Due to the COVID-19 pandemic, pharmacy hospital practical training across the country required significant adjustments from the academic years 2020 to 2022. It is crucial to examine whether the practical training program developed in response to the pandemic met pharmacy students’ expectations and needs. In this study, we analyzed the results of a satisfaction evaluation survey administered to pharmacy students who had completed their practical training at Saitama Medical Center. The survey included four assessment items: 1) Overall impression, 2) Physical burden, 3) Facilities, and 4) Instructional materials. Furthermore, we assessed the satisfaction with lecture content and practical guidance across eight departments. Text mining analysis was applied to evaluate the free text responses. When comparing the results between normal times and the pandemic, there was no noticeable decrease in satisfaction for most items throughout the pandemic. The practical training program at our hospital did not disregard the on-site training that aimed at skill acquisition, but incorporated remote training in a planned manner after considering the possibility of substitution. Analysis of the questionnaire results suggests that these measures contributed to the positive evaluation by pharmacy students.

We explored factors related to dysphagia in elderly convalescent stroke patients using the Food Intake Level Scale (FILS) on admission and discharge.

Subjects included 405 stroke patients aged 65 years or older who were discharged from a comprehensive rehabilitation ward between April 2018 and May 2023.

A univariate analysis was performed with 69 patients without dysphagia at admission FILS level 10 and with 336 patients with dysphagia at levels 1 – 9. Then, a multiple logistical analysis was used to examine factors associated with dysphagia on admission. Furthermore, patients with levels 1 – 9 on admission were grouped into patients with levels 10 (n = 79) and patients with levels 1 – 9 (n = 257) at discharge. After univariate analysis, multiple logistical analyses were performed to examine factors affecting dysphagia at discharge.

Factors related to dysphagia on admission were Geriatric Nutritional Risk Index (GNRI) (OR = 5.54, P < 0.001), cognitive impairment (OR = 2.14, P = 0.0117), and BMI (OR = 2.21, P = 0.0141), while factors affecting dysphagia at discharge were GNRI (OR = 2.88, P = 0.003), polypharmacy (OR = 1.74, P = 0.047), and motor Functional Independence Measure efficiency (OR = 0.26, P = 0.026). There was no association with drugs that increased or decreased or caused a decline in swallowing function.

It was speculated that GNRI was the factor positively associated with dysphagia on admission and discharge, and that polypharmacy was a positive factor in dysphagia at discharge. While it is already clear that appropriate rehabilitation and nutritional management are effective in improving swallowing in the rehabilitation ward, it is also useful to review polypharmacy during hospitalization.

Cooperation between community pharmacies and hospitals during the perioperative period is crucial for the effective management of preoperative withdrawal drugs. A shared information tool that spans from preoperative to postoperative stages is required to facilitate this collaboration. This study aimed to evaluate the utility of a proprietary collaborative tool through a questionnaire survey and case collection. According to the survey, the awareness rate of this tool was 44％ (16/36) for hospitals and 76％ (19/25) for community pharmacies. In the span of three months, 19％ (3/16) of hospital pharmacists and 16％ (3/19) of community pharmacists had utilized the collaborative tool. Hospital pharmacists expressed less optimism regarding the utility of the tool in the preoperative setting, potentially due to the presence of existing hospital-specific collaborative tools and limited awareness of this particular tool. In contrast, all community pharmacists (3/3) agreed with the statement, “Do you think that the information provided to hospitals about preoperative withdrawal drugs will be consistent and eliminate omissions?” In the postoperative setting, both hospital and community pharmacists tended to be highly satisfied with the tool. However, out of 15 cases where community pharmacists shared preoperative withdrawal drug information, only 27％ (4/15) received responses from hospital pharmacists using the collaborative tool after surgery. This suggests the need to revise the tool’s format and operation procedures, considering the existence of hospital-specific collaborative tools.

The combination of a renin−angiotensin-system inhibitor, a diuretic, and a nonsteroidal anti-inflammatory drug (NSAID), also known as “Triple Whammy,” has been reported to increase the risk of acute kidney injury (AKI). Triple Whammy drugs are often prescribed by multiple physicians. Therefore, interventions by community pharmacists are important to prevent AKI. In 2018, we started an educational campaign in Shiga Prefecture to raise awareness about the risk of AKI due to Triple Whammy among community pharmacists by providing examples of how to respond to Triple Whammy. This study aimed to evaluate the campaign using a questionnaire survey over four years. Four surveys were conducted from 2018 to 2022, and we found that before the campaign, the awareness of the risk of AKI due to Triple Whammy was 30.0％, with no pharmacists inquiring about it. However, after the campaign started, the awareness increased to > 80％ and continued to increase over time. The percentage of pharmacists with inquiries also increased to 18.8％. Additionally, 38.0％ of pharmacists had experience in teaching patients about Triple Whammy, and 15.0％ of pharmacists had experience in teaching patients about caution or discontinuation of NSAIDs as over-the-counter drugs for Triple Whammy. In conclusion, the awareness of Triple Whammy and the number of pharmacists with experience in making inquiries markedly increased after the educational campaign, indicating the success of the campaign. The continuation of the campaign is expected to improve patient adherence and contribute to AKI prevention and early detection.

Drugs discontinued as potentially inappropriate medications (PIMs) during hospitalization are often resumed after discharge from the hospital. In this study, we examined the maintenance proportion of PIMs discontinuation at the first visit within 1 year of discharge in patients who had discontinued PIMs during hospitalization to evaluate the effectiveness of the provision of the discharge medication information sheet. The proportion of patients who maintained discontinuation of PIMs was 86.1％ (31/36) and 65.2％ (15/23) in the group with and without information provision, respectively, showing no significant difference between the groups. The proportion of drugs that remained discontinued was 90.0％ (63/70) in the group with information provision, and significantly higher than 68.1％ (30/44) in the group without information provision (P = 0.006). In the subgroup analysis for patients who visited other hospitals after discharge, the proportion of patients and medications that remained on PIMs discontinuation was significantly higher in the group with information provision than without the provision (P = 0.049 and 0.011, respectively). The provision of the drug information sheet at discharge is useful for maintaining PIMs discontinuation, especially in patients who visited other hospitals.