Objective: The dispensing fee revision of April in 2016 made a review of the assessment of inquiries about prescriptions.  The requirement was added by articles that seemed to be pharmaceutically necessary, showing an increase of responsibility for pharmacists.  Based on this, we performed a discussion while collecting the cases of inquiries about prescriptions.
Method: Among the inquiries about prescriptions performed at Jinjo Pharmacy for 4 months starting from April in 2016, we selected 83 cases where a prescription was changed by the pharmacist’s recommendation, based on pharmaceutical information such as drug duplication or drug interaction and confirmation of leftover medicine.  Then, we compared them with the study of inquiries about prescriptions performed by the Japan Pharmaceutical Association in 2015.
Result/Consideration: Inquiries about dose were the leading content, followed by those about duplication with other drugs of same indications and appropriateness of dose considering the adjustment of number of days due to residual drug, which showed the importance of medicinal history and prescription records.  It is considered necessary to renew the contents of the prescription record properly, based on the information acquired, while at the same time changing the pharmaceutical history based on those records.  It is thought that an inquiry about prescriptions will be performed appropriately by making a judgment based on such information. In order to do that, updated knowledge about medicine and updated information about drugs is necessary.  In comparison of the two studies, both showed that the drug information on “safety” and “dose and dose regimen” accounted for a large part of inquiries.  Further consideration on them will be necessary.

Objective: Recently, since usage of the kampo-medicines has changed from conventional usage, it is possible that the tendency of adverse reaction also changes.  Pharmaceuticals and Medical Devices Agency (PMDA) discloses information reported by Pharmaceuticals and Medical Devices Safety Information Reporting System.  In this study, we analyzed adverse drug events of kampo-medicines using Japanese Adverse Drug Event Report (JADER) database of PMDA.  We also investigated what adverse drug events are likely to be occurred by kampo-medicines and what kampo-medicine is likely to cause a particular adverse drug event.
Methods: We focused on reports referring to suspected drugs for kampo-medicines from JADER database of PMDA for about nine years from April 2004 to February 2013.  We analyzed kampo-medicines, organs, and adverse drug events based on the number of reports.
Results and Conclusion: We found 1,958 reports on adverse drug events for kampo-medicines.  The largest number of reports for kampo-medicines was on Shakuyakukanzoto, followed in order by Bofutsushosan, Saireito and Yokukansan.  The breakdown of each organ of adverse drug events reported was 34% for hepatobiliary system disorders, followed in order by 26% for respiratory, thoracic and mediastinal disorders, and 9% for metabolism and nutrition disorders.  A total of the above adverse drug events accounts for 70% of all adverse drug events.  The largest number of adverse drug events reported was 406 cases for interstitial lung disease, followed in order by 294 cases for liver disorder, 260 cases for hepatic dysfunction, 165 cases for hypokalemia, and 102 cases for pseudoaldosteronism.  There are many reports about pseudoaldosteronism of Yokukansan regardless of containing only 1.5 g ricorice per day.  As for cardiac disorders of Yokukansan, we need to pay attention to information in the future.

Objective: To optimize aluminum packaging used for medicinal products based on universal design (UD), the material properties of this packaging were evaluated.  In addition, a questionnaire on the usability of this packaging was conducted for the same purpose.
Methods: Tear resistances of the films used for both aluminum and polypropylene packaging were measured using a tensile tester. To evaluate tear linearity of both packaging types, gap widths from standard line to tear line were measured after the samples were torn 75 mm in length.  A survey of 480 pharmacists was conducted on usability.
Results: Regarding material properties, the maximum value of tear resistance for aluminum packaging was approximately 28 times higher than that for polypropylene packaging.  The maximum gap width from standard line to tear line was approximately 10 mm for both types of packaging.  Regarding the questionnaire, the total response rate was 41.0%.  In valid responses, approximately 90% of pharmacists experienced frustration when opening aluminum packaging and requested improvements in usability. In addition, 88% of pharmacists opened packaging in the longitudinal direction by hands.  For the important point in usability of aluminum packaging, the following answers were confirmed: “speed of opening (43%),” “ease of tearing (31%)” and “ease of taking blisters out (20%).”
Conclusion: Our results suggest that current aluminum packaging is difficult to open and tear linearly based on the evaluation of material properties.  These points are consistent with the concerns highlighted in the survey of pharmacists.  We therefore conclude that the points to be improved when considering UD are the ease of opening and linear tearing for more efficient use of aluminum packaging in a clinical setting.

