Injectors for the self-injection of insulin, a drug used to treat diabetes mellitus, have been considerably improved with regard to usability and convenience as well as therapeutic safety and efficacy. However, it is possible that users may face difficulty in using them due to problems on their side, such as decreased grip strength. Therefore, there is a need to select the appropriate drug both from the formulation and injector perspective. In this study, we inves-tigated the relationship between grip strength and insulin infusion time. Grip strength of the dominant hand was measured in fourth-year pharmacy students, and the time required to infuse 8 units of insulin formulation was measured using four different pen-type injectors. The prescription quantity for each injector was determined using NDB open data. The results revealed a longer injection time for three of the four injectors (FlexTouch®: FT, FlexPen®: FP, Myriopen®: MP, and Solostar®: SS), namely FP, MP, and SS. NDB open data results also showed that FT was the most used injector despite delivering the lowest number of for-mulations. Although differences in infusion time attributed to those in grip strength were evident, we inferred that unlikely to have a direct impact on treatment efficacy, since the time difference was approximately 0.2 to 0.3 seconds for 8 units of insulin in all injectors. However, as grip strength is not the sole factor affecting infusion time, it is important to personalize instructions for individual patients.

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Our survey recommended that pharmaceutical manufacturers and distributors of ethical ophthalmic solutions dispense information in Braille to improve the visibility of promotional items in order for visually impaired patients to understand the appropriate usage methods of eye drops and maintain medication adherence. In this study, an awareness survey was conducted among 44 pharmaceutical manufacturing companies (29 respondents; 15 non-response bias) on the implementation of market research on medication adherence support for visually impaired patients to properly use eye drops, and the development status of products such as promotional items. Our data showed the questionnaire response rate of 65.9% (29/44 companies). Additionally, there were 12 pharmaceutical manufacturers (41.3%) that conducted user awareness surveys, which was intended to gain feedbacks on convenience from use of the eye drops being developed, on not only medical personnel such as doctors and pharmacists, but also patients and their families. Moreover, 14 companies (48.3%) produced promotional items such as Braille labels to be attached to eye-drop containers, to indicate the correct administration technique. Notably, more appropriate promotional items had been created by significantly higher number of pharmaceutical marketing authorization holders who conducted awareness surveys compared to those who did not.

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Cancer cachexia is strongly associated with symptoms that reduce patients' quality of life (QOL), such as weight loss, anorexia, and fatigue, and is also involved in decreased tolerance to anticancer drugs and cancer pain, which are factors that worsen prognosis. In addition, taste disturbance and stomatitis, which are side effects of anticancer drugs and radiation therapy, are thought to be involved in the progression of cancer malignant fluid. Among these, dysgeusia is a side effect that occurs in more than half of patients treated with anticancer agents. However, it is not considered important because it is not a fatal side effect and does not directly affect treatment outcomes. No effective treatment for cancer cachexia existed until the approval of anamorelin hydrochloride in April 2021. The pharmacological effects of anamorelin are thought to be the release of growth hormone (GH) in the pituitary gland by acting on ghrelin receptors and the increase in muscle mass and body weight by increasing appetite in the hypothalamus. On the other hand, because anamorelin hydrochloride is a new drug, the number of patients using it is small and information about the drug is limited to the package insert and interview form. Therefore, we report a case of taste disorder in a patient with advanced pancreatic cancer who developed cancer cachexia, and whose quality of life was improved by anamorelin hydrochloride.

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Magnesium oxide, a low-price laxative without a habit-forming tendency after long-term use, is widely used for treating constipation in Japan. However, its use has been associated with hypermagnesemia in patients with impaired magnesium excretion function such as renal insufficiency. Therefore, in this study, we investigated the use of magnesium oxide tablets, which may be administered to the elderly on a long-term basis. We found the total number of prescriptions has increased year by year and exceeded 4 billion tablets in FY 2020. The use and number of prescriptions were highest among individuals in their 80s, and more than 70% of patients taking the drug are aged 70 years or older. Since the elderly experience physiological functional decline, pharmacists must make effective use of not only age but also laboratory data listed on prescriptions when dispensing these medications in order to prevent adverse events.

