The dispensing procedure based on the gaze movement of pharmacists has not been analyzed. In addition, many aspects of the mechanisms of dispensing errors are unclear. So far, the error factor has been estimated depending on the memory of the pharmacists who caused the dispensing errors. In this study, we measured the gaze movement of the pharmacists using the eye-tracking method. As a result, we could elucidate the confirmation procedure in dispensing and the causes of dispensing errors from the viewpoint of recognition and behavior of pharmacists.

In this study, we revealed that drugs with multiple specifications are safe by their right-slanted placement. We also showed that the complication of dispensing is related to “single specification drug < double specification drug, left-side area < right-side area.” Furthermore, we were able to identify one of the behaviors of pharmacists affected by the placement of drugs from the result that the confirmation procedure in dispensing was changed in the right-side area, in which it is difficult to identify the location. Based on the new findings obtained in this study, we aim to reduce dispensing errors by pharmacists, thereby further improving the quality and safety of medical care.

Inhalation medicines are useful for treating asthma and chronic obstructive pulmonary diseases (COPD). We reported inhalation counseling given by pharmacists enabled asthma patients to learn the proper inhalation technique and helped in relieving their symptoms. In this study, we investigated whether counseling for COPD outpatients by pharmacists improved their symptoms, which were evaluated using a COPD assessment test (CAT), lung functions, or inhalation technique and whether there was any correlation between them in the first time inhalation therapy support (the first time) and re-support (the second time) of pharmacists' intervention. As a result, patients with an improved or unchanged score of CAT in the second time counseling were increased for the average score of the inhalation technique, compared to the first time counseling. We found a significant positive correlation between inhalation technique and forced expiratory volume in onesecond (FEV₁), percent predicted forced expiratory volume in one second (％FEV₁), or vital capacity (VC) in COPD outpatients with mild symptoms. These results indicate that counseling for inhalation therapy by pharmacists enabled COPD patients to learn the proper inhalation technique and helped in relieving their lung function. Pharmacists give COPD outpatients the appropriate inhalation technique or use, and some useful information for the pathophysiology of COPD.

It is sometimes difficult for foreign patients to communicate with medical staff, which can cause medical safety problems because it can result in such patients not being able to sufficiently describe their symptoms. In this study, we developed a multilingual symptom-monitoring tool to support pharmacists' work in cases in which communication is hindered by language difficulties. Furthermore, we evaluated the usefulness of this monitoring tool via role-playing with foreign students. The patients' symptoms were better understood by pharmacists in the group in which the monitoring tool was used than in the control group (3.8 ± 1.6 points vs 2.3 ± 1.6 points). In addition, the interview time (130 ± 61 seconds vs 280 ± 48 seconds) and communication error (0.4 ± 0.7 points vs 0.8 ± 0.9 points) were also reduced in the group in which the monitoring tool was used. Therefore, it is suggested that the multilingual symptom-monitoring tool developed in this study could help pharmacists to appropriately evaluate patients' symptoms, and it could also help to reduce medication errors due to communication problems.

To explore preventive measures for enteral feeding tube occlusion during the administration of enteral nutrition, we examined specific tube occlusion conditions by mixing enteral nutrient and highly versatile disease-specific nutritional supplements. We also examined whether tube occlusion could be prevented by stopping pH decrease through mixing enteral nutrient with sodium bicarbonate or other drugs that are alkaline in aqueous solution (magnesium oxide and fosfomycin). Mixing ornithine preparation (ORNUTE^®) with Ensure Liquid^® lowered pH and resulted in tube occlusion. At the same time, under the same conditions, the simple addition of suspended sodium bicarbonate kept the pH value within the dosage range specified on the package insert and avoided occlusion. Furthermore, when compared with the control cases, similar experiments using magnesium oxide or fosfomycin in the mixture were shown to prevent the pH decrease caused by ORNUTE^®. However, tube occlusion was unavoidable because of impurities and residue. This study demonstrates that a mixture including a disease-specific nutritional supplement with the potential to decrease pH is a risk factor for tube occlusion in enteral feeding administration. On the other hand, we consider drugs which produce no insoluble residue, such as sodium bicarbonate, to be suitable for addition to the ENSURE LIQUID^® prior to administration in order to prevent pH decrease.

When anticancer drugs that are eliminated through the kidney are administered to patients with renal failure, their dosage should be reduced according to renal function to avoid severe side effects associated with delays in elimination. We have established dose reduction criteria for cisplatin, capecitabine, and gimeracil/tegaful/oteracil potassium administered to patients with renal failure, aiming to develop a common viewpoint among the medical staff. The dose reduction criteria were utilized to select the chemotherapy regimens in a conference and to check prescriptions in the pharmacy. After establishing the dose reduction criteria, improper dose and/or regimen administered patients with renal failure were decreased significantly. This suggests that the establishment of dose reduction criteria contributed to the proper use of anticancer drugs eliminated through the kidney in patients with renal failure. However, it is necessary to accumulate clinical evidence evaluating whether dose reduction results in a reduced incidence of side effects.

The blood suction port of commercial blood glucose measurement sensors used for self-monitoring of blood glucose (SMBG) is positioned on the front or on the side. However, there is no report examining the ease of operation of SMBG depending on the difference in position.

In this study, we created a simulative blood glucose meter, a simulative sensor, and a simulative puncture part. Then, for 82 healthy subjects, we evaluated ease of operation depending on the difference of positions of the blood suction port of the sensor by shortness of operation time. As a result, the operation time of the front position was significantly shorter (P < 0.05).

Furthermore, the operation time of the front position was significantly shorter regardless of male or female and SMBG experience (P < 0.05). On the other hand, as a result of a questionnaire survey of ease of operation for all subjects, 83％ (71/82) of subjects answered that it is easier to operate at the front position, and operation time was significantly shorter at the front position (P < 0.05). Therefore, it became clear that the shorter the operation time, the more subjects feel performing the measurement operation is easier.

In conclusion, it became clear that the blood glucose measurement sensor on which the blood suction port was installed at the front position was easier to operate.