Objective: A perception survey of healthcare providers and pharmaceutical industries about the current package insert (PI) was conducted to evaluate whether its layout and issues such as the contents concerning drug-drug interactions are found appropriate.
Methods: A questionnaire was sent via the Internet to physicians of various subspecialties, or via the postal service to pharmacy-employed pharmacists and pharmaceutical industries.  It consisted of questions regarding the PI layout, the information contents on drug-drug interactions and other matters about PI revision.
Results: The survey showed that the PI is a major source of drug information for physicians (82.4%) and pharmacists (98.7%).  The layout (order of appearance of headings and information about drug interactions in a tabular format) of the current PI is widely accepted by physicians, pharmacists, and pharmaceutical industries.  There was, however, some degree of disagreement within these three groups in the perceptions about the presentation/contents of the several drug interactions, as well as about the timing for its updating.  Around 24% of physicians and 35% of pharmacists view that the content of drug interactions is insufficient, and that information about adverse drug reactions and drug interactions is not enough updated in the PIs.  On the other hand, near 86% of pharmaceutical industries were prone to wait for accumulation of enough data until revising the information in PIs.
Conclusions: Differences of perception were found between healthcare providers (i.e., PI users) and industries.  Our survey revealed that the basic layout of the current PI should be preserved, but there are issues such as the contents and updating of information regarding drug interactions and adverse drug interactions that may require modifications according to the healthcare providers’ point of view.

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Objective: Similarity of drug names is one factor of dispensing incidents.  The aim of this study was to survey the relation between sensual similarities of drug names and the occurrence of taking errors for pharmacists who actually prepare medicine.
Methods: A pair of drugs (15 incident pairs and 104 control pairs) was displayed on a computer screen at random.  The subject’s task was to determine the sensual similarity of them.  Thirteen pharmacists who prepared these pairs and caused their incidents participated in the experiment.
Results: The result showed that the sensual similarity of drug names of incident pairs was found to be highly significant in comparison to one of the control pairs [p=0.026].  However, the similarity in incident pairs is not necessarily high.  It was suggested that the similarity of drug name was not the only factor of taking error.  Multiple linear regression analyses of the sensual similarity in control pairs were performed, in which 10 variables were reported as quantitative indicators of similarity of drug name and were able to be measured on the internet.  The correlation was good [R²=0.828].  However, this regression model was not useful when adjusting to incident pairs.  In incident pairs, the similarity value calculated by the regression model was lower than the measured sensual similarity.
Conclusion: The result suggested that measured sensual similarity includes other risk factors of taking error, such as appearance similarity and/or efficacy similarity and/or short distance arrangement.  It seemed that the pharmacist’s ability complicated the factor of taking error.

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Objective: It is important to prevent dispensing errors for the safety of patients.  For this purpose, it is necessary to improve the dispensing process on the basis of risk priority.  Quantitative evaluation of risk in each operation makes it possible to compare the risk relatively.  In this study, we analyzed data reported in the Pharmacy Risk Error Management System (PREM-S) to evaluate the risk priority in the medicine preparation step of the dispensing process.
Methods: Data of 1,202 cases concerning medicine preparation step were extracted from in 2,458 cases reported into PREM-S between May 2010 and April 2011.  We classified the medicine preparation step into 31 categories based on the operation.  We analyzed the levels in each category as adverse effects on patient’s health by the errors and also the relationship between adverse effect and detection time.  The level represents the degree of adverse effect for the patient.
Results: Information on levels of the 31 categories was obtained from the analysis.  Eight categories included reports of effects on the health of patients.  Three categories such as calculation of powder medicine included level 4 cases.  Detection time was significantly different between level 1 and levels 2 to 4, but there was no significant difference between levels 2 to 4.
Conclusion: The results suggest that analysis of data reported in PREM-S enables evaluation of the risk priority systematically and efficiently.  Evaluation of the risk priority will contribute to prevention of dispensing errors and health effects derived from them.

