Objective: The delivery of medicines by the postal service from pharmacies to patients' homes has increased to address medicine supply shortages. However, owing to recent abnormal weather conditions, medicines may be delivered in harsh environments exceeding 40℃. Therefore, this study aimed to measure the temperature at which medicines were mailed in the summer and investigate whether the interview form contained evidence that could guarantee the quality of the medicines mailed under those temperature conditions.

Methods: Between August 5 and September 11, 2024, medicines were mailed from 15 postbox locations using a service provided by the Japan Post. The mailing environment was assessed via mean kinetic temperature (MKT) with reference to the United States Pharmacopeia (USP). The medicines in shortage were identified based on information published by the Japan Pharmaceutical Manufacturers Association.

Results: Approximately 87.5% of the medicines mailed had an MKT above 25℃ (maximum 28.0℃), which deviates from the USP standard. Some medicines temporarily reached a maximum temperature of 47.5℃. Moreover, the results of the stress tests at temperatures above 40℃ were not listed in the interview form for 78.3% of the medicines that were likely to be mailed due to inventory shortages.

Conclusion: To guarantee the medicines quality when mailed in the summer, it is important to consider appropriate measures to protect medicines from excessive heat, even medicines stored at room temperature. Furthermore, it is important to assess the medicine stability by referring to the stress tests (50℃) results listed on the interview forms for the product in question and the original and longlisted drugs. To resolve dissatisfaction between pharmacies and patients due to supply instability, it is necessary to actively publish the results of stress tests on interview forms and make appropriate efforts.

Objective: This study aimed to elucidate how the physical properties of containers and formulations of glaucoma eyedrops contribute to differences in squeezing force and drop volume among products within the same pharmacological class. This study seeks to generate valuable insights for product selection, patient guidance, and formulation improvement.

Design: Physical measurements of multiple glaucoma eyedrop products were made under various conditions, followed by comparative analyses of the data and the characteristics of each product's container and solution. The study determined how the product selection and instillation technique affected the squeezing force and drop volume.

Methods: Eyedrop products commonly used as first-line treatments were evaluated, including all brand-name drugs and high-usage generic drugs. Based on the clinical guidelines and NDB open data, 17 products were selected, consisting of prostanoid receptor-related drugs and beta blockers. Each product was tested at various angles to measure squeezing force and drop volume. These measurements were combined with basic container characteristics, including the material, design, and size, to compare and identify trends. Multivariate regression analysis was conducted to examine the factors affecting squeezing force.

Results: The squeezing force varied significantly among the products (0. 68-1. 57 times the average), whereas the drop volume exhibited relatively minor differences (0.79-1.12 times the average). Some products showed marked variability in squeezing force and drop volume between drops, depending on residual volume and container angle. Additionally, containers with smaller finger-contact areas, made of materials other than polyethylene, non-cylindrical designs, and formulations with higher viscosity were estimated to require greater squeezing force.

Conclusion: Squeezing force and drop volume vary significantly by product and instillation technique, which highlights the importance of understanding these differences when prescribing and guiding patients. Further systematic studies on other eyedrop products should be carried out to enhance appropriate drug use and inform the development of user-friendly formulations.

Objective: This study evaluated the practical utility of Microsoft Copilot PRO^®, a GPT-4-based generative AI tool, in addressing diverse medication inquiries at a hospital's drug information center.

Design: We conducted an observational study in which three experienced drug information pharmacists independently evaluated the AI-generated responses and rated their overall utility using a three-point scale.

Methods: A total of 330 inquiries drawn from 11 predefined categories (e.g., dose conversion, pharmacokinetics, and administration during pregnancy) were selected from five years of archived queries. Each question was entered verbatim into Copilot's "GPT-4 Strict" mode to generate one response per query. The raters classified the answers as "useful," "not useful," or "uncertain".

Results: A total of 44.9% of the 330 answers were deemed "useful." Among the 11 categories, the highest proportion of "useful" responses was observed for pregnancy-related inquiries (58. 9%), while the lowest occurred for questions on admixture stability (15.6%).

