Applied Therapeutics
Online ISSN : 2432-9185
Print ISSN : 1884-4278
ISSN-L : 1884-4278
Current issue
Displaying 1-8 of 8 articles from this issue
  • Reiko Konishi, )Junichi Isogai, Sayaka Ishikawa, Ren Miyamoto, Tsubasa ...
    2022 Volume 17 Pages 1-11
    Published: 2022
    Released on J-STAGE: February 10, 2022
    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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  • Eri Ohta, Mitsuru Ohta, Tanaka Seiji, Takako Ichinose, Takaya Ohno, Ta ...
    2022 Volume 17 Pages 12-24
    Published: 2022
    Released on J-STAGE: February 22, 2022
    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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  • Shiori Amano, Hirotaka Inoue, Yuna Ito, Sadamasa Mase, Shoko Honnda, M ...
    2022 Volume 17 Pages 25-34
    Published: 2022
    Released on J-STAGE: June 29, 2022
    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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  • Rie Nakajima, Theera Rittirod, Chernporn Navanukraw, Naoto Uramaru, Mi ...
    2022 Volume 17 Pages 35-48
    Published: 2022
    Released on J-STAGE: March 22, 2022
    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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  • Masaaki Yoneda, Nobuyuki Doi, Katsuaki Arai, Etsuko Miyamoto, Shingo ...
    2022 Volume 17 Pages 49-58
    Published: 2022
    Released on J-STAGE: April 28, 2022
    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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  • Masatsugu Sato, Shiho Fujita, Atsushi Ishimura, Yoshikazu Matsuda
    2022 Volume 17 Pages 59-68
    Published: 2022
    Released on J-STAGE: June 27, 2022
    Supplementary material
    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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  • Atsushi Ishimura, Mayumi Tomizaki, Yoshitsune Yamato, Yoshikazu Matsud ...
    2022 Volume 17 Pages 69-77
    Published: 2022
    Released on J-STAGE: June 27, 2022
    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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  • Atsushi Ishimura, Akito Ikeshita, Hidenori Kominato, Tomohisa Higuti, ...
    2022 Volume 17 Pages 78-82
    Published: 2022
    Released on J-STAGE: June 27, 2022
    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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