Objective: Depressive patients tend to avoid communication with health care staff even on their own therapies. However, success in the therapy of depression requires that patients should be educated about their medication from pharmacists. Therefore, it's important to build good environments in which the communication with pharmacists is easy for patients. In this study, we research patients' requirements for pharmacies and pharmacists to offer good pharmaceutical care for depression.

Method: Subjects were 988 depressive patients collected through an investigational research company under certain conditions. The data were obtained through a questionnaire on “How much they have experienced consultation with pharmacists”, “how much they recognize the importance of the medical explanation from the pharmacists”, “how much they recognize the importance of the pharmacy's function” and “how much they appreciate the pharmacy's contribution to their medication and health”. The questions were answered using a five or seven point Likert scale.

Result: Sex and educational background affected the experience of the consultation with pharmacists. The patients' recognition score of importance for both the explanation from pharmacists and the contribution of pharmacies to them were 10 - 20％ and 6 - 9％ higher in the group having experience of consultation than the no experience group, respectively.

Conclusion: This result shows that the medication instruction from pharmacists considering the patients' personal information including educational background could satisfy depressive patients and lead them to a deeper understanding of their own medication. From this result, we expect to provide good medication practice for depressive patients.

The objective of this study was to identify the perceived usefulness of various health consultations at the community pharmacy among the residents. We conducted a web survey of nationwide panelists enrolled by a research company. For 2,400 respondents, the degree to which respondents perceived there was an integrated usefulness for there being a pharmacy where various health consultations were enriched (i.e., “comprehensive usefulness”) was assessed. “Comprehensive importance” of a pharmacy user was compared among different groups of respondents disaggregated by several characteristics. “Encouragement of a medical institution” and “consultation on nutrition” had a relatively strong effect on “comprehensive importance”. The need to provide a pharmacy service that recognizes the viewpoint of health promotion and maintenance of the user regarding the consultation on nutrition and dietary habits adopted from this investigation was clarified in the health consultation duties of the pharmacy.

Patients with cancer pain tend to be engaged in polypharmacy, using cancer treatments, analgesics, and supportive therapy drugs for side effects. We retrospectively examined patients on opioids and actual state of polypharmacy.

Oral oxycodone was introduced in 85 inpatients in Nagoya University Hospital between April 1 2011 and March 31 2012. The number of daily oral drugs before/after oxycodone introduction was researched. Drugs were classified by purpose of use. Risk factors for polypharmacy were determined using univariate and multivariate analysis. Drug-drug interactions and points of note on attached documents about driving were examined. Depending on the number of oral drugs after oxycodone introduction, patients were classified into 3 groups, 0-4 drugs (non-polypharmacy: NP group), 5-9 drugs (polypharmacy: P group), higher than 10 drugs (hyper-polypharmacy: HP group). Median value was 8 drugs after oxycodone introduction, but 4 drugs before introduction. NP group, P group and HP group contain 6, 58 and 21 patients each. The number of drugs tended to increase more in aging, number of diseases, and shift to best supportive care (BSC) (P < 0.05). One drug (0-6 drugs) had drug-drug interaction in the median. Three drugs (1-9 drugs) were required attention for driving, and increased in 3 groups significantly (P < 0.001). In patients on oxycodone, aging, increase in the number of comorbidities, and shift to cancer end-of-life become the risk factors of polypharmacy. It is suggested that polypharmacy increases the risk of drug adverse effects, and continuous assessment of oral drugs is required in future.

This study investigated whether contamination can be mitigated by halving the filling volume of autologous serum eye drops from 5.0 to 2.5 mL eye drop bottles. Twelve 5.0 mL and eleven 2.5 mL ophthalmic solution bottles were prepared. The ophthalmic solution was all used after opening, leaving one to two drops of the remaining liquid. Immediately after preparation, the remaining liquid was cultured, and, after use, the nozzle and residual liquid were cultured. As a result, twelve 5.0 mL and nine 2.5 mL ophthalmic solution bottles were collected. The average use days of the 5.0 mL ophthalmic solution were 9.6 days and those of the 2.5 mL eye drops were 4.7 days. Bacteria and fungi were not detected from the residual liquid immediately after preparation. However, after use, bacteria were detected in at least one of the nozzles or residual liquid of all eye drops, and fungi were detected in one. Contamination could not be reduced by shortening the period of use of eye drops. Therefore, 20％ autologous serum eye drops need to be handled more appropriately.

