The government is promoting social support for patients with cancer. Consequently, the use of outpatient chemotherapy is increasing. Outpatient cancer chemotherapy requires monitoring and follow-up for adverse events after patient discharge, making medical institution–local pharmacy collaboration crucial.

This study examined the reporting status of four types of medical fee notification items related to outpatient cancer chemotherapy to bolster regional medical collaboration. A total 33.7％ of hospitals nationwide reported outpatient tumor chemotherapy treatment fees. Collaboration enhancement and specific drug management guidance additions were 16.5％ and 13.6％, respectively. Among the number of medical institutions in each secondary medical area, the percentage of hospitals with collaboration enhancement addition is 64.0％ in large cities, 56.8％ in regional cities, and 48.8％ in depopulated areas, indicating that hospitals with collaboration enhancement addition are in densely populated areas. In areas with low population density, secondary medical care areas did not have outpatient tumor chemotherapy treatment fees or collaboration enhancement hospitals. Compared with outpatient tumor chemotherapy treatment fee hospitals that are yet to receive collaboration enhancement, the number of working pharmacists and registered dietitians was considerably higher in hospitals that received collaboration enhancement. Even in the specified drug management guidance addition 2, the number of pharmacists working in registered pharmacies was notably higher than that in unregistered pharmacies.

In the future, the use of information and communication technologies, such as web conferencing systems, and nonpharmacists and the mechanization of dispensing operations will effectively advance regional medical collaboration systems for outpatient cancer chemotherapy.

This study aimed to evaluate the effect of systolic blood pressure (SBP) or estimated glomerulus filtration (eGFR) rate on sacubitril/valsartan (S/V) treatment discontinuation. A total of 148 Japanese patients who received S/V treatment for heart failure at Gifu General Medical Center between September 2020 and December 2022 were included. The treatment continuation rate considerably differed between the four groups for eGFR; no difference was observed for SBP. Furthermore, the eGFR and SBP for the risk of S/V treatment discontinuation calculated using the receiver operating characteristic curve were <31.24 mL/min/1.73m² (specificity: 0.636; sensitivity: 0.748) and <117.5 mmHg (specificity: 0.545; sensitivity: 0.593), respectively, with 0.700 and 0.550 as the area under the curve. Thus, eGFR influenced treatment interruption more than SBP. The influence of eGFR on S/V treatment continuation was verified using the Kaplan–Meier curve because the number of patients with eGFR greater than this cutoff level was 8 of 22 patients who discontinued S/V. The eGFR of ≥45 and <45 groups were 398 (343 – 452) and 505 (465 – 545) days, respectively (P = 0.024). The hazard ratio of each risk factor for discontinuing S/V treatment was calculated using an eGFR of <45. Although only serum chlorine (Cl) levels were detected (hazard ratio: 3.053, P = 0.052), there was no significant difference. Reportedly, long-term S/V treatment for patients with eGFR of <45 mL/min/1.73m² and Cl of <98 mmol/L should be performed under stricter inspection monitoring.

Adrenaline auto-injector is a first-line emergency treatment for anaphylaxis. In July 2023, Ogaki Municipal Hospital (our hospital) opened a pharmaceutical outpatient clinic to train patients in EpiPen use, aiming to shift tasks from doctors, strengthen patient education, and provide EpiPen guidance using hypothetical scenarios. To assess this clinic, we provided the a questionnaire survey to the parents of the patients for investigating the benefits of EpiPen outpatient care provided by pharmacists and identifying any potential issues. Between July 2023 and July 2024, the questionnaire was administered to 107 patients who visited our pediatric outpatient clinic for guidance on the use of EpiPen. Customer satisfaction (CS) was analyzed based on their responses. The survey items addressed comprehension (4 items), teaching content (4 items), instructors (1 items), outlook (4 items), and overall evaluation; the responses were based on a five-point Likert scale. Although no key improvement items were identified in the CS analysis, actual use was selected as an improvement item. The highest degree of improvement was observed during the CS analysis (13.21). The median (range) overall rating was 5 (4 – 5). The most needed items (4 of ≥5) for future improvement were education for schoolteachers and children (95.7％), emergency procedures (79.8％), and continuing guidance (77.7％). EpiPen instructions using a hypothetical scenario were beneficial, as revealed by high parent satisfaction. Reportedly, education is crucial for school-teachers and children.

Clinical inertia (CI), in which appropriate treatment is not provided at the right time, is critical in diabetes care. This study aimed to investigate how well CI is understood and recognized pertaining to stigma and advocacy; this influences the formation of CI and the content of medication counseling in diabetes treatment. A survey was conducted among 256 pharmacists, who frequently interacted with patients undergoing diabetes treatment, working at community pharmacies. Although 17.0％ of the pharmacists were familiar with the term CI, only 28.3％ of those were aware of its concept concerning medication counseling. Furthermore, 45.3％ of the pharmacists were familiar with stigma, but only 21.9％ were conscious of it. Regarding advocacy, only 13.2％ of the pharmacists knew the term, and only one pharmacist was aware of it. Furthermore, pharmacists who did not check patients’ frequency of visits or the reasons for poor medication adherence were potentially unaware of CI (P = 0.011 and 0.002). Therefore, CI, stigma and advocacy are not well understood among community pharmacy pharmacists. Moreover, increasing awareness of CI can lead to more proactive medication counseling by pharmacists, further helping overcome clinical inertia in diabetes treatment.

The COVID-19 pandemic has substantially influenced pharmacists’ lifelong learning. Everyone easily held online seminars, but organizing workshops with group discussions required extra efforts. This study aims to demonstrate an ideal online training structure such that anyone can easily conduct the necessary online training, derive the expected challenges and solutions, and verify their validity.

Our study was comprehensive, involving books, articles, and web-based information for thoroughly overviewing the state of online training and extract key issues.

Next, we developed specific solutions to the identified issues. To ensure our solutions were valid, we sought feedback from participants and instructors using a pre-prepared evaluation questionnaire.

Consequently, more than half of the participants indicated that the 16 specific solutions to the seven issues raised during the online training contributed to problem solving. However, the percentage of participants who indicated that solutions related to communication and learner support methods contributed to the resolution of issues was lower than those related to the development of the online environment. Results suggest the applicability of the 16 specific solutions. However, issues persist in the methods of learner support.