When a physician orders an out-of-hospital prescription that includes the drugs corresponding to a contraindication based on the most recent patient laboratory test data, contraindication checking in the electronic medical system, which shows a warning message, was activated in August 2018. In addition, the most recent individual laboratory test data were printed on out-of-hospital prescriptions after January 2020. To evaluate the effects of this two-step checking system using the laboratory test data on the appropriateness of prescribing for outpatients, the number of prescriptions containing contraindication warnings and that of changes by the inquiries of the community pharmacies were investigated using out-of-hospital prescriptions for each of 17 months from March 2017 to October 2022. The proportion of prescriptions containing contraindication warnings to the total out-of-hospital prescriptions significantly decreased in the three periods after activation of the contraindication checking system compared with the period when no checking system was implemented (3.29％, 3.41％, and 3.34％ versus 3.62％, P < 0.001, respectively). Furthermore, the changed prescriptions by the inquiries of the community pharmacies based on the clinical laboratory data increased significantly after providing out-of-hospital prescriptions including patient laboratory test data (2.38 and 1.60 versus 0.17 per 10,000 out-of-hospital prescriptions, P < 0.001, respectively). In conclusion, both the contraindication warning message in the electronic medical system at the time of the physician’s prescription order and out-of-hospital prescriptions including patient laboratory test values are useful for promoting the proper use of drugs.

The role of pharmacists in perioperative pharmacological management is gaining significance with the increasing number of surgical procedures. Although operating room pharmacists are also required to control surgical site infection (SSI), the point of intervention is unclear. This study aims to address these uncertainties.

The study included patients who underwent colorectal surgery between January 1 and December 31, 2021, to assess perioperative antimicrobial use and factors associated with SSI. A total of 218 eligible patients were included. The guideline compliance rates for dosage, type, preoperative prophylaxis, duration of administration, and additional intraoperative administration of perioperative antimicrobial agents were 96.8％, 92.2％, 91.3％, 83.9％, and 45.2％, respectively. Risk factors for SSI included BMI ≧ 22, contaminated wound surgery, and operative time ≧ 145 minutes. Conversely, appropriate preoperative prophylaxis was identified as a factor associated with reduced risk of SSI (odds ratio: 0.298; 95％ confidence interval: 0.10 – 0.90).

These findings highlight significant challenges in optimizing perioperative antimicrobial therapy, particularly concerning the use of additional intraoperative antimicrobial agents. Moreover, optimization of preoperative prophylaxis may lead to reduction in the risk of SSI. Both aspects should be the focus of intervention by operating room pharmacists.

With the digital transformation in healthcare, a large amount of medical data generated in the process of daily medical treatment has been accumulated. In this study, we extracted medical data from a data warehouse and analyzed it to monitor the appropriate utilization of drugs associated with safety information, reported incidents, and to pre-avoid aiming to preclude potential adverse events.

The survey was conducted from April 1, 2023, to October 31, 2023. Pharmacists in charge of drug information analyzed 4,030,575 prescription and injection orders, and 529 alerts were issued. Pharmacists in charge of drug information checked the content of the alerts and the patient’s medical records, and shared information with ward pharmacists about 364 alerts that were important. There were 33 interventions by ward pharmacists (prescription proposals and test requests), with an acceptance rate of 81.8％. The time required to carry out this initiative (mean value ± standard deviation) was 59.2 ± 13.3 min per day.

By analyzing the medical data, we were able to systematically and continuously monitor the proper use of drugs that require particular attention in hospitalized patients.

The exact mechanisms underlying hand-foot syndrome (HFS) caused by capecitabine remain unclear. This observational single-center exploratory study aimed to assess the association between capecitabine-induced HFS and meteorological elements in patients’ residences. Patients who received capecitabine for the first time from January 2013 to December 2022 at Miyagi Cancer Center and who were scheduled to receive capecitabine on days 1 – 14 of a 21-day cycle to be continued for at least 90 days, including the rest period, were included in this study. Meteorological data were obtained from the Japan Meteorological Agency. We determined the mean temperature and incidence of Common Terminology Criteria for grade 2 (G2) Adverse Events or higher HFS 90 days after treatment initiation. The optimal cutoff value for the mean temperature was determined using receiver operating characteristic analysis. A multivariate analysis was performed using a logistic regression analysis. A total of 173 patients were enrolled in this study. The incidence rate of ≥ G2 HFS was 16.2％. The mean temperature was not significantly higher in patients with ≥ G2 HFS than in those without (P = 0.06). The risk factors for ≥ G2 HFS were as follows: capecitabine dosage (2,500 mg/day) (odds ratio, 7.07; 95％ confidence interval [CI], 1.90 – 26.40) and mean temperature (≥ 21.6℃) (odds ratio, 3.11; 95％ CI, 1.22 – 7.96). This result was attributed to the increased capecitabine excretion from sweat glands due to the increasing temperature and dose dependence of HFS. In conclusion, high temperature is associated with capecitabine-induced HFS.

Recently, there has been an increasing demand for home-care medicine for terminally ill patients, fostering greater collaboration between healthcare institutions and insurance pharmacies to enhance patient medication management. However, no reports have examined the concrete status of home care medicine support provided by insurance pharmacists to terminally ill patients, specifically from the perspective of medical institutions. Therefore, this study retrospectively examined the factual scenario concerning visits made by insurance pharmacies to terminally ill patients receiving home care from Kagayaki Clinic and Kagayaki Home-Care Clinic within a year starting from July 2022. Of the 98 patients analyzed, two groups were formed: non-malignant and malignant. The rates of visits by insurance pharmacists were 64％ and 92％ for patients with non-malignant and malignant tumors, respectively. Furthermore, in the malignant tumor group, the proportion of temporary prescriptions issued significantly increased the week before death. This survey elucidated the precise role of insurance pharmacists in end-of-life home care from the perspective of medical institutions.