We report the case of a patient with carbamazepine- and esomeprazole-induced hypocalcemia after parathyroidectomy. The patient was a 60-year-old man who had undergone pharyngo-laryngo-cervical-esophagectomy and total thyroidectomy for hypopharyngeal cancer. Postoperatively, he had been treated with calcium and vitamin D for hypocalcemia. He recovered completely and was discharged from our hospital. However, he was admitted again to our hospital for hypocalcemia and seizure, which we addressed with an increase of calcium and vitamin D. However, it had no effect on the hypocalcemia. The pharmacists provided drug information about carbamazepine and esomeprazole-induced hypocalcemia to the attending physicians. After withdrawal of carbamazepine and esomeprazole, the levels of serum calcium normalized, and his symptoms resolved.

In 2007, the first report that hydrogen removes active oxygen was published, and many clinical and non-clinical studies have since been conducted using hydrogen gas and water. Dietary supplements are used by a large number of patients as self-medication. Although dietary supplements cannot be considered as drugs, patients expect pharmacological benefits from them since they usually have very little knowledge of their effects. Thus, pharmacists have the responsibility to expand their knowledge of dietary supplements so that they can give better advice to patients who are using them.

This study examined the effect of temperature on the dissolved H₂ concentration in water and clarified the difference in changes in H₂ concentration among commercial hydrogen water products. We compared 5 commercial hydrogen water products packed in aluminum pouches (Product A, Product B, Product C), aluminum cans (Product D) or plastic bottles (Product E), and measured the dissolved H₂ concentration for up to 120 days when stored at 26℃ and 37℃ using a needle-type H₂ sensor. We found that the H₂ dissolved in Product A was stable for 120 days at 26℃ and 37℃. Product B and C maintained high H₂ concentrations at 26℃, but the H₂ concentration gradually decreased at 37℃. The H₂ concentrations of products D and E were low and undetectable, respectively. Our experiments suggest that all products packed in aluminum pouches, aluminum cans or plastic bottles stored during distribution at 26℃ and 37℃ may be influenced by the time course of changes in the concentration of hydrogen.

Combined epirubicin + cyclophosphamide (EC) therapy and combined 5-fluorouracil + epirubicin + cyclophosphamide (FEC) therapy are standard care in terms of adjuvant chemotherapy for breast cancer and are classified as highly emetogenic chemotherapy regimens; to date, few studies have evaluated chemotherapy-induced nausea and vomiting (CINV) related to these treatments over multiple treatment cycles. This study examined the incidence rates of nausea and vomiting in 61 patients who received EC/FEC therapies between 2010 and 2012 during each cycle for up to threecycles. The results showed that in the FEC group, incidence rates of nausea were significantly lower in the second (P = 0.036) and third cycles (P = 0.013) than in the first cycle. Furthermore, when referring to the previous literature, we observed good results pertaining to complete suppression of vomiting. Based on the results of this study, we confirm that during FEC and EC therapies, nausea is not exacerbated in subsequent treatment cycles, at least with FEC therapy.

Pharmacists have supported warfarin control (WFc) for hospitalized patients, but not yet for outpatients. Active involvement of pharmacists is believed to be useful after discharge from hospital or the first visit as outpatients, since it is difficult for other medical staff to contribute to WFc.

In 2015, Kyoto-Katsura Hospital established the “Warfarin Outpatient Clinic” for outpatients taking antithrombotic drugs, mainly warfarin, and pharmacists participated in this clinic to support the physicians. We investigated whether the involvement of pharmacists in WFc is useful.

The subjects were new patients who were administered WFc, and time in therapeutic range (TTR), patient waiting time, and adverse events were compared between those who had WFc by a WFc-pharmacist at the “Warfarin Outpatient Clinic” (Ph group) and those who had WFc by a cardiology physician (Dr group).

TTR was significantly higher in the Ph group than in the Dr group (82.5 [0 - 100] ％ and 52.5 [0 - 97.3] ％, respectively, P = 0.014). Patient waiting time was significantly shorter in the Ph group than in the Dr group (40.0 [15.0 - 200.0] min and 70.0 [30.0 - 240.0] min, respectively, P < 0.001). Brain hemorrhage, anemia, and bleeding leading to blood transfusion were not observed in either group.

The implementation of WFc supported by pharmacists in outpatient clinical practice was considered to be safe and effective. Pharmacists should participate in drug treatment via various outpatient services.