Introduction: The aim of this study was to investigate the current status of patient safety management systems in primary care clinics in Japan.Methods: An online survey on patient safety management systems was conducted among primary care physicians certified by the Japan Primary Care Association who serve as clinic managers.Results: A total of 183 physicians participated in the survey. We found that 53.0%, 73.2%, 38.8%, and 32.8% had developed medical safety guidelines, nosocomial infection control guidelines, drug safety guidelines, and medical device safety guidelines, respectively. Furthermore, 64.5% had fewer than 10 incident/accident reports in the past year, the most common of which were prescription errors, vaccine errors, falls, and needle sticks.Conclusion: The issues identified in this study serve as a basis for promoting the development of educational programs and the creation of evaluation and improvement tools aimed at enhancing patient safety in clinics.

[Objective]The purpose of this study is to evaluate an effect of electroacupuncture therapy on low back pain of collegiate athletes.
[Methods]Subjects were 28 collegiate athletes with low back pain who gave informed consent. They consulted a medical doctor beforehand. The electroacupuncture therapy was performed as acupuncture. The evaluation items were as follows:Visual Analogue Scale (VAS) which expresses the state of the pain (Pain-VAS), VAS which shows a training state (Training-VAS), five phases of evaluations to show a training state, pain at the time of the trunk movements, Roland-Morris Disability Questionnaire (RDQ), and Japanese Orthopedic Association (JOA) score. The correlation of each item was estimated.
[Results]The chief complaint of 27 people was low back pain, and one person had pain of the low back and the lower extremities. In the diagnosis, 16 people had non-specific low back pain, 5people had lumbar vertebrae discopathy, and 3had a lumber vertebrae herniated disk. As a result of acupuncture, the training-VAS and five phases of evaluations to show the training state and JOA score were significantly improved. However, as for the pain-VAS and pain at the time of trunk movements and RDQ, a significant difference was not accepted.
[Conclusion]Training-VAS is useful for measuring the outcome of an athlete with low back pain. It is important that athletes with low back pain evaluate their training.

Objectives: The purpose of this study was to investigate current fact of cancer outpatients’ opioid pain management and its possible abusive applications and to establish corrective treatments by the palliative care team. Methods: Our palliative care team investigated cancer outpatients’ prescribed opioid clinical records for 4 months in 2014, and the result revealed inappropriate opioid use which could lead to further abuse or dependency. Through this the team recommended attending physicians viable options including decrease of opioid eventually leading to final withdrawal. Results: Among 67 cancer outpatients, the finding of inappropriate opioid use which could lead to further abuse or dependency was in 5 patients (7.4%). The details are as follows: (1) Three patients were treated with opioid analgesia for initial pain relief but the application continued in spite of recovering from a cancer which had been responsible to the pain. (2) Two patients were medicated with opioid for pain but further diagnosis revealed the disease which caused pain was benign. Four out of 5 patients were successfully withdrawn from opioids. Conclusion: In cancer outpatient settings, it can be overlooked or undetected inappropriate use of opioids which may lead to abuse or dependency without a team approach. To prevent opioid abuses, it is imperative to find the cause of pain as accurately as possible.

Objective : The purpose of this study was to examine the relationships between levels of self-efficacy on health behavior of outpatients with rheumatoid arthritis (RA) and patient's assessment of RA conditions.
Methods : A cross-sectional study was performed using a self-administered anonymous questionnaire between October and December 2010 on 406 RA outpatients who consecutively visited 3 urban hospitals in Japan. The following variables were investigated ; (1) the scale of self-efficacy on health behavior in chronic disease patients (CD-SES), which has 2 subscales : active coping behavior with disease (14 items) and controllability for health (10 items). (2) The demographic data ; age, gender, duration of disease, treatment. (3) patient's assessment of RA conditions : painful joint count, swollen joint count, serum C reactive protein (CRP), patient estimate of global status (PGS) which was measured on a 100-mm visual analogue scale (0=best score), functional disability according to Japanese version of modified Health Assessment Questionnaire.
Results : CD-SES data were obtained from 191 patients. 80% was female with mean age 64.4 yr. Total CD-SES scores significantly correlated with age, PGS and functional disability. The scores of active coping behavior with disease correlated with age, and the scores of controllability for health correlated with PGS. The other variables such as painful joint counts, swollen joint counts, and serum CRP showed no relationship with the scores of self-efficacy.
Conclusion : Self-efficacy on health behavior of RA patients related to PGS and functional disability. The longitudinal study is necessary to ascertain whether the psychological support enhances self-efficacy, and affects clinically important outcome measures such as PGS.