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Objective: We analyzed articles in the Japanese Journal of Drug Informatics with the goal of identifying recent research trends in drug informatics.
Method: The appearance frequencies of keywords in the Japanese Journal of Drug Informatics (2001: vol. 3 (1) to 2009: vol. 11 (4)) and Japanese Journal of Pharmaceutical Health Care and Sciences (2009: vol. 35 (1) to (6)), and words in abstracts in Japanese Journal of Drug Informatics (2009: vol. 11 (1) to 2010: vol. 12 (4)) were analyzed.
Results: To investigate keywords in the Japanese Journal of Drug Informatics, appearance frequencies of information, drug, drugs and pharmacist in 2001: vol. 3 (1) to 2003: vol. 5 (4), those of information, drug, drugs, medical, medication and questionnaire in 2004: vol. 6 (1) to 2006: vol. 8 (4), and those of information, drug, questionnaire, survey, pharmacist, adverse and generic in 2007: vol. 9 (1) to 2009: vol. 11 (4) were higher than those of other keywords.  In the Japanese Journal of Pharmaceutical Health Care and Sciences, appearance frequencies of drug, pharmacy, care, patient, pharmaceutical, cancer, education, training, analysis and drugs were higher than those of other keywords.  Information, drug(s), patients, pharmacists, hospital, use, questionnaire, medical, adverse, survey, agents, generic and pharmaceutical were high frequency words used in abstracts published in the Japanese Journal of Drug Informatics.  These words in abstracts indicate a Zipf’s law-like rank distribution.  Co-occurrence network graphs using abstracts showed that the first cluster consisted of medical, drug, adverse, drugs, pharmaceutical, hospital, doctors, contents and drug around information and pharmacists as hubs, and the second cluster consisted of 3 words (agents, woman and pregnant).  Furthermore, co-occurrence network graphs indicated that care, medical, pharmaceutical, information, adverse, pharmacists, hospital, doctors, questionnaire, woman, pregnant, package and side were matters of important arguments and/or phenomena.
Conclusion: These data suggest that the scope of themes in articles published in the Japanese Journal of Drug Informatics is establishing definitive categories.  The recent themes and contents of the Japanese Journal of Drug Informatics were closely and mutually related.

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Objective: The objective of this study was to clarify the light stability of cyclosporin fine granules 17% ?? Mylan ?? (CsA-FG) after packaging by a dividing and packing machine.
Methods: CsA-FG packaged within cellophane-laminate paper was stored under three different covering conditions: (stored uncovered, in a medicine bag, or in a light shielding bag).  In these covering conditions, we examined changes in the residual rate and elution pattern of CsA for up to 12 weeks in the differently covered samples stored at room temperature under fluorescent lighting.
Results: Under the light exposure condition, the residual rate decreased with time and fell below 95 percent at 12th week.  Although a slight decline in the residual rate was observed in samples stored in the medicine bag at 12th week, the rate was less than 5%.  On the other hand, no change in the residual rate was observed for samples stored in the light shielding bag storage for up to 12 weeks.  There was no change in the elution pattern of CsA in any group, except the decline in the elution rate caused as the resulting from the decline in the residual rate.
Conclusion: In this study, we have clarified that the packaged CsA-FG covered by stored in a medicine bag or light shielding bag is stable for up to 12 weeks under normal storage conditions.  However, CsA-FG should be stored in a light shielding bag or undergo the split dispensation, if it’s stored in a more severe lighting condition and/or if it is to be stored for more than three months.

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Objective: In hospitals, the most recent medical information paper delivered by the hospital pharmacy is essential for obtaining information about the newest therapies and/or avoiding adverse effects of medicines.  To improve the medical information paper (hereafter, Medical News), we investigated the dissemination of Medical News delivered monthly by the Pharmaceutical Department in Oami Hospital.
Methods: Questionnaires about Medical News were distributed to each occupational category working in Ohami Hospital, and collected during June and July 2010.
Results: Responses were obtained from 127, including 19 doctors (full-time and part-time).  Ninety (70.9%) knew about Medical News, and 75 (59.1%) had read it.  It was revealed that there were differences in the familiarity with to Medical News among job classifications, and articles described on the same Medical News.
Conclusion: It insufficient to satisfied to provide drug information as a one-way provision by Medical News; however, as there are differences in the information required for each job, it is difficult to deliver a large number of copies in the small-scale hospital.  Overlooking the most up-to-date information about medicine and medical devices can lead to serious problem.  We have to review the information and provide important and accurate drug information to the staff in our hospital.

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