Objective: We surveyed community pharmacists and hospital pharmacists on the usefulness of electronic package inserts since they replaced paper-based package insert information for prescription drugs.

Methods: We conducted a questionnaire survey with 1,258 community pharmacists and 126 hospital pharmacists on how they search for package insert information, handle data revisions, use paper or electronic media, and their opinions on work efficiency.

Results: Questionnaire responses were obtained from 178 community pharmacists (response rate: 14.1%) and 82 hospital pharmacists (response rate: 65.1%). Among respondents, 98.9% and 98.8% of community and hospital pharmacists used personal computers connected to the internet, and 30.9% and 56.1% of community and hospital pharmacists used personal digital assistants. As for package insert medium, 79.2% and 61.8% of community pharmacists used paper and electronic media for package inserts while 50.0% and 98.8% of hospital pharmacists used paper and electronic media. To nine of ten questions about work efficiency, more than half of the hospital pharmacists reported that efficiency increased with electronic package inserts. More than half of community and hospital pharmacists reported that revision made to electronic data were more quickly reflected in practice.

Conclusion: The survey revealed that community pharmacists prefer paper-based package inserts, while hospital pharmacists prefer electronic package inserts to check package insert information. The results also showed that using electronic package inserts was perceived to improve work efficiency. Furthermore, personal digital assistants will become important in promoting electronic package inserts.

Objective: Exhaustive search is the basis for meta-analysis and evidence based medicine (EBM). The validity of searches can be confirmed by evaluating the core journals included in the search results. Core journals also exert significant influence because they serve as the hub of each discipline. However, the qualitative relationship between core journals and published articles has not been fully evaluated; therefore, core journals were selected for clinical articles on respiratory infectious diseases and were evaluated for their quality.

Methods: We searched PubMed for clinical articles in three areas: drugs for respiratory infections, drug resistance, and vaccines. The core journals were selected based on Bradford’s Law. The quality of the selected articles was further assessed using the double-blind and randomized controlled trial (RCT) methods.

Results: The Bradford curve that was created displayed a high R² accuracy of 0.9971, 0.9981, and 0.9953 at the linear portion. Evaluation of the research quality of selected core journals revealed a statistically high quality in the field of respiratory infections and vaccines; however, no statistically significant difference was observed in the field of resistant bacteria.

Conclusion: With exceptions in some areas, the quality of publications tended to be higher when core journals were selected based on Bradford’s Law. Different evaluation methods are required for fields unsuitable for randomization or blinding. In the future, it will be vital to consider evaluation methods for core journals according to the characteristics of the studies.

Objective: The “One-half Rule” for OTC drug sales has been eliminated, and furthermore, “Remote-controlled sales” of OTC medicines by qualified sellers is under discussion. The number of registered sales clerks is greater than the number of pharmacists selling OTC drugs. Although this is a result of the different employment status of pharmacists and registered sales clerks due to their salary structure and role in the store, it can be said that registered sales clerks are the main people to deal with the general public when they purchase OTC drugs. Therefore, we conducted a survey of registered sales clerks in order to understand their actual work and their awareness of the revision of the system, and to estimate the impact on customers and patients.

Methods: The questionnaire was administered at an external training session held by the Tokyo Metropolitan Druggist Association from April 16 to 18, 2022.

Results: Valid responses were obtained from 319 participants. Responses were obtained for the ratio of work as a registered sales clerk before becoming a qualified, after qualification (present), and what they think would be an ideal work ratio. The percentage of “pharmaceutical consultation and sales” increased from 7.7 to 15.9, and finally 26.4% before, at present, and ideally, respectively. It was clear that the acquisition of the certification increased the percentage of specialized tasks and that the respondents would like to further increase this percentage. Awareness of the “One-half Rule” and “Remote-controlled sales” was 43.6 and 23.8%, respectively.

Conclusion: It was inferred that the introduction of “Remote-controlled sales” would improve convenience but dilute interpersonal work, which would hinder the operation, maintenance, and management of the store, including courteous customer service that cannot be handled through a screen. Therefore, from this study, we believe that registered sales clerks express doubt about the introduction of “Remote-controlled sales”.

