Infection caused by drug resistant bacterium is one of the global issues. Therefore, in April, 2016, Ministry of Health, Labour and Welfare formulated the National Action Plan on AMR and is working on proper use of antibiotics. In this study, we investigated the receipt data of our 248 pharmacies which operated by the group from April 2013 to March 2019. The effect of the Action Plan on AMR was determined by segmented regression analysis of interrupted time series for the prescription number of times and the prescriptions days of antibiotics. According to the formulation of the AMR action plan, changes in the prescription times of antibiotics was −202.3 times/month (95% Confidence interval (CI) −325.7, −79.0), and the prescription days was −1905.9 days/month (95%CI −2969.0, −842.9). In addition, the monthly means of the prescription number of times of the oral third generation cephem antibiotics, the 14-membered ring macrolide antibiotics, and the new quinolone antibiotics also showed a significant decreasing from April 2015 to March 2019. Based on these results, the AMR action plan is thought to have reduced the number of prescription times and prescription days for antibacterial drugs in pharmacies.
Summary: A previous evaluation of the pharmaceutical stability of tablets of acetaminophen (AAP)-containing over-the-counter (OTC) drugs formulated with a combination of the excipients erythritol (ET) and crospovidone (CP) revealed that high-temperature and high-humidity storage conditions caused a delayed release of AAP. Reasons for the delay included decreases in micropore volume within tablets due to the deliquescence of ET under high-temperature and high-humidity storage conditions, and the subsequent formation of aggregates after the tablets were returned to room temperature. Erythritol has a pleasant taste, cooling feel, and is an inexpensive and useful flavoring agent. The optimal disintegrant to use with ET as a flavoring agent was studied. The disintegrants tested were CP, low-substituted hydroxypropylcellulose (L-HPC), and sodium starch glycolate (SSG). Results showed that the formulation with the combination of ET and L-HPC disintegrated within 30 min, indicating pharmaceutical stability. Delayed release occurred in Meloxicam, other active pharmaceutical ingredient (API) formulations containing ET and CP. This result suggested that other API formulations including ET and CP also delayed release. It has been confirmed that the use of L-HPC as a disintegrant in acetaminophen preparations could maintain the quality even under high-temperature and highhumidity storage conditions, but other APIs need to be further studied in detail in the future.
We surveyed the current use of medicine and health care products and knowledge of health food among high school and college students in Ishikawa prefecture, Japan. The health care products included over-the-counter (OTC) drugs, health foods, and supplements. Among the high school students, 10.5 % used prescription medicines, 43.0 % used OTC medicines, 18.8 % used health foods, and 13.1 % used supplements either continuously or temporarily. Among the college students, 16.5 % used prescription drugs, 58.1 % used OTC medicines, 32.2 % used health foods, and 27.3 % used supplements either continuously or temporarily. Regarding the use of health foods and supplements, 18.5 % of students reported that they were not advised to “go to a medical institution if their health became worse” when taking the health foods. In addition, 34.5 % thought that “health foods will cure illness.” This result suggests that it seemed to be necessary to carry out not only the education of the medicines but also the education on the utilization of health food and supplement for the junior high school student in school curricula “Education for Medicines”.
A questionnaire survey was conducted for pharmacy students to clarify the current situation of headache treatment in pharmacy practice and the effects of experience in practical practice on students. The subjects were pharmacy students (219) who completed the practical training. The recovery rate was 100% (219/219). In the practical training, 98 students were able to observe and/or treat headache patients, and 121 students were unable to experience either. Many students felt the need to treat headache patients in practical training. In particular, students who were able to observe and practice in practical training had strong feelings. Motivation of students can be increased by providing opportunities for students to practice what they learned before the practical training at the university.
In recent years, health insurance pharmacists have been required to diversify their work, thus potentially raising the risk of incidents due to increasing stress. However, the relationship between work-related stress and incidents among health insurance pharmacists is not clear. This study seeks to clarify that relationship. A questionnaire survey on working conditions, work-related stress, desire to leave work, and incidents was conducted among health insurance pharmacists at Tsuruha Co., Ltd. (212 stores) in December 2016. An analysis of the data provided by 397 respondents indicated that work-related stress factors such as ‘psychological work burden (amount)’, ‘work aptitude’, ‘rewarding work’, and ‘desire to leave work’ were related to the occurrence of incidents. These results point to the importance of creating an environment in which these incident-related factors can be identiﬁed early.
A novel suspension method, different from the conventional crushing and simple suspension, was developed for solid preparations for internal use involving a test tube mixer (hereinafter, vortex suspension). After vortex suspension in 20 mL of water at 24±1°C using a centrifuge tube, most solid preparations for internal use were disintegrated and suspended within 5 minutes, allowing passage through an 8 Fr. feeding tube (hereinafter, tube). For simple suspension, tablets that require the disruption of film coating were subjected to vortex suspension without disruption. Then, the tablets were disintegrated and suspended to be passed through the tube. Capsules could not be passed through the tube at 24±1°C. Thus, the vortex suspension can disintegrate and suspend solid preparations for internal use, except for capsules, even in water at 24±1°C, allowing their passage through a tube. Therefore, this method may be highly useful, particularly for film-coated tablets.
Patients can freely decide which insurance pharmacy they bring their prescription to, but they tend to choose a pharmacy near the hospital that they can easily access. However, the Ministry of Health, Labor, and Welfare promotes “family pharmacies” that check polypharmacy, possible unnecessary prescribed medicine, and residual medicines which were not taken. In this study, we performed a survey to assess 1) how to become a “family pharmacy” that is chosen by patients and 2) how patients select an insurance pharmacy. Our result revealed that many patients selected “a place (location)” as a dominant preference. This suggests that although the Japanese government is promoting “family pharmacies,” many patients choose insurance pharmacies based on their location. In addition, the selection criteria that the patients had for “family pharmacies” were investigated. The first requirement is that “they are nice to patients.” Second, they need to have a “wide knowledge about health.” These results suggest that to become the “family pharmacy” chosen by patients, knowledge about medicine and health is necessary. In addition, the ability to communicate is important for pharmacists and clerks in a pharmacy. Moreover, “online medical examinations,” “electronic prescriptions,” “using a computer to provide explanation about medicine to a patient at a distant place,” and “delivery of medicines” are recently conducted in national strategy special zones. If these systems are accepted in the future, then “family pharmacies” where information about a patient’s disease and medication is available would become common. Moreover, “family pharmacies” would reduce the burden of patients on national programs.
To clarify enteral formula use among patients on enteral nutrition receiving home care and drug administration, a questionnaire survey was conducted involving insurance-covered pharmacies in Osaka Prefecture. Among 98 pharmacists who responded, 47% had experience of providing enteral nutrition guidance. Many pharmacists answered “I don’t know” for the questions regarding the rate and duration of enteral feeding. Drugs for patients on enteral nutrition were mostly administered, as instructed by doctors, but the administration at various other periods was also observed in many cases. The results revealed that many pharmacists still lack knowledge for the appropriate use of enteral formulas, although they are expected to play an important role in ensuring that enteral feeding is performed by appropriate methods, and drugs are administered at appropriate times.