Background : With a suppport from Ministry of Health and Welfare (MHW) Japan, we studied the feasibility of conducting event monitoring in Japan similar to Prescription-Event Monitoring in England. The manuscript presented is a report to MHW in 1996.
Methods : Means available in Japan to identify drug, patient and doctor are examined. In addition, any modification needed to make on a questionnaire sent to doctors in PEM conducted in Japan is examined.
Results and Conclusion : Monthly claims called as “Rezept” issued by individual hospitals and clinics and sent to insurers and outpatient prescriptions issued by hospitals to be dispensed by the pharmacies outside the hospitals are considered to be two available means to identify drug, patient and doctor. To have a sample representative of all drug users, the use of “Rezept” is needed as only a fraction of outpatient prescriptions are dispensed by independent pharmacies. However, the use of prescriptions dispensed by the independent pharmacies together with the cooperation of individual pharmacies is capable of finding a contemporary control which is a group of patients who have recently started “old” drugs comparable to the new “test drug”. In Japan no doctor may have a complete list of the hospitals and clinics a patient has visited and it is mandatory to ask doctors the last date when the patient visited the doctor. To clarify what problems arise when a PEM-like study is introduced to Japan, a pilot study is going to be done during 1997 and the feasibility will be examined further based on the results.

An 83-year-old female was referred to our hospital because of a swelling and pain of the left lower extremity. An endoaneurysmorrhaphy and bypass surgery between the left common iliac artery and the external iliac artery were performed under the diagnosis of deep vein thrombosis associated with a left isolated internal iliac aneurysm. Forty patients with isolated internal iliac aneurysm were reported in Japan and deep vein thrombosis occurred only in our patient. The external growth of the aneurysm behind the external iliac artery might cause compression, congestion and phlebitis of the common iliac vein, resulting in deep vein thrombosis.