Objective: A medication notebook is developed in order to unitedly manage medication information of patients and is used by writing medication information such as history of ethical drugs, over-the-counter drugs and health foods, anamnesis, history of adverse events and allergy.  Adverse events, interaction and duplication of drugs can be prevented by showing a medication notebook to doctors and pharmacists.
Data Sources·Study Selection·Data Extraction: In this article, we reviewed literatures regarding preceding studies on the utilization of medication notebooks comprehensively.
Results·Conclusion: In our review, we could comprehend literature on medication notebooks systematically and could summarize a lot of evidences that confirm the usefulness of medication notebooks.  We need to produce further evidences on medication notebooks to spread medication notebooks.

View full abstract

Objective: In conjunction with the introduction of medical fees for pharmaceutical practices in hospital wards, the pharmacy department at Sakai City Medical Center has solely managed PREAVOID and reported the results to the Japan Society of Hospital Pharmacists (JSHP) since 2012.  We investigated the pharmacological management being performed by pharmacists and what knowledge is necessary for the super-aged society according to our PREAVOID reports.
Methods: We totaled and analyzed the PREAVOID preventive reports (pattern 2) that were reported to JSHP from April 2014 to March 2016.
Results: Elderly people had the highest number of PREAVOID reports (p<0.001).  “Transcription error and incorrect prescription” was the most common cause, followed by “special condition (impaired renal function, etc.)” and “overdose.”  Regarding the elderly generation, the number of reports in the 2-year period was the highest for “special condition” (173 cases, 5.30% ?? ), which was 3.69-times the number for adults (p<0.001).  These results demonstrate that involvement of pharmacists is indispensable for pharmacotherapeutics in generations with greatly differing drug metabolic functions.
Conclusion: This survey revealed that adverse effects were caused by inadequate medication.  As “pharmaceutical management” was involved in most reports, these results indicate that it is important to manage pharmaceuticals in hospital wards.  It is possible to improve pharmacological knowledge by sharing and utilizing the analysis results of these PREAVOID reports in order to appropriately medicate elderly patients.  According to this study, pharmacists play a crucial role in medication of the elderly.

View full abstract

Objective: In order to improve the comprehension of Over-The-Counter (OTC) drug package inserts, we developed corresponding precautionary pictograms before usage and implemented a comprehension test.  In this study, pictograms were included in OTC-drug package inserts and we evaluated their influence on consumer attention and comprehension degree towards usage precautions.
Methods: Three package insert versions (A, B, C) were designed regarding a stomach medicine that is currently in the market.  A contained text only, B contained intelligible pictograms and text, and C contained unintelligible pictograms and text.  Both an eye-tracking survey (attention) and questionnaire (comprehensibility) were conducted among university students.  In the eye tracking survey, research objects evaluated a randomly selected package insert, following which they were separated into three groups (A, B, C) and compared.
Results: The eye-tracking survey revealed that group B’s dwell time was longer than group A in the [Lactating women] and [Consultation matter before use] sections.  The comprehension test indicated that group B scored higher than group A in terms of [Symptoms that require consultation before use] accuracy.
Conclusion: The eye-tracking survey results indicate that group B’s pictograms can help consumers better understand information in OTC-drug package inserts, directing consumers’ attention to information that might easily be overlooked.  The comprehension test results confirm that group B’s pictograms positively enhance comprehension degree.