Objective: Analysis of data from reports of medical device faults in drug-device combinations (DDCs) can prevent adverse events caused by errors and lead to improvements. However, there is a paucity of published articles reporting the analysis of data on faults in DDCs. The aim of this study was to analyze data of faults in these medical devices in Japan.

Methods: The review summarized information from the Pharmaceuticals and Medical Devices Agency data on “case reports of suspected failures of the mechanical and instrumental parts of DDCs” reported between 25 November 2014 and 31 July 2022. Information was collected from public documents on “year reported”, “age”, “gender”, “trade name”, “generic name”, “mechanical device part name”, “mechanical device part failure status”, and “hazard” and “outcome”.

Results: There were approximately 1,300 reports of medical device faults in DDCs over the study period, with the number increasing year by year. Five device parts (insulin pen injectors, pre-filled syringes, drug and vaccine injectors, disposable hypodermic needles, and intrauterine contraceptive devices) accounted for 90% of the reports. We found that there was a considerable amount of missing data on reportable items such as age and gender of the patient. Our analysis also showed that 90% of the medical device fault reports involving DDCs were related to malfunction or breakage.

Conclusion: In order to use DDCs more safely and effectively it is important to review reports and analyse data of faults in these devices.

Objective: Owing to the increase in the rate of outpatient prescriptions each year, community pharmacists are expected to actively participate in the drug treatment of patients. Currently, tracing reports (TRs) are used as a tool to feedback patient information obtained at community pharmacies to medical institutions. However, it is reported that about 30% of community pharmacists have never used TRs. It has been reported that the use of templates can increase the use of TRs. Community pharmacists need to understand cancer chemotherapy regimens as outpatient cancer chemotherapy is increasing. The purpose of this study was to examine the utility of using hospital websites as one method of obtaining TR templates and cancer chemotherapy regimens.

Methods: 348 hospital websites in Osaka Prefecture were visited between June 26 and August 28, 2022 to investigate the TR template and cancer chemotherapy regimen.

Results: Among hospitals in Osaka Prefecture investigated in this study, 16.2% posted tracing reports and 24.0% posted cancer chemotherapy regimens. By the bed functions, both tracing report postings and cancer chemotherapy regimen postings decreased in the order of decreasing acuity. By secondary medical area, although there were regional differences, both tracing reports and cancer chemotherapy regimens were posted in all medical areas.

Conclusions: This study allowed many of the surveyed hospitals to access their websites, and found the current status of patient information sharing tools between community pharmacies and hospitals on hospital websites. The percentage of hospitals where these tools are posted is low. However, there are hospitals in all regions that have these tools posted, and it is utility to use hospital websites as a way for community pharmacists to obtain these tools.

Objective: The package inserts are official clinical decision-making documents that provide pharmacological treatment information. However, it has been noted that package inserts on perinatal drug usage differ greatly from expert opinions. This study identified Japanese package insert drugs that are contraindicated for pregnant women and compared them to foreign risk categories.

Methods: The survey included 19,022 drugs on the drug pricing list as of April 2022, with package inserts available on the Pharmaceuticals and Medical Devices Agency website. We retrieved the package inserts with the word “pregnant” in the “Contraindications” section and reviewed the descriptions to exclude those that satisfied the exclusion criteria. We also checked the foreign risk categories of contraindicated ingredients for pregnant women. This study used the Australian Therapeutic Goods Administration’s categorization for prescribing medicines in pregnancy (the TGA classification).

Results: Of the 19,022 medicines studied, 4,111 (21.6%) were contraindicated for pregnant women. Conversely, 19 (5.1%) ingredients categorized under the relatively safe TGA classifications A, B1, and B2 were also contraindicated for pregnant Japanese women.

Conclusion: This study revealed that Japanese package inserts contraindicate over 20% of drugs for pregnant women. On the other hand, some forbidden ingredients did not match the foreign risk categories. Therefore, healthcare professionals should be aware of the limitations of Japanese package inserts concerning pregnant women and make careful decisions based on both package inserts and additional drug information.