1.Analysis of Actual Pharmacist Research Activity at Japan Pharmaceutical Association (JPA) Congress of Pharmacy and Pharmaceutical Science
Takamasa Sakai ; Fumiko Ohtsu ; Nobuyuki Goto
Japanese Journal of Drug Informatics 2012;13(4):183-188
Objective: The purposes of this study were to verify the actual state and to identify the problems associated with research activities by pharmacists.
Methods: The abstracts presented at the 42nd and the 37th Japan Pharmaceutical Association (JPA) Congress of Pharmacy and Pharmaceutical Science were investigated. They were categorized into six research types: “Outcome research”; “Intervention research”; “Observational study”; “Status report”; “Case report”; and “Other”. They were then ranked according to evidence level, with “Outcome research” ranked the highest. In addition, “Outcome research”, “Intervention research” and “Observational studies” were checked for whether they had structured abstracts, and form scores were awarded.
Results: We found that only 0.8% of abstracts were “Outcome research”. but the level was higher at the 42nd Congress than the 37th (p=0.03). Structured abstracts were also more common at the 42nd Congress than at the 37th (p<0.01). However, the form scores were not significantly different between the 42nd and 37th Congresses.
Conclusions: Our findings suggest that pharmacist research activities are improving, but that there is still room for further development. The referee system and the guidelines for research design are useful methods to encourage more activity. The target of this study was community pharmacy, and further studies are necessary for hospital pharmacy.
2.Clinical Evaluation of Therapeutic Drug Monitoring (TDM) on Antibiotic Therapy for Methicillin-resistant Staphylococcus aureus (MRSA) Infection with the Diagnosis Procedure Combination (DPC) System
Nobuyuki Goto ; Shigeki Yamada ; Kenji Fujimori
Japanese Journal of Drug Informatics 2014;15(4):165-168
Objective: The purpose of this study was to clarify the importance of therapeutic drug monitoring (TDM) at acute care hospitals using Diagnosis Procedure Combination (DPC) data.
Methods: We used DPC data from about 3,500,000 inpatients at about 950 acute care hospitals. The investigation period was from July 2010 to December 2010. Patients were divided into 2 groups: TDM intervention (n=22,012); and non-TDM intervention (n=26,400). We compared the clinical indicators (length of hospital stay, payment based on performance and drug costs) and use of antimicrobials.
Results: TDM intervention was carried out in 45.5% patients for whom an anti-MRSA agent was prescribed. The duration of anti-MRSA agent administration was significantly longer in the TDM intervention group than in the non-TDM intervention group. The total daily cost of anti-MRSA agents was significantly lower in the TDM intervention group than in the non-TDM intervention group.
Conclusion: Our results suggest that TDM intervention is often performed for seriously ill patients who require continuous treatment. TDM intervention may prevent adverse reactions as a result of adjusting the dosage of the anti-MRSA agent.
3.Classification and Evaluation of Medical Terms in Briefing Papers Given to Patients about Adverse Drug Reactions
Yuka Ota ; Fumiko Ohtsu ; Nobuyuki Goto
Japanese Journal of Drug Informatics 2014;16(3):125-136
Objective: Nowadays, patient-centered medical care is essential. It is very important to use layman’s terms that patients can understand. However, most medical staff tend to use difficult medical terms. The purpose of this study was to investigate the amount of difficult medical terms in briefing papers given to patients.
Methods: We conducted a questionnaire survey on September 21, 2012 of 246 non-medical professionals in order to identify difficult medical terms used in a manual for handling disorders due to adverse drug reactions.
Result: It was found that there were 387 terms of those in the manual (n=980) that non-medical professionals had never seen or heard before (39.5%). There were 128 terms for which they could not correctly replace Japanese kana (phonetic) characters with kanji (pictorial) characters (13.1%).
Conclusion: The results indicate that the manual has many terms that are difficult for non-medical professionals to understand. This may hinder patients’ comprehension. These difficult medical terms need to be replaced with layman’s terms.
4.Questionnaire Survey on the Information Contents that Hospital Pharmacists and Community Pharmacists Request from Pharmaceutical Companies
Kayo Sakuraeda ; Humiko Ohtsu ; Nobuyuki Goto
Japanese Journal of Drug Informatics 2009;11(1):24-30
Objective: Pharmacists are supplied a great deal of information by pharmaceutical companies, but the information contents are various. Therefore, in this study, we carried out a questionnaire survey to evaluate the information contents that hospital pharmacists and community pharmacists request from pharmaceutical companies as information providers.
