the simple suspension method was significantly higher among the insurance pharmacies having experience with guidance to patients about the simple suspension method (14.9%, 7/47 pharmacies) than among those without such experience. When asked about how the simple suspension method was learned, the majority (55.3%) answered that they learned it on “Internet websites.” Care needs to be taken with the information available on these websites since the reliability of the information is sometimes low. It is desirable, henceforth, that pharmaceutical companies appropriate information about the suspension procedure of their products by means of interview forms, homepages, etc. Furthermore, to enable pharmacists to provide appropriate support about the simple suspension method to patients on tube medication and to their caregivers, it is desirable that hands-on training be provided at the initiatives of pharmacist associations or the like, accompanied by measures such as reinforcing the system for collection and supply of highly reliable information and increasing the opportunities for on-site training.

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With recent advances in medical development and increasingly complex patient characteristics, it is helpful to cooperate with each medical staff equipped with professional skills. For this reason, as part of the medical team, pharmacists have been participating in medical conferences and rounds. As a result, it is helpful for task-shifting and sharing performed with multi-medical staff. However, little is known about the effect of pharmacists' participation in medical conferences and rounds with respect to pharmacist provisional prescribing as task-shifting and sharing of physicians’ work. Hence, we studied the effect of shifting physicians' work to pharmacists as pharmacist provisional prescribing in inflammatory bowel disease (IBD). A retrospective analysis was conducted on the prescriptions of IBD patients hospitalized and prescribed at Tsujinaka hospital Kashiwanoha between January 2018 and December 2020. Out of the total prescriptions registered, 835 were internal and topical medications and 2105 were injections. Pharmacist provisional prescribing accounted for 581 (69.6%) internal and topical medications and 503 (23.9%) injections. Furthermore, in a multivariate analysis of pharmacist provisional prescribing, “Regularly participates at rounds with physicians” had significant positive factors, with an adjusted odds ratio (adj-OD) of 5.03 (95% CI [confidence interval] 2.31-10.96, P‹0.001) for internal and topical medications and an adj-OD of 6.26 (95% CI 3.50-12.01, P‹0.001) for injections. Therefore, we found that a positive factor in task-shifting from physicians to pharmacists was initiatives by pharmacists who regularly participate in rounds with physicians.

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Ulcerative colitis (UC) is an intractable inflammatory disease of unknown etiology, with no effective radical cure. The treatment is centered on drug therapy. The first-line drug for the induction and maintenance of remission in mild to moderate UC is 5-aminosalicylic acid (5-ASA). The goal of treatment is to maintain long-term remission by selecting a suitable treatment method based on the pathological condition and symptom control. Patient adherence is considered an important factor in improving the therapeutic effect for maintaining remission. Therefore, to examine the patient approach and medication guidance measures taken by pharmacists to improve medication adherence, we explained the current status of compliance of patients receiving 5-ASA medication and requirements for pharmacists to take necessary actions. An attitude survey was also conducted. Responses were obtained from all 32 patients prescribed with oral 5-ASA medication. Incomplete adherence was observed in 19 patients, accounting for more than half of the patients. Factors that influence medication adherence may be related to patient age. In addition, more than half of patients with incomplete medication adherence preferred a single daily dose before or after breakfast. Half of the patients (n=16) reported that they had received a request for treatment from a pharmacist. The most selected item was the continuous administration of medication observed in 9 patients (60.0 %), whereas the number of medication advice, provided to 8 patients (50.0 %), was ranked second. The pharmacist's approach to improving medication adherence in patients with UC ensures continuous management and guidance of medication, and plays the role of a family pharmacist and pharmacies in providing the required patient care. The most suitable drug is selected according to the number of doses and the duration of administration depending on the stage and lifestyle of the patient. Therefore, it was considered important to make proactive prescription proposals to doctors. In particular, attention should be paid to young patients requiring long-term continuous administration of medication.

