1.The Perception and Utilization of a Prescription Record—A Survey with Community Pharmacists and Patients—
Takahiko Norose ; Yuta Kimura ; Satoshi Nodu ; Hidehiko Sakurai
Japanese Journal of Social Pharmacy 2014;33(1):15-20
A “Okusuri-techo,” which refers to a prescription record, is utilized in medical institutions as an information tool necessary for the prevention of side effects, drug-interaction, and/or in case of emergency medication. However, the record is not shared sufficiently between patients and pharmacists and thus remains underutilized. To explore how the record could be used more effectively, a survey was conducted with the pharmacists of 73 community pharmacies that were members of the Otaru Pharmaceutical Association, and patients who received prescriptive medicines from these pharmacies. A total of 148 pharmacists and 157 patients responded. Approximately 80.9% of the patient group responded that the prescription record was useful, whereas 100% of the pharmacists answered that it was helpful. In the cross-analysis of the patients’ responses, the presentation of the prescription record to medical staff was correlated with the degree of helpfulness of the record. It was suggested that the function and effective usage of the record were rarely shared between patients and pharmacists. Sufficient understanding of the value and effective usage of such a record will therefore promote its active utilization among patients and pharmacists.
2.The Relationship between Medication Adherence and Medical-service Evaluation among Chronically-diseased Outpatients under the Separation of Prescribing and Dispensing: An Empirical Study Aiming at Reducing Unused Medicines and Promoting Family Pharmacies
Hidehiko Sakurai ; Mitsuko Onda ; Takahiko Norose ; Hitomi Yanaguimoto ; Seiichi Furuta
Japanese Journal of Social Pharmacy 2016;35(1):23-33
In addition to the notion of promoting generic drugs to lower pharmaceutical costs, another approach that has gained attention as vital to policy reform is that of utilizing health insurance pharmacies to decrease over-prescription and surplus of drugs. Such a move would perforce require separating medical and dispensary practices. There is increased need for more efficient provision of pharmaceuticals, including proper inventory control, outpatient clinics that function as family pharmacies, and support of home-bound patients’ medication regimens. However, chronic ailments in particular tend to lack subjective symptoms, and decreased intake of medication and surplus medication compound to make these larger policy issues difficult to solve. This has led to the Revised Dispensing Service Fee changes in 2012 and 2014 putting stricter controls on medication regimens and checks of surplus medication. This research examines in parallel the issues of patient satisfaction and loyalty alongside adherence to medication regimens, issues that have been previously treated in isolation in the existing literature. By comparing their respective inter-relationships and influencing factors, we conducted a re-analysis of the relationship between insurance pharmacies and patients. We collected data from patients with diabetes and high blood pressure via an Internet survey. Responses on loyalty, patient satisfaction, overall perceived quality, and degree of medication adherence were obtained, as well as responses on the factors believed in a cross-sectional sense across research disciplines to contribute to the above, and the results measured on a quantitative scale. Path analysis was then used, with a model defined using overall perceived quality as a parameter and measuring the degree of satisfaction, loyalty, and medication adherence. In addition, a multiple-group analysis was simultaneously performed. Although there was variance by ailment in terms of patient satisfaction and loyalty, factors contributing to perceived quality were the strongest, followed by the rating of the prescribing doctor. However, for adherence, only self-efficacy and prescribing doctor rating contributed. Ultimately, no correlation was found between patient satisfaction, loyalty, and adherence, and the contributing causes were found to vary, so improving these various vectors would seem to require respectively differing strategies. In terms of medication adherence, the results suggested the need for strategies to increase patients’ self-efficacy, partner with prescribing doctors, and improve the perceived rating of prescribing doctors; different quality improvements are needed by medical area, whether medicine or dispensary practice.
3.Investigation of scenarios for healthcare education by multidisciplinary faculty
Hiroki Yasui ; Takahiko Norose ; Katsuo Amioka ; Shinobu Sakurai ; Muneyoshi Aomatsu ; Keiko Abe ; Yoshihisa Hirakawa ; Kazumasa Uemura
Medical Education 2013;44(4):253-257
In scenarios developed by a multidisciplinary faculty for interprofessional education, practical problems that emerged included: “medical incident” and “shortage of medical resources” from the perspective of patient and families,” and “information sharing,” “evaluation and feedback,” and “insufficient feeling of accomplishment” from the perspective of health-care professionals. Discussions identified “interprofessional collaboration,” “mutual understanding for professionalism,” and “embodiment of professional culture” as key words for problem solving. Finally, scenarios were developed in the hospital, home-care, nursing, or community care settings that referred to 2 themes, “end of life” and “dementia.” Pilot case studies performed with health care professionals demonstrated the utility of the scenarios and the effectiveness of interprofessional education.
4.Chronic Intoxication Experimentally Induced by Small Doses of Sumithion-an Organophosphorous Insecticide
Eishiro Abe ; Kiichiro Sasaki ; Kazuo Kurosawa ; Shinji Asanuma ; Akira Suzuki ; Takahiko Sakurai ; Shyosui Matsushima ; Takeji Nakano ; Kazuhiro Kawahara
Journal of the Japanese Association of Rural Medicine 1984;33(2):183-189
Over the past eight years, small doses of an organophosphorous insecticide known in Japan as Sumithion (fenitrothion) have been administered weekly to rehsus monkeys and beagles. In this report, the results obtained during the past three years are discussed.
During the period, two monkeys and one hound died. Pathohistological examination revealed degeneration and disappearance-regeneration of liver tissues, edema of oculomotor muscle stomas, spinal cords and oculomotorius nerve fibers, and atrophy of limph nodes. These are considered the effects of the insecticide.
The surviving animals did not develop any abnormal changes or signs associated with Sumithion-induced disorders. Weight loss was not observed. Routine blood tests were negative. However, serum chemical analyses conducted in the seventh year showed that there are statistically significant differences in GPT, LDH and cholinestrase activity among the animals.