医療薬学
Online ISSN : 1882-1499
Print ISSN : 1346-342X
ISSN-L : 1346-342X
最新号
選択された号の論文の3件中1~3を表示しています
一般論文
  • -経口プロトンポンプ阻害薬における検討-
    松沼 悟, 原田 和治, 磯貝 博之, 吉元 公一
    2023 年 49 巻 6 号 p. 205-213
    発行日: 2023/06/10
    公開日: 2024/06/10
    ジャーナル フリー

    The cost and cost-effectiveness of drugs are often not prioritized in drug selection due to the busyness of daily clinical practice. In this study, we listed the drug price next to the drug name in the electronic medical prescription system for proton pump inhibitors and potassium ion-competitive acid blockers to encourage consideration of drug cost when selecting drugs. The impact of this initiative on drug costs was examined. The results showed that, during the intervention period of six months, the number of patients prescribed lansoprazole increased by 52, and those prescribed Nexium® and Takecab® decreased by 110 and 59 compared to the standard period. Total drug costs for the target drugs were ¥3,851,734 in the standard period and ¥3,338,236 in the intervention period, a decrease of ¥513,499 (13.3%) in six months. The approach to listing the drug price next to the drug name was very simple, required little effort, and resulted in a reduction in total drug costs.

ノート
  • A Questionnaire Survey
    Hiroyuki Tamiya, Akihisa Mitani, Toshihide Abe, Yukie Nagase, Hideaki ...
    2023 年 49 巻 6 号 p. 214-230
    発行日: 2023/06/10
    公開日: 2024/06/10
    ジャーナル フリー

    Inhaler devices have been the mainstream treatment for obstructive lung diseases including asthma and chronic obstructive pulmonary disease. Community pharmacists play an essential role in educating patients regarding the handling of inhaler devices. However, real-world data regarding the impact of pharmacy characteristics on inhaler instruction such as detailed instructional methods and instructional capabilities for each device are limited. We conducted a questionnaire survey among community pharmacists to investigate their practices regarding the provision of inhaler instruction to patients in routine clinical settings. Of the 140 pharmacists who responded, 127 (90.7%) routinely provided inhaler instruction. Pharmacies that received requests for inhaler instruction from neighboring healthcare facilities were more likely to provide detailed instruction such as patient handling demonstrations and leaflets than those that did not. Most pharmacists indicated that they were able to provide instruction for most of the devices; however, only three devices (Diskus, 87.9%; Ellipta, 90.0%; and pressurized metered-dose inhalers, 76.4%) were identified as “having no difficulty in providing instruction for them” by more than 70% of pharmacists. Several characteristics seemed to be involved in the difficulty in instruction provision, including the number of working pharmacists, initial instructing time, use of uniform instruction method, receipt of request for instruction from healthcare facilities, and opportunity for device instruction. Collaboration between community pharmacies and clinics/hospitals, such as being proactive in requesting inhaler instruction and providing educational opportunities for device handling and efficient instructional methods, may be useful in improving inhalation therapy outcomes.

  • 島田 裕脩, 家田 維哉, 坂部 彩, 頭金 正博
    2023 年 49 巻 6 号 p. 231-240
    発行日: 2023/06/10
    公開日: 2024/06/10
    ジャーナル フリー

    Proton pump inhibitors (PPIs) have been widely co-administrated to patients with atrial fibrillation who are receiving anticoagulant therapy with a direct oral anticoagulant drug (DOAC), to prevent gastrointestinal bleeding. However, there has been controversy over whether there is an effect of co-administered PPIs on the onset of central nervous system bleeding, which also leads a poor prognosis. We therefore examined the effects of PPIs on the onset timing of adverse drug reactions to DOACs, using the Japanese adverse event reporting database, JADER. After adjusting risk factors for bleeding, the results obtained show that the onset timing of central nervous system bleeding is earlier in rivaroxaban-administered patients co-administered with a PPI as compared to non-PPI-co-administered patients. These results suggest that co-treatment with PPI and rivaroxaban may be a risk factor accelerating the onset of central nervous system bleeding.

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