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The new coronavirus contagion is highly infectious and has spread worldwide in a few months. In Japan, these circumstances promoted the consideration of various medical professionals to participate and establish a system that can provide vaccination promptly. Therefore, pharmacists and dentists were also considered. Although dentists were admitted as a special case, pharmacists were not admitted. Against this background, the pharmacy university, the regional pharmacist association, and the three companies collaborated to hold a training session that discussed measures for pharmacists to demonstrate their abilities under the current law. Moreover, a questionnaire survey was shared with the participants of the workshop. The questionnaire included questions regarding their knowledge of injection techniques and vaccines, and their satisfaction with the workshop. The questionnaire was collected from 45 (97.8 %) of the 46 participants. The responses to the question on knowledge about injection techniques and vaccines showed that the knowledge improved after the training as compared to before the training. Furthermore, all respondents answered that they were satisfied with the workshop. Considering these findings, under the current law, one of the –measures pharmacists can use to demonstrate their abilities is to acquire the knowledge about injection techniques and vaccines, and to respond to consultations from patients to eliminate their anxiety about vaccination. This will ensure improved inoculation rate. Therefore, we would like to contribute to the society as a pharmacist by continuing the work of the workshop.

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Background: Guidelines in the United States and Europe recommend the addition of olanzapine to the standard triple antiemetic therapy for chemotherapy-induced nausea and vomiting (CINV) in patients receiving highly emetogenic chemotherapy (HEC). However, no meta-analysis has directly compared the efficacy and safety of standard triple antiemetic therapy with the addition of olanzapine for CINV in patients only receiving HEC. This study aimed to conduct such a meta-analysis of randomized controlled trials. Methods: We searched the MEDLINE, Cochrane Library, and Igaku Chuo Zasshi databases for articles published between 1966 and October 2021 for randomized controlled trials (RCTs) that compared the efficacy and safety of the two therapies for CINV in patients receiving HEC. Results: Among the 1041 relevant articles, five RCTs were eligible for inclusion in the meta-analysis. The add-on olanzapine therapy was significantly more effective than the standard triple antiemetic therapy; the odds ratio [95% confidence interval] of complete response, no nausea, no vomiting, and the use of rescue medications were 2.30 [1.80 to 2.95], 1.84 [1.22 to 2.78], 2.71 [1.59 to 4.61], and 0.59 [0.48 to 0.74], respectively. The add-on olanzapine therapy was associated with mild somnolence more frequently than the standard triple therapy (2.20 [1.26 to 3.85]); however, it did not affect the treatment continuation. The incidence of insomnia was significantly low (0.72 [0.54 to 0.95]) with additional olanzapine therapy, and that of hyperglycemia was comparable between the two groups (2.33 [0.34 to 15.91]). Conclusions: The present meta-analysis would endorse that the add-on olanzapine therapy demonstrated significantly higher efficacy and tolerability than standard triple antiemetic therapy in CINV patients receiving HEC.

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General consumers use over-the-counter (OTC) eye drops for the prevention and treatment of mild eye diseases such as eyestrain and allergic symptoms. Because eye drops are sterile preparations, inappropriate use may cause bacterial contamination and lead to infectious complications. Therefore, pharmacists/registered sellers must consult with purchasers of OTC eye drops about their proper use. In this study, we conducted a questionnaire survey on general consumers with a record of purchasing/using OTC eye drops (hereafter “consumers with a purchase record”) regarding how they purchase them, how they selected specific eye drops, why they purchased them, and knowledge and understanding of the proper use of them. 70.7% of consumers responded that pharmacists/registered sellers provide no particular instruction about the proper use of eye drops. Only 53% of respondents (254/480) read attached package insert of eye drops (hereafter “package insert”) immediately after opening the package. Similarly, they were not considered highly self-motivated in obtaining drug information by reading the package insert at the time of use, informing the use of contact lenses to pharmacists/registered sellers or showing their medication record book when they purchased eye drops. Furthermore, our study showed that pharmacists/registered sellers sell OTC eye drops to general consumers without confirming the purpose of use and patients’ background, suggesting that the instructions on proper use of eye drops may not be provided sufficiently. Collectively, our study indicates that current purchasers of OTC eye drops may have a risk of drug interactions, adverse events, and/or adverse reactions.