Methods: Marketing specialists conducted questionnaire survey on the information contents thinking hospital pharmacists and community pharmacists were necessary of pharmaceutical services.
Results: As a result of the questionnaire survey, it became clear that the tendency and the common items of the information contents thinking each of them was necessary, by the difference of the workplace form of the pharmacist. Many hospital pharmacists needed the information about the team medical care mainly. Many community pharmacists needed the information about instruction on the use of drugs and communication between hospital pharmacists and community pharmacists mainly. All pharmacists needed the information such as safety measures.
Conclusion: It’s preferable that information providers distinguish the information that both hospital pharmacists and community pharmacists need from the information that considered an environmental difference of each workplace, and provide them distinguished for hospital pharmacists and community pharmacists. These results imply that it should lead to achieving optimal use of drugs.
5.The Current Status of Health Food- or Supplement-Related Adverse Health Effects
Mayu Koike ; Fumiko Ohtsu ; Jinsaku Sakakibara ; Nobuyuki Goto
Japanese Journal of Drug Informatics 2013;14(4):134-143
Objective: Recently, use of health foods and supplements, as well as the amount of information available about them, has been steadily increasing. Therefore, a noticeable increase in adverse drug reactions caused by health foods and supplements has also been seen. The purpose of this study was to clarify the current status and backgrounds of patients with health food- or supplement-related adverse health effects.
Methods: We selected the cases of health food- or supplement-related adverse health effects from the Case Reports of Adverse Drug Reactions and Poisoning Information System (CARPIS) database, which contains over 57,000 case reports of adverse drug reactions. We investigated the background, suspected products and adverse events in each case and conducted univariate logistic regression analysis to determine significance.
Results: We obtained a total of 327 cases consisting of 103 causative products. Women comprised 66% of study subjects and had a significant association with dietary supplements. Patients with a history of liver disease had a significant association with liver damage caused by “Ukon,” a drink made from turmeric root and sold as an anti-hangover remedy in Japan.
Conclusion: The causative products had several unique features. This information should be utilized to prevent health food- and supplement-related adverse health effects in the future.
6.Risk Factors and Subjective Symptoms of Drug-Induced Thrombocytopenia
Masayuki Kakeya ; Fumiko Ohtsu ; Reiko Yano ; Jinsaku Sakakibara ; Nobuyuki Goto
Japanese Journal of Drug Informatics 2014;16(2):70-80
Objective: The present study investigated risk factors and subjective symptoms associated with drug-induced thrombocytopenia.
Methods: We selected 361 patients with drug-induced thrombocytopenia from the Case Reports of Adverse Drug Reactions and Poisoning Information System (CARPIS) database of over 65,000 case reports of adverse drug reactions and assigned these patients to a case group. We also randomly selected 794 cases of adverse drug reactions not associated with thrombocytopenia as a control group.
Results: Data were compared between the case and control groups, and results were analyzed using logistic regression analysis. We identified type of infection (non-viral) and renal failure as risk factors for drug-induced thrombocytopenia. In addition, administration of carbamazepine, methotrexate, interferon alpha, ticlopidine or valproic acid significantly increased the risk of drug-induced thrombocytopenia. Significant associations were also found between drug-induced thrombocytopenia and purpura, fever, and mucosal bleeding.
Conclusion: These findings provide helpful information for early detection and prevention of thrombocytopenia as a serious adverse drug reaction.
7.Development of an Application for Using the Pharmaceuticals and Medical Devices Agency Side Effect Dataset More Effectively
Hiroshi Sakata ; Yukari Inagaki ; Mizuki Nakazaki ; Fumiko Otsu ; Nobuyuki Goto
Japanese Journal of Drug Informatics 2014;16(2):81-89
Objective: The Pharmaceuticals and Medical Devices Agency (PMDA) discloses reports with accumulated side effect information in comma-separated value (CSV) format. It is difficult to use the information in this type of text file because the amount of data is large and composed of multiple fields. Therefore, we developed an application that presents the data in a way that is easier to read and understand.
Methods: The application can display the whole dataset, or the search results of certain medicines and side effects within the database in Microsoft Access 2013. It exports data from search results into an Excel spreadsheet organized by medicine and side effect.
