Objective: Providing patients with information and medication instruction regarding direct oral anticoagulant (DOAC)antagonists is becoming increasingly important. Comprehensive knowledge of DOAC antagonists can expedite the transportation and treatment of emergency cases, such as bleeding with antagonists, in hospitals. We investigated the awareness of idarucizumab and whether the information provided in the Risk Management Plan was reflected in the actual provision of information and medication instruction.
Methods: Pharmacists in dispensing pharmacies and Kameda Medical Center were included in the survey conducted from May 2022 to June 2022. Using a web-based questionnaire, we obtained answers to questions related to idarucizumab awareness. Respondents answered a series of questions regarding idarucizumab awareness, sources of information, patient information, and medication instruction.
Results: We received responses from 1,118 people. In all, 25.9% pharmacists were aware of idarucizumab, and 10.3% provided information and medication instruction on DOAC antagonists to patients. Pharmaceutical companies, books, drug information departments, workshops, and wholesalers were the sources of information on idarucizumab for 24.8, 21.0, 19.0, 10.7, and 3.1% of the pharmacists, respectively.
Conclusion: Pharmacists had knowledge of DOAC antagonists and provided information and instructions to patients infrequently. Improved awareness will lead to prompt response during the occurrence of adverse events such as bleeding.
Objective: To keep medical costs down, it is important to promote the use of generic drugs at pharmacies, where prescription volumes are high. However, many parents do not opt for generic drugs. This study examines the effectiveness of pharmacists’ explanations to parents, with the aim of promoting the use of generic drugs among young patients under the age of 20.
Method: A questionnaire-based survey was conducted from November 25 to December 1, 2019, at 129 pharmacies.
Results: During the survey period, 91 pharmacies received 4,491 prescriptions from young patients. The percentage of generic drugs dispensed per prescription was lower for the young patients than for adult patients (65.4% vs. 70.4%; p < 0.001). Statistically, the percentage of prescriptions dispensed using generic drugs was higher in pharmacies that explained costs, equivalence of quality and efficacy, safety, side effects, and the trial system (divided dispensing), compared to pharmacies that did not use these explanations. Conversely, the percentage of prescriptions dispensed using generic drugs was lower at pharmacies that explained dosage form and ease of swallowing. Many pharmacies explained the equivalence of quality and efficacy (85.7%), with many questions from parents (82.4%). However, only a few pharmacies explained the trial system (divided dispensing) (1.1%), with no questions raised by parents (0.0%).
Conclusion: This study found that pharmacists’ explanations are effective in promoting the use generic drugs for young patients. However, there is a lack of awareness among parents about the trial system (divided dispensing), and public institutions and pharmacists are not responding appropriately. To promote generic drug usage among young patients, it is important to develop educational tools regarding the trial system (divided dispensing), create awareness campaigns for parents, and revise medical fee. Furthermore, to ensure safe drug therapy, pharmacists should also provide information on the appearance and taste of generic drugs.
Objective: Health information, including the labelling, must be presented in a manner that is easily understandable to consumers. In recent years, the European Union and the United States have introduced standards for providing health information in a way that is easy for consumers to understand. The Clear Communication Index (CCI) published by the Centers for Disease Control and Prevention (CDC) is a useful tool for this purpose. Unfortunately, there is no such tool in Japan. Therefore, focusing on the package labelling of foods with functional claims (FFCs) sold in Japan, we constructed a Functional Clear Communication Index (F-CCI) and evaluated the FFCs.
Methods: The F-CCI was developed by six people, including university staff with pharmacist qualifications and public health experts, by referring to the CDC CCI. The evaluation of FFCs using the F-CCI was performed using the Delphi method, which is one of the formal consensus-building methods in the field of health and medical information. The evaluation was conducted by three qualified pharmacists on five FFC products, and the degree of internal agreement among the evaluators was calculated using Fleiss’ κ.
