Objective: There have been reports of health hazards caused by medical devices, cosmetics, quasi-drugs, daily necessities, hygiene products, etc. (health-related products) sold in pharmacies and drugstores. However, the role pharmacists play in dealing with the health hazards caused by health-related products has not been clarified. Therefore, we conducted a survey on the cases of health hazards related to health-related products and the views of pharmacists.

Methods: A questionnaire was administered anonymously by email to 601 pharmacists working in community pharmacies or drugstores between December 11 and 20, 2019.

Results: The number of valid responses was 585. The breakdown of health hazard cases where pharmacists counseled customers were 60 for medical devices, 31 for cosmetics, 18 for quasi-drugs, 9 for hygiene products, and 20 for daily necessities and others. Of those 138 cases, 19 cases of medical devices were estimated to have an intermediate risk as a health hazard, and the other 119 cases were all classified as low. Of the cases that the pharmacists were not approached for help, but were aware of, 57 were medical devices (21 high, 31 intermediate, 5 low), 44 were cosmetics (12 intermediate, 32 low), 12 were quasi-drugs (7 intermediate, 5 low), 7 were hygiene products (7 low), and 64 were daily necessities and others (26 high, 34 intermediate, 4 low). With regard to health-related products, 95% of the respondents indicated that they had responded to customer questions with advice.

Conclusion: Our results show that there are various cases that could develop into health hazards due to health-related products, and most respondents felt a need to alert the public. As such, pharmacists and other staffs in drugstores will continue to provide health support functions to their customers by advising them on not only pharmaceuticals but also these health-related products.

Objective: Following the amendment of the Pharmaceutical and Medical Device Act in December 2019, continuous follow-up of patients during treatment has been mandated for pharmacists. The follow-up methods may involve contacting patients via telephone and social networking services (SNS). The SNS is advantageous over telephone, because patients can respond to the pharmacists at their convenience. Therefore, we developed a patient compliance instruction support system “FollowNavi” using LINE. We prepared a content of inhalation drugs used to treat bronchial asthma for assessment using FollowNavi and conducted questionnaire surveys among patients and pharmacists to validate its utility.

Methods: FollowNavi was used from May1 to July 31, 2020, to follow up patients diagnosed with bronchial asthma for whom long-term control medicine (inhalation drugs) was prescribed for the first time or prescriptions were changed from other inhalation drugs. Subsequently, when the patients revisited the pharmacy, we conducted a questionnaire survey regarding the usability of FollowNavi. We also conducted a questionnaire survey among the pharmacists.

Results: Seven and five responses were received from patients who were followed up via FollowNavi and pharmacists who used FollowNavi, respectively. Furthermore, 28.6% of the patients responded “I could solve the problem through LINE” and 71.4% responded “I did not have anything in particular that I could not understand.” As for pharmacists, 60.0% responded that they could obtain sufficient information from the patients through FollowNavi.

Conclusion: The results suggest that follow-up after providing inhalation instructions using the inhalation drug content of FollowNavi may be useful for both patients and pharmacists.

Objective: The guidance on “what to do when patients missed a dose” is an important item of medication instructions; however, only a small number of prescription drugs contain it. The “Drug Guide for Patients” and “Kusuri-no-Shiori” are documents designed to facilitate medication instructions for patients, having a section on “what to do when patients missed a dose.” Specific descriptions under it differ among medication instruction documents for some drugs, including those containing the same active pharmaceutical ingredients; however, the actual status of such discrepancies has not been clarified. In this study, we conducted a fact-finding survey to clarify such discrepancies using two medication instruction documents for drugs containing the same active pharmaceutical ingredients.

Methods: The medication instructions of “Drug Guides for Patients” and “Kusuri-no-Shiori” for 532 active pharmaceutical ingredients used in oral drugs were included in the survey. After reading the descriptions under the “what to do when patients missed a dose” section, we divided them into six groups and determined whether the descriptions for the same ingredient in the documents fell in the same group.

Results: For 186 ingredients (35.0%), we identified discrepancies between the documents. Among these, the instructions for 61 ingredients (11.5%) contained contradicting descriptions, such as “take the missed dose as soon as you remember” in one document and “always let go of the missed dose” in another document.

Conclusions: A substantial number of discrepancies in descriptions about “what to do when patients missed a dose” were found between the two documents, raising concerns of confusion in medication instructions when the documents used were different. Therefore, the descriptions should be improved to resolve the discrepancies among medication instruction documents. Moreover, it is important for pharmacists or other healthcare professionals to review the descriptions thoroughly before using the document to provide appropriate medication instructions without confusion.

Objective: Among the opioids used for treating dyspnea in cancer patients, the evidence for clinical use of fentanyl is not adequate. We report a case that suggested that fentanyl citrate patch improved dyspnea caused by lung metastasis of ureteral cancer.

Case: An 86-year-old female was scheduled to start opioids for dyspnea caused by exacerbation of lung metastasis from ureteral cancer. Morphine hydrochloride was not chosen due to renal dysfunction, and oxycodone hydrochloride extended-release tablet was initiated. However, one day after starting medication, the patient refused to take the tablet because of vomiting. Given the difficulties in using morphine hydrochloride and oxycodone hydrochloride extended-release tablet, fentanyl citrate patch 0.5 mg/day was started for the purpose of improving dyspnea. The dose was eventually increased to 1.0 mg/day. Dyspnea improved and she was discharged.

Conclusion: This case suggested the possibility that use of fentanyl citrate patch may be effective for dyspnea. Fentanyl citrate patch may provide one option when other drugs such as morphine hydrochloride and oxycodone hydrochloride cannot be used. However, since this is a report of a single case, further verification is required to clarify the effectiveness of fentanyl citrate patch for dyspnea.

Objectives: It is important for patients to make correct use of drug information (DI) to promote the proper use of medicines. Many patients use the Internet to find DI, but awareness about the websites of public institutions that provide DI is low. This study aimed to identify the actual use of the Internet for DI and associated problems to inform development of a comprehensive DI website for patients.

Method: Patients with diabetes were set as a model case for patients who take medicines and need DI. A questionnaire survey was conducted among patients with diabetes who visited community pharmacies in Kagoshima City from March 2019 to October 2019. The survey covered Internet use, DI needs, methods of sourcing DI, and problems obtaining DI via the Internet.

Results: There were 349 valid respondents (median age 64 years), of which 52.1% used the Internet at least once a week. Around half of the Internet users searched for DI on the Internet. More than half of these respondents chose a DI acquisition site because it “appeared at the top of search results” and was “easy to understand.” However, around half of these respondents felt that “there is too much information on the internet and I don’t know what is correct.”

Conclusion: This study suggests that older patients with a long history of diabetes use the Internet to obtain DI. However, patients face various problems accessing DI via the Internet. It may be necessary to construct a comprehensive website that is easy to use and enhance public health literacy to support the proper use of medicines by patients.