Postpartum rubella vaccination is recommended for puerperal women with low rubella antibody titer to prevent congenital rubella syndrome. We have constructed a protocol-based pharmacotherapy management (PBPM) that contributes to the efficiency and safety of rubella vaccination, and we report the results. The ward pharmacist identified a puerperal woman with low rubella antibody titer, provided drug guidance regarding the rubella vaccine to that person, and requested a doctor to prescribe it. When identifying the subjects, it was confirmed whether or not they were inappropriate for vaccination as described in the package insert of the rubella vaccine. The subjects were puerperal women who gave birth at our hospital from April 1, 2017 to March 30, 2020. The vaccination rate (56.7％) after the introduction of PBPM was not significantly different from that when led by a doctor (60.0％). The vaccination avoidance rate for those who were unsuitable for rubella vaccination was 71.4％ (5/7) before the introduction of PBPM, and 100.0％ (9/9) after the introduction of PBPM. Intervening after confirming the package insert is considered to be the work of the pharmacist from the viewpoint of drug management. The introduction of PBPM not only reduces the burden on doctors, but also avoids the health hazards of the rubella vaccine and the inadequate effectiveness of the vaccine, which is considered to be a significant initiative.

In this study, we investigated the perceptions of occupational exposure among pharmacists who prepare anticancer drugs for injection and the exposure control measures taken by individuals and their facilities. Thirty-one hospitals were selected as the target facilities, and 523 pharmacists who were working at the target facilities at the time of questionnaire collection were surveyed. The purpose of this study was to identify the problems that need to be improved not only in each facility, but also in each pharmacist by investigating how to utilize the manuals and guidelines for the preparation of injectable anticancer agents and how each individual pharmacist is implementing the details of their own techniques and procedures. Although all the facilities had prepared their own procedures using common manuals and guidelines, there were some items that were not followed in the procedures. More than half of the pharmacists engaged in the preparation of anticancer drugs performed their work with a sense of anxiety about health hazards and had experience of exposure. In this study, we conducted a survey of the actual conditions of the environment for the preparation of anticancer drugs in medical facilities, as well as a survey of the perceptions of individual pharmacists engaged in the work and their preparation techniques and procedures, to clarify the current problems and future issues. Although it is necessary to use reference materials in accordance with each facility, individual preparation techniques and procedures need to be standardized and mastered to reduce occupational exposure.

Pharmacists are intervening in home healthcare as part of the comprehensive community care system promoted by the government. However, medium-sized cities may not have the medical resources in the same forms as metropolitan areas. In this study, we conducted an interview with pharmacists involved in home medical care in Hikone City, Shiga Prefecture, and added qualitative analysis to clarify the current situation of pharmacists and specific issues in medium-sized medical areas.

Semi-structured interviews were conducted with pharmacists involved in home healthcare in Hikone City, and results were analyzed using a modified grounded theory approach. Using data from 11 pharmacists collected from October to November 2020, 33 concepts and 12 categories were extracted, and a story line was generated.

Lack of confidence among some pharmacists may have created a vicious cycle in which they feel hesitant to speak out regarding opportunities for collaboration, contrary to the general understanding that multi-professional collaboration is important. One of the factors troubling pharmacists was the absence of a place for mutual education among pharmacists; an environment in which they cannot casually ask questions about home operations keeps pharmacists away from home care. In addition, there are not as many imminent medical needs in medium-sized cities as in large cities, and pharmacies specializing in home care may not be viable. We insist that a response that does not follow the successful examples of urban cities, but that instead considers the unique nature of medical care in each region will help pharmacists’ work proceed smoothly.

The association between the latent preliminary group of locomotive syndrome (LS) and handgrip strength was investigated among 96 women over age 40 years who attended health promotion events that were held 5 times between Sep. 2016 and Nov. 2019. The latent preliminary group of LS was evaluated based on three factors: bone mineral density, muscle mass and toe grip strength as an evaluation of the balance ability. The ratios of participants that declined in each factor were 82.3％, 36.5％ and 26.0％, respectively. There was a significant relationship between handgrip strength and bone mineral density, muscle mass and toe grip strength. Participants were divided into two groups based on the number of factors since it is accompanied by the functional decline of the plural locomotive organs for the onset of LS. Participants with zero or one factor were categorized as the “non-pre-LS group”. Participants with two or three factors were categorized as the “latent pre-LS group”. There was a significant difference between the median value of handgrip strength between the non-pre-LS group and the latent pre-LS group. ROC analysis indicated the cut-off value of handgrip strength corresponding to latent pre-LS was 26.0 kg, which was 6.13 as the odds ratio estimated by logistic regression analysis. The measurement of handgrip strength might be a convenient screening tool for latent pre-LS in the community pharmacy.

Pharmacists, as members of the perioperative management team, need to manage patient medication by checking their perioperative medication status to improve medical safety. However, no reports have evaluated the effectiveness of pharmacist interventions on the cancellation rate of surgeries. In this study, we retrospectively evaluated the effect of preoperative drug confirmation by pharmacists at the perioperative support center on the surgery cancellation rate. In addition, questionnaires with other medical staff were conducted to evaluate pharmacist interventions in perioperative patients. Since the initiation of pharmacist interventions in 2014, the surgery cancellation rate was found to have decreased gradually. This reduction is suggested to be the result of the increase in the pharmacist intervention rate in preoperative drug confirmation. Furthermore, preoperative drug confirmation performed by pharmacists at the perioperative support center was highly evaluated by other medical staff. These study findings indicate that preoperative drug confirmation by pharmacists can help to reduce the surgery cancellation rate and improve the medical safety of perioperative patients.

In recent years, pharmacists have shifted their approach from a non-personal to an interpersonal one, with communication skills becoming essential for their daily work. It is not clear how much high school students, at the age at which they have to plan their careers, are aware of pharmacists’ work. The purpose of this study was to clarify the perception of pharmacists among high school students and guardians, which may influence their career paths. In July 2020, an online survey involving 300 high school students and 300 guardians of the students was conducted to examine their perception of pharmacists. The survey included questions about the image of pharmacists (hospital and community pharmacists separately), their tasks, need for knowledge, importance of aptitude, and need for communication. Both high school students and guardians had low awareness of interpersonal work such as consultation other than medicine (46.0％-52.0％), home visitation (30.7％-44.0％), and multidisciplinary cooperation of community pharmacists (39.7％-45.3％). Moreover, they did not consider that the job particularly required communication skills. It is suggested that pharmacists should make efforts to raise the awareness of high school students and guardians about the pharmacy profession and actively engage with patients, their families, and the community.

Busulfex^® is a non-aqueous injection of insoluble Busulfan dissolved in the oil-based solvents Polyethylene Glycol 400 (PEG400) and N,N-Dimethylacetamide (DMA). The use of a closed system transfer device (CSTD) is strongly recommended for the preparation of all hazardous drugs, and we use a CSTD for the preparation and administration of anticancer drugs at Nara Medical University Hospital. We experienced a case of frequent blockage of the intravenous route when Busulfex^® was administered. In the present study, when the test solution containing PEG400 and DMA mixed in the same ratio as Busulfex^® was syringe aspirated by CSTD, the CSTD was broken and foreign particles were generated within 3 minutes of aspiration. When DMA was syringe aspirated by CSTD, polycarbonate, the material of CSTD, was eluted, and functional abnormality of CSTD was observed 30 minutes after aspiration. Oil-based solvents are used as additives in many anticancer drugs. The suitability of a CSTD for the preparation of anticancer drugs should be determined by considering not only the hazard classification of the anticancer drug, but also the type and ratio of the additives.