Objective: Currently, post marketing surveillance (PMS) for prescription-only to over-the-counter (OTC) switched products is conducted based on questionnaires to patients.  These questionnaires appear in the form of postcards and are completed and posted voluntarily by patients.  With such a method, however, it is not possible to select samples randomly and there may be a bias in respondents.  In addition, the response rate of questionnaire postcards tends to be low.  It is not really credible that the efficacy and safety of OTC switches are confirmed by such a method.  An investigation was therefore conducted with the aim of developing an effective method of PMS for OTC switches in order to achieve the intended objective of PMS.
Method and Subjects: Famotidine purchasers were asked to complete a questionnaire form.  The pharmacists asked the subjects to complete the questionnaire form again on their second visit and also checked patient compliance with drug treatment.  The effectiveness of this method was evaluated by reviewing responses to the questionnaire on the first and second visits.
Results and Discussion: It was suggested that the method tested in this investigation may possibly facilitate evaluation of the efficacy of OTC switched products, detection of adverse drug reactions and monitoring of patient compliance with drug treatment.  However, the questionnaire used in the investigation was not suited for detecting symptoms that triggered patients to purchase famotidine.  It was considered necessary to prepare additional questions specifically designed to detect such symptoms.

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Objective: From the viewpoint of drug cost reduction, many generic drugs have appeared in the eye drops market.  Although the price of eye drops is defined on a per bottle (or per mL) basis, the difference in the total number of drops per bottle between the original drug and its generic drug may alter the drug cost reduction effect greatly.  Moreover, the difference in the total number of drops per bottle may also affect the number of pharmacy visits made by a patient in one year.
Methods: The total number of drops per bottle of an original drug and a generic drug was computed, and the influence of the number of drops on the drug cost reduction effect, including drug cost, was evaluated.
Results: Distinct differences in the volume per drop and the total number of drops per bottle were observed between the original drug and its generic drug, and those differences were found to clearly influence the drug cost reduction effect.  Moreover, in a survey of patients who shifted to generic eye drops, there were some patients who returned to the original eye drops because they could not apply the generic eye drops with ease or their eyes started to smart after using the generic eye drops.
Conclusion: This study revealed the need to take into consideration patient’s ease of use and the drug cost reduction effect, in the selection of eye drops.

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Objective: The Brown Bag program is a drug use review service conducted by community pharmacists.  To improve this program for promoting appropriate drug use, we studied the Medicine Use Review (MUR) program introduced in the UK in 2005, which is similar to the Brown Bag program.
Methods: First, we obtained data through an internet-based search on MUR, which included data on the skills and accreditation required by pharmacists for conducting this program, the conditions required in pharmacies, the target patient groups, and financial reimbursement of pharmacists/pharmacies for these services.  Subsequently, we visited professional pharmaceutical organizations, a university, and a pharmacy in the UK to conduct interviews involving a predetermined questionnaire, with a total of 6 interviewees.
Results: The MUR is a medication review program provided free of cost to patients mainly with chronic conditions.  It aims to identify potential safety concerns and improve medication adherence.  In addition to knowledge regarding pharmacotherapy, pharmacists require advanced communication skills for evaluating the use of medications and for providing appropriate consultations in face-to-face sessions. Providing an environment that protects patient privacy is also important.  After the MUR was introduced, the number of services has increased every year and good practices in this regard have increased.
Conclusion: Information regarding patient selection, check sheet items (e.g., drug names, mode of drug use, reasons for use, and side effects), and feedback procedures was obtained from the MUR program.  The Brown Bag program should be improved to apply this activity to promote appropriate medication use and enhance risk communication service.

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Objective: In the intensive care unit (ICU), drugs are administered in sequence as the conditions of the patient change rapidly, and there are often cases where many injections are administered simultaneously.  For this reason, it is important to quickly select the appropriate administration route.  In this study, we prepared a quick reference table for incompatibilities of frequently used and highly important injections in the ICU (referred to as the “quick reference table”) that will enable selection of the appropriate administration route, and we investigated the status of use and usefulness of this quick reference table.
Methods: The drugs included in the quick reference table were extracted from prescription records from May to October 2009, and these were finalized by discussions with the nurses in the ICU.  Three reference materials were used: Manual on the Supervision of Injection Preparation (3rd Edition), Data Search on Injection Incompatibilities 2009, and MICROMEDEX®.  The survey was conducted with all 12 nurses in the ICU after 4 months of distributing the quick reference table.
Results: The quick reference table included 57 pharmaceutical items, and compatibility was classified into 10 categories.  The quick reference table was prepared as one A3 page for convenience.  The retrieval rate of the survey was 100%.  The average number of years of practical experience as a nurse was 12.2 years, and 11 out of 12 nurses used the quick reference table.  Of the 11 nurses who used the table, 6 answered that it was “very useful,” while 4 answered that it was “useful.”  All 11 nurses who used the quick reference table answered that they “consulted the pharmacists less frequently.”
Conclusion: Satisfactory evaluations were obtained with regard to the details included in the quick reference table, and the table was estimated to be highly useful and important even for ICU nurses with many years of experience.  Furthermore, it was suggested that the quick reference table was also useful in reducing the workloads of the pharmacists.

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