View full abstract

Objectives: The aim of this study was to investigate both the time-to-onset and the onset-pattern of drug-induced blood disorders (DIBD) following the administration of small molecule molecularly-targeted drugs via the use of the spontaneous adverse reaction reporting system of the Japanese Adverse Drug Event Report (JADER) database.
Methods: The JADER database from April 2004 to March 2017 was downloaded from the Pharmaceuticals and Medical Devices Agency (PMDA) website.  The DIBD dataset for small molecule molecularly-targeted drugs was constructed based on the data for the patient demographic information, drug information, and the adverse drug reaction information for thrombocytopenia, platelet count decreased, neutropenia, neutrophil count decreased, leukopenia, white blood cell count decreased, pancytopenia, and anaemia of the Preferred Term in Medical Dictionary for Regulatory Activities (MedDRA).  This dataset was then used to calculate the median onset times for the DIBD and the Weibull distribution parameters.
Results: The median onset times of the DIBD for bortezomib, dasatinib, erlotinib, everolimus, and temsirolimus were less than 2 weeks, with the Weibull distribution determining an early failure type profile for dasatinib and temsirolimus, a random failure type profile for bortezomib and erlotinib, and a wear out failure type profile for everolimus.  The median onset times of the DIBD for crizotinib, gefitinib, imatinib, lapatinib, nilotinib, sorafenib, and sunitinib ranged from 2 to 4 weeks, with the Weibull distribution determining an early failure type profile for imatinib, sorafenib, and sunitinib, a random failure type profile for crizotinib, gefitinib, and lapatinib, and a wear out failure type profile for nilotinib.
Conclusions: The results of the current study clarified both the most likely time period and the onset-pattern of DIBD that can occur in patients after the administration of small molecule molecularly-targeted drugs.

View full abstract

Objective: In recent years, the utilization of 3D printers has attracted attention in medical settings.  An exploratory study on the production of aids using 3D printers was conducted to compare the usability of an originally-developed prototype of Aid D for Miriopen® and Aid S provided for free by a pharmaceutical manufacturer.
Methods: The subjects were 19 university students in their 20s who were blinded to all aspects of the study prior to its commencement.  A paired comparison was conducted to assess the usability of those aids, with “being easy to grip”, “being easy to push”, “being easy to hold”, and “general assessment” as assessment items.  The students were asked to inject chemicals into melamine sponge, and the weight of the sponge was measured prior to and following injection to examine the effects of wearing aids on the volume of chemicals injected.
Results: Mean favorability scores of Aid D for three assessment items (excluding “being easy to hold”) were significantly higher.  The use of aids had almost no influence on the volume of chemicals injected.
Conclusion: In production using 3D printers, the depths of concaves and convexes and intervals between each of them, and the length of the body can be easily changed according to the sizes of the hands and fingers of subjects.  Aid D was easier to grip and push because the concaves and convexes on the surface of the body and the length of the protrusions were customized.  Therefore, 3D printers are useful tools for the production of aids.

View full abstract

Objective: Smart drugs are widely used for nonmedical reasons in Western countries.  Given that smart drugs are often used for years, long-term effectiveness and safety are essential, but particularly difficult and costly to determine.  The use of smart drugs seems to be common among individuals in cognitively demanding environments, such as schools and universities, although the actual consumption of smart drugs has not been elucidated in Japan.  To monitor the prevalence of smart drugs among undergraduates, we conducted an awareness survey in Kyushu University and Healthcare Management College.
Results: We found that 98% of students had never used smart drugs.  When asked “Would you like to use smart drugs ?” 55% of the students answered “No,” 10% answered “Yes,” and 33% answered “I couldn’t say.”  No associations were observed between these answers and sex, drinking, smoking, and pressure on academic performance.  It is suggested that users of soft enhancers, such as caffeine-containing products for cognitive enhancement, are more likely to use smart drugs.  We found that half of the students had used energy drinks for neuroenhancement prior to an exam.
Conclusion: The present study indicated a low prevalence of smart drug use compared with that in other countries, whereas the use of caffeine-containing products for cognitive enhancement appeared to be similar to Western usage.  Furthermore, approximately 30% of the students agreed with the use and effectiveness of smart drugs.  Further studies of smart drugs among students should be conducted to prevent the abuse.

View full abstract

Objective: The present study investigated the transition to and procedures for using general-name external prescriptions and the additional premiums generated through these prescriptions at the Nippon Medical School Hospital.
Method: Distribution of externally sourced general-name prescriptions for medical care began at the outpatient clinic at the Nippon Medical School Hospital in May 2013.  During this transition, physicians were educated about the advantages of using general-name external prescriptions and changes were initiated to increase the number of general-name external prescriptions available on the institution’s electronic medical records database.
Result/Consideration: A total of 326,164 (approximately 39.8%) general-name external prescriptions were distributed through the Nippon Medical School Hospital between May 2013 and March 2017.  The results indicated that increasing the use of general-name external prescriptions through physician education and making institution-wide changes to the electronic medical records can generate additional premiums, which contribute to hospital management without costs.

View full abstract