In April 2014, a Letter of Rapid Safety Communication was issued, because 21 fatalities following administration of paliperidone palmitate (PP) were reported over a 5-month period since its launch in November, 2013. At the Department of Pharmacy of Hakodate Watanabe Hospital (our hospital), we established criteria for the use of long-acting antipsychotic injections (LAIs) when we began to prescribe LAIs at our hospital and shared information on the use of LAIs with pharmacists at community pharmacies by placing seals in medication notebooks. In March 2014, we conducted a questionnaire survey of pharmacists at 223 community pharmacies in Southern Hokkaido to compared the investigation items by the percentage of prescriptions filled in by the department of psychiatry among all the prescriptions dispensed by the pharmacies. The pharmacists who answered that injectable drug use information and seals for medication notebooks were necessary accounted for 75.8% and 74.2% of the responders, respectively. On the other hand, the percentages comprising the acquisition rates of information on injectable drug use and information on the injectable drugs used were low with 12.1% and 7.6% respectively. Also, a significant difference was seen in the recognition of LAI use in the comparison by the percentage of prescriptions filled in by the department of psychiatry among all of the prescriptions dispensed by the pharmacies (p＝0.001). Our results show that collaboration between hospital pharmacists and community pharmacists is necessary to ensure the safe use of LAI.

Early detection and treatment decrease the mortality rate associated with gastric cancer (GC). However, the natural history of GC remains unclear. An 85-year-old woman was referred to our hospital for evaluation of a gastric tumor. Esophagogastroduodenoscopy identified a 6 mm, flat-elevated lesion at the lesser curvature of the antrum. A biopsy specimen showed a well-differentiated tubular adenocarcinoma. The depth of the lesion was estimated to be intramucosal. Although the lesion met the indications for endoscopic resection, periodic endoscopic follow-up was performed due to the patient's advanced age and comorbidities. The mucosal GC invaded into the submucosa 3 years later, and finally progressed to advanced cancer 5 years after the initial examination. The patient died of tumor hemorrhage 6.4 years after the initial examination. In this case, mucosal GC progressed to advanced GC, eventually leading to the patient's death from GC. Early and appropriate treatment is required to prevent GC-related death.
Adenocarcinoma ; Aged, 80 and over ; Biopsy ; Comorbidity ; Endoscopy, Digestive System ; Female ; Follow-Up Studies ; Hemorrhage ; Humans ; Mortality ; Natural History* ; Stomach Neoplasms*