The aims of this study were to clarify the factors that affect patient satisfaction with drug information provided by healthcare professionals and to examine the actual conditions of this information provision. A Web-based questionnaire survey was conducted with outpatients who continued pharmacotherapy within the past year. Data collection ended when the number of respondents reached 1,030. The questionnaire covered the conditions of information provision and satisfaction with the drug information provided by healthcare professionals, experiences of using information sources other than healthcare professionals, and drug information needs. Among the 1,030 respondents, 763 (74.1％) were male and 528 (51.3％) were 70 years of age or older. Of the respondents, 1,006 (97.6％) received drug information from healthcare professionals, of whom 861 (85.5％) were satisfied with it. Female sex, adequate Health Literacy (HL), and receiving drug information from physicians, hospital pharmacists, community pharmacists, and nurses were associated with a high degree of satisfaction. In 622 patients (60.4％) who had searched for drug information themselves, “drug effects” and “side effects” were rated highly for both information-seeking experiences and needs. Community pharmacists, physicians, and websites were rated highly for both information-seeking experiences and needs. Patients were more satisfied with community pharmacists and physicians than with websites (P < 0.001). Satisfaction with information provided by community pharmacists was as high as that provided by physicians, so community pharmacists fulfilled their role sufficiently.

The number of cancer patients who demand information on the side effects of anticancer drugs is increasing. It is, however, unclear where cancer patients receive or obtain the information and how it affects the self-regulation of medication. This study investigated how patients obtain side effect information, and identified the relationship between the experience of receiving information and the self-regulation of medication. A questionnaire survey of cancer patients was conducted on the website. The number of valid responses was 488. Ninety-four (27.8％) of the 338 respondents, who had any experience of obtaining information about side effects of anticancer drug from sources other than medical institutions, considered self-regulation of medication, and 58 (61.7％) of those actually reduced the dosage or stopped taking the medication. “Obtaining an explanation of the side effects of anticancer drugs from a pharmacist at a medical institution before the start of cancer chemotherapy” suppressed planning self-regulation of medication, while “using the inquiry window of pharmaceutical companies as an information source for side effects” promoted it. In order for cancer patients to continue outpatient chemotherapy, pharmaceutical companies should carefully consider that the response to patients who use the inquiry window may affect the adherence of patients, and should respond by encouraging confirmation at medical institutions. Furthermore, it is important for medical institutions to promote the concept that pharmacists should explain the side effects of anticancer drugs to the patients before the start of chemotherapy.

Introduction: The aim of this study was to evaluate the awareness and attitude of generic drugs (GD) in a remote area.

Methods: We conducted a questionnaire survey in a remote clinic during November-December 2018. We excluded patients who did not meet the eligibility criteria (patients with dementia including mild cognitive decline, pediatric patients, or psychiatric patients).

Results: Of 285 respondents, 162 (57％) were aware of GD. Of all respondents, 239 (84％) agreed to adopt GD, 30 (11％) disagreed, and 16 (5％) didn’t answer. Ninety nine (35％) respondents had anxiety about GD. Aging was significantly associated with lowered awareness of GD (adjusted odds ratio (OR) = 4.08, 95％ confidence intervals (CI) 2.22 to 7.51). The anxiety of GD was significantly associated with lowered willingness for generic substitution (adjusted OR = 0.0358, 95％ CI 0.00753 to 0.171).

Conclusion: In remote Japan, awareness of GD was still low. Our findings suggest that higher age was related to the lower awareness of GD. Anxiety about GD was related to a passive attitude towards the use of GD.

The use of docetaxel as the primary treatment for metastatic castration-resistant prostate cancer is frequently associated not only with neutropenia but also liver dysfunction. Neutropenia in most patients is usually accompanied by liver dysfunction, but the relationship between the two disorders is unclear. In this study, by analyzing the alanine aminotransferase (ALT) levels of 60 patients who received initial docetaxel therapy, the relationship between grade 4 neutropenia and liver function was investigated. With regard to neutropenia, 31 patients developed grade 4 and 29 developed grade 0 - 3, with mean ALT levels of 34.1 ± 26.6 U/L and 22.3 ± 11.7 U/L, respectively. ALT levels were higher in grade 4 neutropenia than grade 0 - 3 neutropenia. The increase in ALT was negatively correlated with the decrease in neutrophil count. In the grade 4 neutropenia group, the mean ALT level before docetaxel treatment and the previous nadir neutrophil count significantly increased from 19.5 ± 7.4 U/L to 30.1 ± 19.5 U/L. Furthermore, between the two groups, ALT fluctuation was significantly greater in the grade 4 neutropenia group. The observed fluctuations in ALT after docetaxel administration were important, as patients with elevated ALT had a high incidence of grade 4 neutropenia after administration; thus, careful monitoring of the neutrophil count may be required.