Objective: For effective use of over-the-counter (OTC) drugs that are provided as relief supplies during a disaster, we aimed to develop a list of OTC drugs that can be used during a disaster.
Methods: We obtained information about OTC drugs useful during a disaster by examining results of previous studies and lists of drugs used during a disaster.  We analyzed this information with the expert pharmacist of disaster support and established a rationale for our list and developed “the List of Useful OTC Drugs During a Disaster” and “the Information Card on Useful OTC Drugs During a Disaster.”
Results: We developed our list of OTC drugs based on the following parameters: (1) while people with severe disorders (e.g. renal failure) are treated by medical teams, those with minor physical conditions are treated using OTC drugs and (2) those OTC drugs that can be used as substitutes for prescription drugs were preferably selected.  The List of Useful OTC Drugs ()—During a Disaster (containing 56 items) was developed for use mainly by medical professionals.  Further, pharmacists from disaster-relief medical teams may not always be available in disaster-stricken areas; therefore, the Information Card on Useful OTC Drugs During a Disaster was developed to enable disaster victims to independently make a certain level of decision.  The information card contained pictograms to call the attention of the disaster victims.
Conclusion: Our results can provide a common tool for drug suppliers, medical professionals engaging in relief works in disaster-stricken areas, and disaster victims.

  In 2008, Japanese Society of Drug Informatics (JASDI) organized the Future Vision Committee (the Committee) to propose the essential focus of drug informatics.  To explore a future vision about the drug information sciences, it was necessary to collect a variety of opinions widely from researchers.  Therefore, at the 11^th annual meeting of JASDI in July 5-6, 2008, the Committee convened a workshop to extract problems in the researches of drug informatics by using KJ method and evaluated the contents.  The major problems raised were “the field of drug informatics is too broad” and “there is no definition and/or no system of the drug informatics”.  Related problems raised are the shortness of the history and lack of originality in the study.  From different viewpoints, it was also pointed out that the methodology of the research is not well established and no systematic education is provided.  Taken together, major problems in drug informatics are concluded to be the lack of definition and the lack of systematizations, and will be solved to a certain extent by defining the outcome of the researches in drug informatics.

Objective: It has been recognized that most medical institutions preferred the printed medium for their information sheets for patient education of inhaler usage. However, some questions have arisen. In a case where patients are not sufficiently informed of drug administration guidance due to limited information with only pictures and text, they might not be able to obtain a proper understanding. Contrarily, it is assumed that video medium, with audio and visual elements, is a format for education conveying a larger amount of information. We conducted comparative research regarding patient’s degree of understanding of inhalation guidance, comparing two groups of print- and video-medium-based instructions for inhaler usage and examined how effective two types of media explanations were on patients.Methods: Research participants were thirty persons visiting Jinjo Pharmacy, who were randomly assigned to the print medium group and the video medium group. After one group read and saw an explanation sheet of an inhaler where the maker wrote inhalation instructions and the other group watched an instruction video, the two groups practiced inhaler usage. Evaluation was performed with specified items and comprehensive assessment, and in addition, the time required for inhalation was measured.Results: Score of the evaluation score was statistically significantly higher in the video medium group than in the print medium group in score of specified items and score of comprehensive assessment, and was also significantly shorter in the operation time of the inhaler.Conclusion: This study clarified that the video medium group had fewer improper inhalation occurrences and shorter operation time and, therefore, showed the effectiveness of the video medium. It is recommended that the video medium should be actively utilized,which could improve patient medication adherence. Accessibility is required for patient education to achieve inhaler techniques by watching video-based instruction.