Objective: The use of direct oral anticoagulants (DOACs) has increased because they have some advantages over warfarin, such as fewer interactions and no requirement for coagulation monitoring in principle. DOACs have dose adjustment requirement based on renal function and other complex criteria that differ depending on specific DOAC preparations and indications. At the Nagoya City East Medical Center, DOAC dose‒related decisions previously depended on the knowledge and discretion of individual pharmacists. However, a dose checking sheet for DOACs (the Checking Sheet) was prepared and used on our electronic medical record system since September 2016 to increase the reliability of prescription checking, eliminate improper prescriptions, and ensure electronic documentation of pharmaceutical inquiries. In this study, we compared percentages of proper prescriptions before and after the introduction of the Checking Sheet to assess the effectiveness of its use, which has not been reported previously.

Method: The percentage of proper DOAC prescriptions was used as a measure to assess the effectiveness of the Checking Sheet. We investigated DOAC prescriptions from March 2017, when the Checking Sheet system had been established, and compared those with prescriptions from March 2016 (before the Checking Sheet was introduced). Prescriptions of rivaroxaban, apixaban, edoxaban, and dabigatran for nonvalvular atrial fibrillation or venous thromboembolism were included; prescriptions dispensed outside the hospital were excluded.

Result: DOAC prescriptions before and after the Checking Sheet introduction were similar in number. The percentage of proper prescriptions increased significantly from 82.4 to 94.3%. Among specific DOAC preparations, the number of improper prescriptions decreased significantly for apixaban and showed a tendency to decrease for rivaroxaban.

Conclusion: The increases in the number of proper DOAC prescriptions observed after introducing the Checking Sheet showed that the Checking Sheet helped ensure a certain level of prescription checking, suggesting its usefulness for promoting proper DOAC use.

Objective: The Risk Minimization Plan is developed in the Risk Management Plan (RMP), patient information materials are sometimes prepared as Additional Risk Minimization Activities (ARMA). On the other hand, there are many patient information materials that are not prepared as RMP materials, but are prepared independently by pharmaceutical companies and are actually used to provide information to patients. However, there is no detailed report on the differences between them. Therefore, in this report, we investigated for description of Important Identified Risks (IIRs) and Important Potential Risks (IPRs) in patient information materials.

Methods: The previously published RMP of 588 drugs were obtained on October 1,2020, and used in analysis. We surveyed the description of IIRs and IPRs in patient information materials, and compared patient information materials based on ARMA in the RMP (patient information materials as RMP materials) and patient information materials developed independently by pharmaceutical companies that are not based on ARMA in the RMP (patient information materials as not RMP materials).

Results: Of the 588 drugs, 454 drugs had patient information materials. In addition, 241 drugs had patient information materials as RMP materials. One thousand fifteen of the 1,577 IIRs were listed in the patient information materials as RMP materials (64.4%listing rate). One hundred sixty-six of the 724 IPRs were listed in the patient information materials as RMP materials (22.9%). On the other hand, 700 of the 1,131 IIRs were listed in the patient information materials as not RMP materials (61.9% listing rate). Ninty one of the 447 IPRs were listed in the patient information materials as not RMP materials (20.4%).

Conclusion: It was found that there was no difference in the description of IIRs and IPRs between patient information materials as RMP materials and patient information materials as not RMP materials.

Objective: Risk factors for hypermagnesemia due to magnesium oxide (MgO) include advanced age, decreased renal function, and long-term administration; however, no study has evaluated patients that present all of these factors. This study was aimed to evaluate the safety of long-term MgO administration in elderly patients with impaired renal function.

Methods: We investigated changes in serum Mg in patients aged 65 years or older, who had been taking oral MgO and presenting a glomerular filtration rate (eGFR) ＜60 mL/min/1.73 m² for 6 months or longer.

Results: Thirty patients were surveyed. Their median age was 81 years (range, 68-92). No significant change in patient background was observed before and after initiating MgO administration, with no change in serum Mg detected. Furthermore, the oral dose of MgO was divided into groups taking ＜1,000 mg and ≥ 1,000 mg; no change in serum Mg was observed in either group. Based on renal function, the analysis was divided into a mildly decreased group (60＞ eGFR ≥ 45) and a moderately to severely decreased group (45＞ eGFR ≥ 15), and no change in serum Mg was observed in either group.

Conclusions: We targeted elderly patients with renal dysfunction who were taking long-term MgO, a known risk factor for hypermagnesemia, indicating that MgO can be safely continued.

Objective: Soon after two massive earthquakes in Kumamoto, Japan, on April 14 and 16, 2016, the Shirakawasuigen pharmacy located in the Minamiaso village received prescriptions for disaster medications. Since prescriptions for disaster medications are typically used at temporary emergency shelters, pharmacies usually do not receive requests for them. On checking the content of these prescriptions, we found numerous prescription errors and queries. This study aimed to assess issues with dispensing medications after disasters.

Methods: We reviewed all disaster medication prescriptions received by the pharmacy from April 20 to May 28, 2016 and the medication histories of these patients. We confirmed each patient’s data and medical and medication histories. Furthermore, we classified disaster prescription errors and queries into five categories according to their content and summed them in each category.

Results: We obtained patients’ medical and medication histories from 100 (77.5%) of the 129 prescriptions received. Of the 129 prescriptions, a total of 158 prescription errors and queries pertaining to 96 (74.4%) prescriptions were confirmed: 88 (55.7%) for unclear medication usage and dosages, 22 (13.9%) for incorrect medication names, 34 (21.5%) for pharmaceutical queries, 8 (5.1%) for exceeding fixed prescription days (within seven days), and 6 (3.8%) for other issues.

Conclusion: Nearly 80% of the prescriptions for disaster medications had prescription errors and queries. Therefore, we evaluated that the prescription’s format and entry method can be improved. Furthermore, to ensure a smooth drug supply and to reduce prescription entry deficiencies and formal prescription queries, pharmacists need to effectively manage disaster prescriptions.

Objective: The worldwide spread of the COVID-19 pandemic since 2020 led to a lack of information even at Japanese pharmacies, which are at the forefront of community medicine. Therefore, the Kyoto University Graduate School of Public Health Pharmacy Information Group has developed information materials related to COVID-19 for pharmacies 0and released them on the COVID-19 countermeasure website, which was launched in haste. However, these days in the information society, the amount of information distributed is explosively expanding. Therefore, it is not possible to reach the target people just by publishing the countermeasure website. Therefore, we set up a public relations team to carry out publicity activities for pharmacists and analyzed the effectiveness of these activities by focusing on changes in the number of page views (PV) on the countermeasure website.

Methods: PV and public relations(Facebook, industry media , e-mail) activities during the first 18 days(EARLY period), which is half of the total PV, and the remaining 164 days(MIDDLE period), covering 182 days from the day before the countermeasure website was opened. The changes in quantity were compared. Furthermore, we also compared the changes in the level of interest in the new coronavirus during the target period using Google Trends.

Results: PV was remarkably large in the EARLY period, and the amount of public relations activity was generally concentrated in the EARLY period and PV. The number of searches for related words on Google Trends was almost the same as PV except for some. Conclusion: The study revealed the importance of establishing a pandemic countermeasure website for pharmacists at an appropriate time and conducting intensive public relations activities in the early stages.