Clinics, pharmacies, and visiting nursing stations involved in home care support require human resource development and education that facilitate the performance of interprofessional work (IPW) in addition to medical information sharing systems and human networks between hospital and community medical care staff. It was confirmed that promoting community-participatory interprofessional education (IPE) deepens the understanding of other professions. IPE is the foundation of human network-based training/education and medical information collaboration in IPW. In this study, I will introduce various IPE and IPW initiatives in Nagasaki, including the author’s own activities.

As a clinical faculty member (practitioner), I have been involved in new pharmaceutical education.

In our laboratory, we have been implementing various initiatives to enable pharmacists who have graduated from the six-year program to play an active role in society, aiming to “cultivate the ‘spirit’ of a medical professional by learning judgment, cooperation, objectivity, and diversity based on knowledge”. Here we introduce some of our representative efforts.

At each university, we have built a system for students to think and learn by themselves by utilizing the connections between the university and the local community and society. In each case, the cooperation of local pharmacists and people in various professions has contributed to the success of this project. I would like to thank them again and introduce our laboratory in the hope that our past activities will contribute to the development and improvement of pharmacy education and research in the future.

Pancreatic cancer is an intractable cancer accompanied by refractory ascites associated with peritoneal dissemination and metastasis, resulting in malnutrition and poor performance. Cell-free and concentrated ascites reinfusion therapy (CART) is an effective treatment modality for patients with malignant ascites for alleviation of the symptoms. Accumulating evidence suggests that the microenvironment of malignant ascites consists of various soluble factors and diverse cell components, including immune cells such as macrophages. Macrophage exists plastically from M1-like to M2-like phenotypes depending on the surrounding environment that is, polarization. M1-like macrophage induced by several pro-inflammatory cytokines, including tumor necrosis factor-α shows anti-tumor activity, while M2-like macrophage skewed by anti-inflammatory cytokines, such as interleukin (IL)-10 supports tumor growth. Here, we determined the influence of the ascites microenvironments derived from pancreatic cancer patients before and after CART on the polarization status of U937 cells, a human macrophage-like cell line. The messenger RNA expression levels of IL-10 and CD163, M2 macrophage-related markers, increased in U937 cells after incubating with the ascites microenvironment, implying the polarization of macrophages toward M2-like phenotypes. Interestingly, concomitant treatment of neutralizing antibodies against IL-10 with ascites before and after CART inhibited the M2-like polarization of macrophages. Furthermore, bioinformatic analysis using clinical RNA sequencing data for the pancreatic tumors and normal tissues exhibited that the IL-10 and CD163 expression levels were elevated in the tumor tissues, and there was a significant positive correlation between IL-10 and CD163 expressions. These findings indicate that the ascites microenvironment derived from patients with pancreatic cancers before and after CART may cause polarization of macrophage toward tumor-supporting M2-like phenotype.

The Japanese government aims to launch electronic prescriptions (e-prescriptions) in January 2023. Adopting electronic prescriptions entails certain costs, but a delay in adopting electronic prescriptions would mean losing customers to other pharmacies. The purpose of this study, is to consider the important factors that affect the adoption of electronic prescriptions in dispensing pharmacies. Based on published data, we quantified the costs required to operate electronic prescriptions and the lost profit in the case of not adopting electronic prescriptions. We found that lost profit is a more important factor than all the costs. This finding suggests that close attention should be paid to the time schedule of issuing electronic prescriptions by medical institutions that are the prescribers, and to adopt electronic prescriptions at an early stage.

Given that electronic prescriptions will surely be launched in the future, it is important that dispensing pharmacies are well prepared to adopt electronic prescriptions as soon as possible, taking into account their locations and customer characteristics, in order not to be overwhelmed by medical DX and to ensure a stable profit.

Although pharmacists had been providing in-home drug guidance before the long-term care insurance system was introduced in 2000, it was often in collaboration with medical professionals. However, with the start of the system, not only medical care but also nursing care workers and various other occupations became involved, and pharmacists were required to demonstrate their expertise and work in collaboration with multiple occupations even more. In the home setting, pharmaceutical guidance is required according to the actual living conditions of patients, and there are many situations in which it is difficult for pharmacists alone to gather information. Furthermore, we believe that pharmacists can demonstrate their professional skills and solve various issues and problems in a cross-professional manner not only by connecting with multiple professions in the community but also by interacting with nationwide organizations of other professions related to home health care.