2.Questions Predicting Severe Disease in Patients with Abdominal Pain at a General Outpatient Department
Ken Kimura ; Masatomi Ikusaka ; Yoshiyuki Ohira ; Tomoko Tsukamoto ; Kazutaka Noda ; Toshihiko Takada ; Masahito Miyahara ; Ayako Basugi ; Kaori Sakatsume
General Medicine 2012;13(1):11-18
Background: Taking a good history is important for the diagnosis of abdominal pain. We investigated questionnaire items that were significantly correlated with causes of abdominal pain requiring hospitalization. We also studied the combination of responses that could exclude severe disease.
Method: Between February 2006 and December 2007, 296 of 317 patients with abdominal pain who attended our Outpatient Department completed a questionnaire for their abdominal pain. They included 32 patients requiring hospitalization (severe group) and 264 other patients (mild group). The percentage of positive responses to each questionnaire item was compared between the two groups, and those showing a significant difference were employed for logistic regression analysis.
Results: The following 4 responses were selected: “It is less than 7 days since the onset of pain” (odds ratio [OR], 2.8; 95% confidence interval [95% CI], 1.2-6.4); “The pain is exacerbated by walking” (OR, 2.8; 95% CI, 1.3-6.2); “The pain is accompanied by weight loss” (OR, 3.8; 95% CI, 1.5-9.8); and “The pain wakes me at night” (OR, 2.3; 95% CI, 1.1-5.2). If a patient had none of these responses, the predictive value was 0.03 for severe disease.
Conclusions: Our findings suggested that pain reported within 7 days, exacerbation by walking, nocturnal awakening, and associated weight loss are features of abdominal pain that predict severe disease. Conversely, severe disease can be almost completely excluded in patients negative for all 4 features.
3.Analysis of Disaster Prescriptions Received at a Pharmacy after the Kumamoto Earthquake
Eriko ANAMI ; Toyonobu SAKAMOTO ; Yuko ISOO ; Tomoharu TOKUYAMA ; Kenji TSUKAMOTO ; Akiko OKITSU ; Tomoko AMAGATA ; Ichiro INABA ; Yasuaki MIYANO ; Hiroyuki KIDO ; Eiji YUKAWA
Japanese Journal of Drug Informatics 2021;23(3):135-142
Objective: Soon after two massive earthquakes in Kumamoto, Japan, on April 14 and 16, 2016, the Shirakawasuigen pharmacy located in the Minamiaso village received prescriptions for disaster medications. Since prescriptions for disaster medications are typically used at temporary emergency shelters, pharmacies usually do not receive requests for them. On checking the content of these prescriptions, we found numerous prescription errors and queries. This study aimed to assess issues with dispensing medications after disasters.Methods: We reviewed all disaster medication prescriptions received by the pharmacy from April 20 to May 28, 2016 and the medication histories of these patients. We confirmed each patient’s data and medical and medication histories. Furthermore, we classified disaster prescription errors and queries into five categories according to their content and summed them in each category.Results: We obtained patients’ medical and medication histories from 100 (77.5%) of the 129 prescriptions received. Of the 129 prescriptions, a total of 158 prescription errors and queries pertaining to 96 (74.4%) prescriptions were confirmed: 88 (55.7%) for unclear medication usage and dosages, 22 (13.9%) for incorrect medication names, 34 (21.5%) for pharmaceutical queries, 8 (5.1%) for exceeding fixed prescription days (within seven days), and 6 (3.8%) for other issues.Conclusion: Nearly 80% of the prescriptions for disaster medications had prescription errors and queries. Therefore, we evaluated that the prescription’s format and entry method can be improved. Furthermore, to ensure a smooth drug supply and to reduce prescription entry deficiencies and formal prescription queries, pharmacists need to effectively manage disaster prescriptions.