Objective: This study aimed to elucidate the factors that affect medication adherence in outpatients with depression using multivariate analysis.Methods: A web-based survey on medication adherence, medication attitude (Drug Attitude Inventory-10; DAI-10), medication self-management, and satisfaction with the prescribing physician/pharmacy for outpatients with depression was conducted in January 2018. T-tests and path analysis were performed to evaluate comparisons of responses based on gender, high/low importance of medication guidance, high/low intention to consult, and high/low frequency of consultations.Results: For mean scores, no significant difference was observed between males and females according to a t-test. In terms of the importance of medication guidance, the high importance group had significantly higher prescribing physician/pharmacy satisfaction and better self-management. In terms of intention to consult, respondents with high intention to consult had significantly higher scores on the DAI-10, better self-management, and higher prescribing physician/pharmacy satisfaction. In terms of frequency of consultations, only pharmacy satisfaction was significantly higher in the high-frequency group. Path analysis revealed that, in general, adherence was influenced by medication attitude and self-management, and prescribing physician/pharmacy satisfaction and self-management were influenced by medication attitude. In the intergroup comparison, pharmacy satisfaction did not affect medication adherence in males or the group with low importance of medication guidance. In addition, medication attitude did not affect adherence only in the non-consultation group.Discussion: These results suggest that it is necessary to improve the medication support measures at pharmacies for outpatients with depression. Furthermore, in order for the measures to improve medication attitudes and adherence to be effective, it is necessary for patients to understand the benefits and importance of using pharmacists effectively, including medication support and consultation, and to be actively involved in the maintenance and promotion of patients' health.

Objective: The purpose of this study was to confirm the effect of feeding Okara fermented by Bacillus coagulans on cecum microflora in rat. Method: Three groups of SD rat of 8 weeks old were used in the experiment. The experimental animals were fed control diet, 2% okara diet, 2% fermented okara diet in each group for two weeks. The experimental diet and water were provided ad libitum. Food intake was measured every day. After 24 hours fast, we performed drawing blood with heparin after the experimental period. After drawing blood, several organs were removed for measuring their weight. In addition, we removed cecum after drawing blood about each three groups and studied their microflora. We also measured about plasma albumin, ALT, AST, ALP, LDH, total cholesterol, triacylglycerol, glucose, and cytokine level. Result: Bifidobacteria of cecum and blood IFN-g levels significantly increased in the fermented okara group. The total cholesterol level in blood significantly decreased. Conclusion: Okara fermented by Bacillus coagulans had an influence on not only intestinal microflora but also the immune system in rat, suggesting that the fermented okara can expect development as functional materials.