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Hyperlipidemia is a risk factor for arteriosclerotic disease. Fibrates have been used as therapeutic drugs for hyperlipidemia. Pemafibrate, a novel fibrate, is a selective peroxisome proliferator-activated receptor α modulator that is prescribed to patients with renal dysfunction owing to its unique metabolism and excretory profiles. However, there is limited information on its use in patients with renal dysfunction, which is a risk factor for adverse events in these patients. This study investigated the effect of administering 0.1 mg of pemafibrate once daily to dyslipidemic patients with chronic kidney disease (CKD) that had progressed to stages G3b or G4. A total of six patients were included in this study and a comparison of clinical laboratory data before and after 12 months of pemafibrate administration was performed. The effects of pemafibrate on triglyceride (TG), aspartate aminotransferase, alanine aminotransferase (ALT), lactate dehydrogenase, creatine kinase, serum creatinine, uric acid, hemoglobin A1c levels, and estimated glomerular filtration rate were examined. Of all the measured parameters, TG and ALT levels decreased over time, but there was no clear effect on the other parameters. These results show that once-daily 0.1 mg pemafibrate can be a potential treatment option for patients with CKD. However, the study needs to be extended to a larger population to validate the findings.

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To reinforce the importance of “medical communication” for medical students, we investigated perceptions of third-year pharmacy and second-year nursing students regarding communication before and after taking a course in “Communication for Patients”, a part of interprofessional education at Setsunan University. A free-form anonymous questionnaire survey was conducted on the course in 2018, 2019, and 2021, and the descriptions were analyzed by text mining analysis using KH Coder. The course was conducted by a lecturer faculty member, and was followed by an exercise for teams of pharmacy and nursing students. They role-played being the patient, nurse, and pharmacist in different clinical cases. They had to listen to the patient’s “physical condition and the medicines they were taking” and observe the behavior associated with each role. After the role-play, students discussed their awareness of communication throughout the role-play and presented their findings to the class. Since the classes were conducted in a face-to-face manner in 2018 and 2019 and in a remote format in 2021, the questionnaires were analyzed separately for these different formats. Before attending the course, and for all the survey years, the pharmacy students said “person with whom we speak” and “tell” for “what is important in medical communication”, and the nursing students said “person with whom we speak” and “listening closely” for the same category. We supposed that the pharmacy students focused on their “medication teaching as a pharmacist”, and the nursing students focused on the “experience of contact with patients in clinical practice”. After the course, for all survey years, the pharmacy students mentioned “empathy”. For “points that I became more aware of after the class”, both the nursing and pharmacy groups listed “look” in the 2018-2019 academic year when face-to-face lectures were held and “facial expressions” in the 2021 academic year when remote lectures were held. It is thought that awareness differed depending on whether the class was held in a face-to-face or remote manner, but both tended to “carefully shift their consciousness toward the person” after the class. The pharmacy and nursing students have different perspectives on communication. However, they became aware of how their behavior affected others and were exposed to other points of view through the joint exercises. They could recognize specific behaviors in their interactions with patients when obtaining patient information, and establish trust relationships with healthcare professionals as a result of attending the class.

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The medical costs in Japan are rising owing to an increasing number of aged population and advances in medical technologies. Thus, there is an urgent need to reduce the ever- increasing medical costs while ensuring a high quality of medical care. Many countries adopt a policy for suppressing medical costs by promoting the usage of generic drugs that are less expensive than branded drugs. The present study investigated the effect of the recently introduced authorized generic (AG) system in Japan on the patients’ preference in switching the branded product of rosuvastatin, one of the first-line treatment for dyslipidemia drugs, either to the AG or non-AG products in a community pharmacy, Funabashi, Chiba. The results showed that 64.3% of the respondents preferred to use generic drugs, and those who preferred to use branded drugs were significantly older than those who preferred to use generic drugs (p=0.004). After the pharmacists’ counselling patients about AG and non-AG (standard) generic drug, 60% of patients who initially chose the branded product switched to AG drug. In conclusion, pharmacists’ adequate guidance and awareness to patients about AGs and non-AG (standard) generic drug may promote the use of generic drugs.