Results: The F-CCI consisted of 18 items that assessed the FFC characteristics. After assessing the labelling of FFCs using the F-CCI, the scores of all the materials ranged between 70 and 80% on the F-CCI, and none achieved 90%, which was considered the acceptable standard (overall κ value_ 0.865). Moreover, it was clear that the ‘readability’ and ‘understandability’ of the labelling were inadequate.
Conclusion: The F-CCI developed in this study for the objective evaluation of the labelling of FFC products will act as a tool that will subsequently lead to the proper understanding and use of FFCs by consumers. Further efforts are needed to build and disseminate such tools and user-friendly ways of providing relevant information.
Objective: In patients with specific backgrounds, comprehensive identification of health problems and proactive pharmacist intervention are crucial to providing safe and effective medical care. However, there are insufficient reports on chemotherapy regimen selection and supportive care management in patients taking immunosuppressants. In this study, to circumvent adverse events, pharmacists intervened with a patient administering tacrolimus (TAC) using known information, focusing on multiple factors attributable to the patient in addition to drug interactions.
Methods: The patient was a male in their 70s who received palliative chemotherapy for gastric cancer during their dermatomyositis treatment with TAC. Pharmaceutical support for cancer chemotherapy was provided using the following four procedures: (1) Patient information was collected from interviews and electronic medical records to identify patient-specific problems; (2) Basic pharmacological information was collected from tertiary sources, focusing on the interaction between TAC and aprepitant (APR). Furthermore, clinical reports were collected, and the pharmacokinetic drug interaction significance classification system was used for quantitative predictions; (3) The information obtained in steps 1) and 2) was evaluated, and comprehensive proposals linked to the patient information were presented; (4) Adverse events, TAC blood level, and patient outcomes were monitored after treatment initiation.
Results: A chemotherapy regimen consisting of S-1/oxaliplatin therapy without APR was selected. The adverse effects were controllable, and the treatment was completed without many adverse events. Meanwhile, TAC adherence was unaffected by cancer chemotherapy, and the TAC blood concentration or dose ratios were controlled within the same range as previously reported.
Conclusion: In cancer chemotherapy, for cases with limited evidence or information, comprehensive pharmaceutical support was provided using known patient information, considering multiple patient factors. This report is beneficial as an example of supportive care management by a pharmacist and contributes to providing optimal service in cases with specific backgrounds.
Objective:Medical device malfunctions can significantly impact pharmacotherapy. With advances in digital technology, smartphone applications for the treatment of nicotine addiction have recently been released in Japan. However, it cannot be denied that the malfunction of medical devices related to such programs may affect drug treatment. Therefore, we investigated malfunctioning medical devices related to the program.
Methods: We investigated reports on malfunctions from FY 2006 to 2021, using the Pharmaceuticals and Medical Devices Agency database.
Results: A total of 94 cases of program-related medical device failures were reported in Japan. The malfunction of medical devices (such as infusion pumps and dialysis machines) associated with drug treatment were confirmed. The events included a rapid infusion of the drug and an inability to ascertain the total dose, both of which were caused by bugs in the program. Although the specifics are unknown, there was a malfunction in the contrast medium injection device as well.
Conclusion: When issues arise with the dosage setting of medical devices, it is necessary to consider both human errors by medical staff as well as program bugs. Additionally, to provide safe drug therapy to patients, pharmacists must inspect the medical devices used in drug therapy when visiting hospital wards and patients' homes.
The identification code of a drug is defined as “a code for identifying tablets, etc.” and is described in the “Composition/Properties” section of the package insert. We investigated whether the Pharmaceuticals and Medical Devices Agency (PMDA) website, which allows users to search package insert information, can be used for drug identification using identification codes in 2019 before the new package insert guidelines were implemented, and in 2022, during the revision period. Approximately 30% of the investigated high-risk drugs were unidentifiable in both years. The most common reason was that images were used to register identification codes on the PMDA website, and character strings were not searchable. We then conducted a questionnaire survey of pharmaceutical companies, and only approximately half of the respondents opined that it would be preferable if the registration format for identification codes was established within the pharmaceutical industry. However, hospital pharmacists urged for more simplified identification of drugs on the PMDA website.