Conclusion: Although Microsoft Copilot PRO^® achieved a 44.9% "useful" rating overall, its performance varied across inquiry categories, with particularly low usefulness for admixture-related questions. Despite presenting reference links that allow pharmacists to scrutinize supporting evidence, concerns remain regarding the limited agreement among evaluators, especially for "uncertain" cases. Further refinement of AI tools and increased availability of high-quality online drug information may enhance the reliability of the copilot. Future studies should examine the reproducibility, explore optimal prompt designs, and involve larger multicenter samples. Although Copilot shows promise, it cannot replace critical human judgment in drug information services, underscoring the need for ongoing evaluation.

Objective: We investigated the health-related quality of life (HRQoL) of patients with chronic diseases in community pharmacies in Japan and examined its relationship to patient attributes, an area that has not been previously studied.

Method: We surveyed 1,500 participants with chronic diseases and 1,500 from the general population without chronic diseases (Free-GP) using the EuroQol (5-dimension, 5-level) questionnaire. Patient attributes included the number of drugs used, duration of medication, number of chronic conditions, perceived disease severity, and perceived treatment importance. Logistic regression analyses assessed how these attributes influenced the likelihood of reporting “full health” (no problems on all HRQoL questions) among patients with chronic disease. An exploratory decision tree analysis was performed to identify patient attributes that might decrease HRQoL.

Result: The HRQoL score of patients (0.856) was lower than that of Free-GP (0.942). The HRQoL of patients tended to increase with aging. Among patients, the mean HRQoL score was 0.781 for polypharmacy, which decreased with the addition of disease severity perception (even lower for those in their 20s-40). Even in the absence of polypharmacy, the average HRQoL score decreased when patients were in their 20s with multimorbidity. The HRQoL scores of non-polypharmacy patients in their 30s or older were higher than the mean scores of patients with chronic disease.

Conclusion: To provide extensive care for patients with reduced HRQoL in community pharmacies, it is necessary to focus on polypharmacy. Reduced HRQoL should be considered in younger patients with multimorbidity, even in the absence of polypharmacy.

With the expanding responsibilities of pharmacists, the time required to create medical records has become a significant burden, highlighting the need for efficiency improvements. Among text input methods, speech recognition offers a faster alternative to keyboard input and is expected to reduce workload. This study evaluated the utility of a speech recognition tool in generating medication management instruction records. First, ward pharmacists rated subjective changes in their workload before and after using the tool on an 11-point scale (ranging from −5 for deterioration to ＋5 for improvement). The median score was 0 (range: −4 to ＋2), indicating no perceived improvement. Next, two sample texts (349 and 605 characters) were transcribed using both the speech recognition tool and keyboard input, with input times measured. Speech recognition required 186±15 and 395±24 for the first and second texts, respectively, compared to 252±19 and 511±26 s for keyboard input, demonstrating a significant reduction in time. Although no subjective decrease in workload was observed, these findings suggest that speech recognition tools may enhance efficiency in record creation. Further research in this area is warranted, encouraging audience engagement in the ongoing scientific process and fostering a sense of shared responsibility.

Objective: The side effects of drug therapy are not only directly attributable to the drugs taken but may also be caused by psychological phenomena. One such phenomenon is the nocebo effect, wherein adverse effects are triggered by the patient’s recognition of symptoms. The patient’s development of side effects may be influenced by the pharmacist’s explanation of side effects, but it is not known how many pharmacists are actually aware of the nocebo effect. Therefore, this survey aimed to clarify pharmacists’ awareness of the nocebo effect and the extent to which they utilize their knowledge of this phenomenon when providing medication guidance, and to determine whether their awareness influences explaining of the side effects at medication guidance.

Methods: A questionnaire survey was conducted using Google Forms. After defining the nocebo effect, the respondents were asked what points they note when explaining side effects, whether they were aware of the nocebo effect, and in what types of patients they tend to be aware of it. Simple tabulations were performed for each item, and subgroup analyses were performed according to the level of awareness of the nocebo effect.

Results: Of the 100 participants, 65did not know the term “nocebo effect”. However 82 provided medication guidance considering the nocebo effect phenomenon, and many pharmacists who were familiar with the nocebo effect responded that it should be taken into consideration when providing drug guidance. Side effects of particular concern related to the nocebo effect are subjective symptoms such as nausea and vomiting, anxiety and depression, and drowsiness and somnolence; patients with neurotic tendencies or high anxiety also require special attention.

Conclusion: Although the term “nocebo effect” is not well known by pharmacists, the phenomenon itself is widely recognized. Many pharmacists reported that understanding the nocebo effect when explaining the side effects, therefore medications leads to improved therapeutic efficacy.