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Epidemic viral infections (such as measles, rubella, varicella, and mumps) are vaccine-preventable infectious diseases. Healthcare workers are frequently exposed to infectious pathogens. Therefore, healthcare workers immunity to infectious diseases is paramount to prevent them from becoming an infection source, proliferating a disease. However, not only healthcare professionals but also students of technical medical training institutes often interact with a variety of patients. Nihon Pharmaceutical University require students to confirm their possession of antibodies for epidemic viral infections and hepatitis B before initiating practical training. The university conducts an antibody titer test of each student immediately before practical training (in year four). Therefore, we confirmed the antibody titers of epidemic viral infections and hepatitis B at the time of medical checkups for all new fourth-year students of the Department of Pharmacy at Nihon Pharmaceutical University from the academic year 2021 to 2023. Our analysis of this report revealed varicella had the highest percentage of students with antibody titers for epidemic viral infections (with 80–90% of students). Rubella and mumps were also present in 40–50% of the students. Conversely, few students had adequate antibodies for measles (approximately 20%) or hepatitis B (0–3%). The reason for the high antibodies to chickenpox may be natural immunity due to infection from the infectious agent and the impact of routine vaccination. However, this poor result may be due to a primary vaccine failure (causing no antibodies to be attained after vaccination) or a secondary vaccine failure (as immunity reduces with time after vaccination). The hepatitis B vaccination purpose in Japan may have influenced the outcome. Epidemic viral infections and hepatitis B antibody status of pharmacy students are limited. Therefore, it is important to improve student vaccination rates to reduce healthcare-associated infections. It is also important for pharmacy institutions to promote student vaccinations.

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Globally, countries are pursuing policies to reduce healthcare costs by using inexpensive generic drugs (GEs); however, healthcare costs in Japan continue to increase. In Japan, GE use is less compared to other countries, owing to the high level of trust in brand-name drugs. In contrast, in the U.S., there is an authorized generic (AG) system under which GEs with the same appearance, ingredients, additives, etc. are launched with the permission of the original drug company during the patent term of the original drug. In such cases, a negative image can be addressed and may be regarded as highly reliable by patients, physicians, and other users. In recent years, the AG system has been introduced in Japan. To GE Recommendation, we conducted a survey to examine patients’ preferences for GEs and their perceptions and choice of AG drugs. Participants comprised patients aged 20 years or older who brought their prescriptions to a Cosmopharma Corporation dispensing pharmacy (Kanto and Tohoku regions) between June 1 and July 31, 2023. Results showed that 15.7% (106/675) of the respondents did not wish to receive GEs and 6.1% (41/675) were aware of AG drugs; 50.0% (53/106) of the respondents did not prefer GEs but were willing to consider it if they were AG. Regional comparisons showed that significantly more people in the Kanto region did not want GEs and were aware of AGs (p=0.015, p<0.001). Therefore, it was inferred that a new policy for GE diffusion corresponding to urban areas needs to be established. Though AGs are considered to be easier to recommend to patients who are reluctant to use GEs, awareness of AGs was low. However, the increasing awareness of AG drugs may be one way to promote GE use, as 50.0% (53/106) of patients who preferred brand-name drugs, regardless of region, were willing to switch to GEs if AGs were available, and if pharmacists provided appropriate explanations of AGs. Nearly 80% of the respondents who preferred brand-name drugs were older adults aged 60 years and above; therefore, appropriate promotional methods need to be established in consideration of this population.

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