To manage the early detection of immune-related adverse events (irAEs), it is recommended to conduct baseline testing before administering immune checkpoint inhibitors (ICIs). Additionally, continued testing is necessary during ICI administration. During ICI treatment, it is important to perform tests such as ACTH, that were not commonly done in traditional cancer chemotherapy. However, ensuring consistent execution of these tests is challenging. Therefore, we developed a dedicated test set specifically for ICIs and implemented a flowchart indicating test values for suspected irAEs and consultation options. In this study, we investigated the overall implementation rate of the designated test items in the test set for patients who received nivolumab or pembrolizumab before and after its implementation. Additionally, we retrospectively examined the rate of consultations with other departments for suspected irAEs. The investigation was conducted during the screening phase and from day 2 to 100. During the screening phase, there was a significant increase in implementation rates from 1 case (1.9％) out of 104 cases to 162 cases (50.9％) out of 318 cases (P < 0.01). Similarly, there was a significant difference during the treatment period. Furthermore, the consultation rate significantly increased from 14 cases (13.5％) out of 104 cases to 74 cases (23.3％) out of 318 cases (P < 0.01). In conclusion, the test set serves as a valuable aid in detecting irAEs, and the flowchart has the potential to contribute to an increased consultation rate.

In the outpatient setting, pharmacists at community pharmacies play a crucial role by working closely with physicians to ensure appropriate antimicrobial use. This study aimed to clarify the actual condition of pharmaceutical inquiries by community pharmacists regarding the appropriate use of outpatient antibiotic therapy. Based on public data released by the Japan Council for Quality Health Care, we performed a retrospective analysis on 757 inquiries related to antibiotics among inquiries recorded by community pharmacists from March 2022 to July 2022. The most common inquiries were about the prevention of adverse effects of antibiotics (70.5％), followed by inquiries about the prevention of decrease in the effectiveness of antibiotics (10.0％). On the other hand, we found that pharmaceutical interventions to reduce unnecessary antibiotic prescriptions for the common cold and to promote the appropriate selection of antibiotics for empirical treatment through the implementation of clinical guidelines, and to optimize the dosage in cases of renal insufficiency estimated from the results of a creatinine test remained as important problems that still need to be solved. In conclusion, our findings suggest that although community pharmacists’ inquiries contribute substantially to the safety and treatment effectiveness of outpatient antibiotic therapy, pharmacists may need to better identify problems before their onset in order to promote the appropriate use of antibiotics.

We conducted a web-based survey to determine the necessity of standardizing intravenous concentrations in intensive care units (ICUs). We analyzed the responses from 186 medical professionals working in ICUs. Of the survey respondents, 80.1％ have encountered dilution-related medication errors in injectable solutions. A total of 92.5％ of the survey respondents believed that standardization of intravenous concentrations in ICUs is necessary, and 94.6％ believed that the standardizations would reduce the number of dilution-related medication errors. Dexmedetomidine had the highest unification rate (91.1％) out of all the standardized concentrations of injectable drugs within each hospital’s ICU and was significantly higher in semi-closed ICUs than open ICUs in each hospital comparison (P < 0.01). Our survey shows that it is essential to standardize intravenous concentrations to reduce dilution-related medication errors of injectable drugs in the ICUs.