Results: This application makes it possible to understand statistics contained in the side effect dataset, such as the number of cases, the medicines, and the side effects themselves. Moreover, the application allows the totaled search results for the medicines and the side effects to be graphed. It also makes it possible to understand the sex and age distribution of patients, as well as the days elapsed before developing a side effect.
Conclusions: Recently, the importance of information concerning the safety of medicine has increased. This system could facilitate the effective use of side effect information and the creation of medicine risk management plans in medical institutions.
8.Development of Code System for Generic Drug Information
Miki Takase ; Fumiko Ohtsu ; Nobuyuki Goto ; Toshiaki Nakamura ; Mikio Masada
Japanese Journal of Drug Informatics 2011;13(3):113-118
Objective: In recent years, the Ministry of Health, Labor and Welfare has actively promoted the use of generic drugs. However, implementation of this policy has not progressed smoothly, as information on generic drugs is poorly organized. As a result, it is difficult for pharmacists to select the appropriate generic drugs. Therefore, we attempted to develop a code system to organize information on generic drugs.
Methods: We analyzed the guidelines used for the approval of generic drugs. We then identified the important aspects for comparison of generic drugs and developed a code system. Next, we tested this code system using temocapril hydrochloride tablets, which is a generic drug.
Results: We were able to develop a code system for selection of generic drugs. Furthermore, we confirmed the utility of this code system for selecting generic drugs in the case of temocapril hydrochloride tablets.
Conclusion: We believe that this code system with be useful for pharmacists, but further development is necessary for other generic drugs.
9.Rehabilitation for Pure Word Deafness and Returning to Work : A Case Report
Anri GOTO ; Nobuyuki SASAKI ; Hidekazu SUGAWARA ; Wataru KAKUDA ; Masahiro ABO
The Japanese Journal of Rehabilitation Medicine 2008;45(4):242-247
We report a 47-year-old right-handed male patient with pure word deafness after suffering an intracerebral hemorrhage. He had been working as a high school teacher before the onset of his stroke. He was emergently admitted to our hospital due to left putaminal hemorrhage and treated conservatively after admission. The patient's neurological findings showed that although his auditory comprehension was severely impaired, he was still able to communicate using written language. Pure-tone audiometry didn't detect any sensorineural hearing impairment. After the diagnosis of pure word deafness was clinically made, we educated the patient and his family, as well as the associated medical staff at our department, about this condition so that they could understand his pathological situation. In addition, we introduced a rehabilitation program for lip-reading and showed him a technique for using articulatory voice production in usual conversation. As a result of our attempts, he developed the ability to communicate using lip-reading skills after 2 months of rehabilitation and successfully returned to his previous work because of the communicative competence he acquired. We also make some proposals for helping other patients with auditory agnosia to return not only to their regular daily activities but also to return to gainful employment, as patients with this condition seem to have special difficulties benefiting from the present welfare service system in Japan.
10.Analysis of Erroneously Dispensed Named Generic Drugs
Takato Kunito ; Kouichi Tanabe ; Takamasa Sakai ; Fumiko Ohtsu ; Nobuyuki Goto
Japanese Journal of Drug Informatics 2016;18(2):131-140
Objective: The purpose of this study is to investigate incidents of erroneously dispensed drugs on the assumption that the incidents stem from the similar names of the drugs. The investigation was also conducted to prevent such dispensing incidents in the future, i.e. to search for factors that can prevent future incidents, and finally to propose a prevention plan which takes each of these factors into account.
Methods: We extracted incident cases related to generic drugs reported by pharmacies in Japan and from those cases examined those that were categorized as cases of erroneously dispensed medicine. We used this data to categorize the difference in relationship between the drugs which were supposed to be prescribed and those which were erroneously dispensed, and to analyze the association between the “Flowchart for Avoiding Confusion Errors between Similarly Named Drugs” and the name similarity index based on this flowchart.
Results: The types of incident cases due to name similarities of generic drugs were categorized into specification mistakes and brand mistakes. The edit of the name similarity index were especially important factors for dispensing incidents between generic drugs.
Conclusion: This study focusing on generic drugs revealed the factors that result in dispensing incidents due to name similarity. Further empirical studies investigating the usefulness of interventions that alter the name similarity index is required.