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Sodium-glucose co-transporter 2 (SGLT2) inhibitors exhibit an insulin-independent antihyperglycemic effect and are used as therapeutic agents for the treatment of diabetes. Recently, they have been shown to exert additional effects, such as prevention of heart failure and protection of renal function. Specifically, empagliflozin (10 mg) has been used to treat chronic heart failure even in patients without diabetes. However, SGLT2 inhibitors are associated with natriuresis and osmotic diuresis, and the Japan Association for Diabetes Society made a series of recommendations regarding the proper use of these drugs. In this study, we investigated the use of empagliflozin for the treatment of heart failure and examined how pharmacists should be involved for its proper use. The ages and values of laboratory tests of patients who were prescribed empagliflozin for either the treatment of heart failure (heart failure group, n=15) or diabetes (diabetic group, n=19) were compared. The median age was considerably higher in the heart failure than in the diabetic group (76.4 ± 11.6 vs 57.7 ± 14.3 years). In contrast, HbA1c was markedly lower value in the heart failure than in the diabetic group (6.9% ± 1.0 vs 9.0% ± 1.6). Additionally, estimated glomerular filtration rate (eGFR) was substantially lower value in the heart failure than in the diabetic group (52.1 ± 17.6 vs 74.6 ± 24.6 mL/min/1.73m2). Blood levels of sodium (Na) and potassium (K) were significantly lower value in the heart failure than in the diabetic group, although both were within normal limits (Na: 138.4 ± 0.83 vs 139.7 ± 2.1 mmol/L; K: 4.0 ± 0.59 vs 4.4 ± 0.25 mmol/L). When empagliflozin is prescribed for the treatment of other pathologies than diabetes, such as heart failure, it is important to check the age and the values of biochemical parameters such as eGFR and electrolyte levels to ensure the appropriate therapeutic efficacy and prevent side effects.

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In Japan, there has been insufficient investigation of the factors affecting medication adherence by patients undergoing ambulatory cardiac rehabilitation. To support medication persistence by these patients, medication adherence was surveyed, and the factors affecting it explored, by using a structured, face-to-face questionnaire survey that was able to assess not only the level of compliance with prescription-drug-taking but also patients’ self-motivation toward treatment. The subscale scores for medication adherence, obtained from 35 patients by using a questionnaire based on the work of Ueno et al., were as follows. “Level of medication compliance” (median, 15 points) and “Acceptance of taking medication and fitting in medication-taking with patient lifestyle” (14 points) were high. However, “Collaboration with healthcare providers in taking medication” (8 points) and “Willingness to access and use information about medication-taking” (7 points) were low. “Level of medication compliance” among non-working people (15 points) and “Collaboration with healthcare providers in taking medication” among married people (11 points) were high. From this preliminary study, we consider that, to improve or maintain the medication adherence of patients undergoing ambulatory cardiac rehabilitation, it is important that pharmacists provide drug information that is based on an understanding of the patients’ information needs. This will improve collaboration with patients and raise patients’ motivation to participate proactively in their treatment.

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As healthcare finances become tighter with the aging society, several studies have aimed at optimizing healthcare costs. One promising approach to reducing healthcare costs is academic detailing, a method of outreach in which academic detailers provide medical information on medical supplies to medical professionals. This activity has existed for over 40 years in other countries; however, it is still in its nascent stage in Japan. In this study, we discuss the development and deployment of an academic detailer training program aimed at fostering human resources for academic detailing in the Japanese medical field. In developing this training program, which brought together highly specialized professionals from different fields, members demonstrated shared leadership based on their professional expertise for a clear shared mission. In addition, the management control system functioned as a mechanism to support organizational operations in which members could incorporate a shared mission into specific activities and act under shared leadership. To implement academic detailing in healthcare settings in the future, pharmacists will need to learn leadership and management skills.

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Within Japan, national medical costs are continuing to increase owing to the aging population and advances in medical technologies. The market share occupied by generic drugs is still low compared with other countries. We investigated trends in the use of generic drugs (tablets) with introduced authorized generics (AGs) using National Database of Japan (NDB) Open Data. We evaluated the impact of introducing AGs on the transition to generic drugs. We found that more than 80% of drugs with AGs had generic usage rates exceeding 70%. AGs are often used to treat chronic diseases, such as hypertension. Branded drug manufacturer-approved AGs are considered associated with less negative perceptions; however, despite this, it remains difficult to say whether the introduction of AGs has promoted the use of generic drugs overall. Furthermore, we inferred that the timing of introduction to the market is vital for AGs. Considering the tight medical financial situation in Japan, shifting to the use of generic drugs, including AGs, would be favorable after patents for branded drugs expire. It is also necessary to conduct a detailed analysis of trends in the use of generic drugs, including AGs.

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