高齢者は加齢に伴い慢性疾患および老年症候群を併存することが多く，その過程で要介護状態の前段階であるフレイルに至る．慢性疾患に伴う薬剤数の増加は，有害事象や処方カスケードの発生リスクを高める．本研究では，高齢者のポリファーマシーとフレイル・老年症候群との関係を多角的に検討した．

レセプトデータ解析では，薬剤起因性老年症候群のうち食欲不振の頻度が高く，約34％で処方カスケードの疑いが認められた．ロコモフレイル外来患者を対象とした解析では，降圧薬の減薬が身体機能改善と関連する可能性が示された．さらに，転倒リスク診断モデルの構築に成功し，社会的孤立の改善・悪化が薬剤数の増減と関連することも確認された．

このように，本研究では高齢者のポリファーマシーとフレイル・老年症候群について，多角的な視点から検討を重ね，その関連の全体像を明らかにしてきた．今後も得られた知見を深化させ，さらなる研究の発展につなげていく．

Introduction: The risk of chronic disease increases with age, leading to a decrease in the health-related quality of life (HRQoL) of older patients. Information on the impact of chronic diseases on the HRQoL of older patients visiting community pharmacies in Japan is limited. Therefore, this study aims to investigate the characteristics of HRQoL among older patients who regularly visit community pharmacies in Japan and clarify the impact of chronic diseases on HRQoL.

Methods: An online survey was conducted with patients aged 20 to 70 who regularly visit community pharmacies. The ratio of male to female individuals in each age group was 1:1 and 1,500 respondents were recruited. HRQoL was measured using the EuroQoL-5D-5L and the burden of each chronic disease was assessed. Multiple regression analysis was conducted with HRQoL as the objective variable and sex, age group, and type of chronic disease as explanatory variables.

Results: Hypertension was the most common disease, followed by dyslipidaemia, depression and other mental illnesses, allergic rhinitis, and diabetes. The results of the multiple regression analysis among all community pharmacy patients showed that depression and other mental illnesses, eye diseases, atopic dermatitis, lower back pain, and other diseases significantly impacted the decline in HRQoL. Being older increased HRQoL. Depression and other mental illnesses were significant factors in the decline in HRQoL across all the age groups.

Conclusion: The types of chronic diseases and their impact on HRQoL among patients who use community pharmacies in Japan were clarified. Community pharmacists should implement interventions to reduce the disease burden among patients with a higher disease burden, while keeping control of primary diseases among patients with a lower disease burden to prevent future declines in HRQoL.

When reviewing pharmacotherapy in older adults, it is essential to comprehensively assess their overall clinical status using the comprehensive geriatric assessment (CGA). Accordingly, the importance of information sharing via CGA items among hospital pharmacists, community pharmacists, and other healthcare professionals is increasing. However, current practices in information sharing remain unclear. This study investigated the current practices and challenges related to information sharing through CGA items. A questionnaire survey was conducted among 149 hospital and community pharmacists with clinical experience. The results showed that for many CGA items, less than 50% of information was exchanged among pharmacists (hospital and community) and other professionals. Significant differences were observed between hospital and community pharmacists in the proportion of CGA-related information shared with pharmacists and other healthcare professionals, particularly in areas such as cognitive function and social factor. These findings indicate that information sharing via the CGA items among pharmacists and other healthcare professionals was insufficient. Furthermore, differences exist in the information-sharing practices between hospital and community pharmacists. To address these issues, standardized formats incorporating CGA items should be used to enhance the pharmacists’ information provision. Additionally, increasing awareness among healthcare professionals regarding the relevance of CGA items to pharmacists may help improve the flow of information from other professionals to pharmacists.