Evaluating the awareness and experience with regard to clinical research and understanding the current challenges are important in promoting the engagement of hospital pharmacists in clinical research. Therefore, we conducted a questionnaire survey on 337 pharmacists working at 28 National Hospital Organization Kyushu Group facilities and 5 National Hansen's Sanatoriums, regarding their experience and awareness of clinical research. The survey was conducted via mail from June 2019 to July 2019. Overall, 335 (99.4％) questionnaires were collected, 280 (83.1％) of which were valid responses and could be analyzed. The survey showed that 48.2％ of the responding pharmacists had delivered conference presentations and only 15.4％ had published articles. The necessity for hospital pharmacists to plan and conduct clinical research was considered “necessary” or “slightly necessary” by 86.0％ of the respondents; the most frequent reason was "for medical development." However, concerns about planning and conducting a clinical study were expressed by 94.6％ of the pharmacists; “statistical analysis” was the most frequent issue. The results of this survey indicate that the majority of pharmacists are interested in clinical research; however, writing a dissertation was a difficult task for hospital pharmacists. Hence, we believe that it is important to include the topics of research planning and statistical analysis in the basic education of pharmacists.

We developed an international journal club, using an online meeting tool, as an evidence-based medicine training program intended for healthcare professionals and students. This study aimed to evaluate the outcome of the journal club via a questionnaire survey. We administered the questionnaire to 53 healthcare professionals and students who participated in the journal club between February 2019 and April 2020. Respondents showed positive improvement scores after participating in the journal club, compared with those before, as conveyed through the use of a seven-point Likert scale. The median scores of critical thinking skills, discussion skills in English, evidence-based practice skills, and the sense of freedom to ask questions and make comments after participating in the journal club were significantly improved from 4 (interquartile range [IQR]: 2 - 5) to 5 (IQR: 4 - 6); 3 (IQR: 2 - 4) to 3 (IQR: 2 - 5); 3 (IQR: 2 - 5) to 4 (IQR: 3 - 6); and 3 (IQR: 1 - 5) to 3 (IQR: 2 - 6), respectively. Moreover, they expressed interest in the opportunity to share articles on topics of interest with other professionals from different disciplines, to exchange clinical practice ideas concerning topics of interest, and to explore differences in clinical settings between Asia and the MD Anderson Cancer Center. They also expressed great appreciation for the online meeting format, novelty, and overall qualities of the journal club. These findings suggest that an international journal club for healthcare professionals and students could be useful in an evidence-based medicine training program and communication in English.

Countermeasures against side effects (sleepiness, nausea, vomiting, and constipation) are necessary to continue pain treatment using opioids. However, as opioid-induced constipation (OIC) does not develop resistance, we consider OIC countermeasures to be particularly important. Therefore, we retrospectively compared the efficacy of naldemedine (a drug approved for OIC) in 33 patients with that of sennoside (a conventionally used colon stimulant laxative) in 32 patients. The spontaneous bowel movement (SBM) rate (times/day) was investigated 7 days before and after the start of treatment. The SBM responder rate and usage rate of rescue laxatives were examined to compare both drugs. The SBM responder rate is the percentage of patients meeting the following conditions: ①Patients with 3 or more SBMs within 7 days of starting treatment and ②those with an increased SBM rate compared with 7 days before starting treatment. We used the inverse probability of treatment weighting (IPTW) method to compare the efficacy of both drugs. The SBM ratio increased significantly with both naldemedine (before treatment: 0.4, After: 1.3, P < 0.01) and sennoside (before treatment: 0.4, After: 0.9, P < 0.05). The SBM responder rate in the naldemedine group was significantly higher as compared to the sennoside group (using IPTW: 75.8％ vs 56.3％, P < 0.05). The usage rate of rescue laxatives in the naldemedine group was significantly lower as compared to the sennoside group (using IPTW: 24.2％ vs 40.6％, P < 0.01). Our study suggests that naldemedine is clinically effective for treating OIC.