Objective: This study quantitatively analyzes the factors causing dispensing errors in community pharmacies and explores the characteristics of these factors and their order of importance.
Design and Methods: We collected data records on the contents and causes of dispensing errors as reported between April and July 2009 by a total of 320 pharmacists at 56 stores of two pharmacy chains (15 stores in Hokkaido and 41 stores in the Kansai area).  We focused on the following three types of dispensing error: 1) “measurement error”, 2) “wrong drug dispensing error” and 3) “wrong dosage form specification error”.  We conducted multiple regression analyses and discriminant analyses with occurrence frequency of each type of error as dependent variables and count frequency of each causal factor as independent variables.
Results: The result of the multiple regression analyses indicated that the primary causes of the three types of errors in order of strength of the regression coefficients were as follows.  For “measurement error”: 1) pharmacist’s wrong assumption and 2) calculation error; for “wrong dosage form specification error”: 1) insufficient confirmation of prescription and 2) pharmacist’s wrong assumption; for “wrong drug dispensing error”: 1) pharmacist’s wrong assumption and 2) insufficient confirmation of prescription.  The results of the discriminant analysis indicated that only for the discriminant coefficient between “wrong dosage form specification error” and “wrong drug dispensing error” no significant difference in the mean was found (p=0.539).
Conclusions: Results show that partly different factors cause “measurement error” as compared with the two other types of dispensing errors.  In addition, while basically the same factors were found to cause “wrong drug dispensing error” and “wrong dosage form specification error,” there was a difference in the order of importance of these factors.  This study uncovered differences in terms of causal factors affecting each dispensing error type.

Oxycodone controlled-release (CR) tablets are used as a first-line opioid analgesic for cancer pain. However, use of oxycodone CR tablets is associated with toxicities such as drowsiness and constipation, leading to deterioration of the quality of life (QOL), especially in patients with gynecologic cancer. In contrast, fentanyl has a superior toxicity profile while still showing a strong analgesic effect. Although fentanyl has been approved for switching from opioid, there have been no Japanese studies of patients with gynecologic cancer who were switched to transdermal fentanyl after experiencing toxicity during therapy with oxycodone CR. More importantly early introduction of palliative therapy for pain has not been adopted routinely in the management of gynecologic cancer. Thus, it appears that treatment for patients with gynecologic cancer remains unsatisfactory at present. We conducted research into improvement of the toxicity profile and pain control with the aim of improving QOL for patients with gynecologic cancer. We showed that pain, drowsiness, and constipation could be significantly improved in gynecologic cancer patients as a result of switching to transdermal fentanyl therapy at an early stage.

　　The process of creating health promotion activities in the community was analyzed by means of document examination. The results showed that the process has four periods, namely, the preparation period, consensus period, planning-implementation period, and continuation period. Based on our results, we propose a general-purpose design for community resident-centered health promotion activities in areas with different characteristics.