Objective : To examine past trend and present status of polypharmacy, multiple drug therapy, which can be a cause of serious adverse events induced by drug interactions.
Design : Drug utilization survey using a database of the Kagoshima University Hospital Information System.
Methods : Data of the prescriptions issued during every May between 1985 and 1994 were extracted from the database. Monthly prescriptions were classified by the number of drugs they included.Furthermore, the data were sorted by patients' ID to obtain the age distribution of patients observed in each year and the distribution of the number of drugs per prescription was analyzed in each age group.
Results : The average number of medicines per prescription was increased from 3.07±2.16 (average±S.D.) in 1985 to 3.46±2.61 in 1994. During 10 years between 1985 and 1994, the proportion of patients receiving ten drugs or more also increased from 1.50%to 3.90%. There was a clear tendency that a large number of drugs were given to old patients and comparatively few drugs to young patients.Proportion of the old patients over 59 years of age increased linearly from 25.71%in 1985 to 35.37% in 1994.
Conclusion : The average number of medicines per prescription was increased during 10 years. This trend is considered to be attributable in part to the increase in the proportion of the old patients. The concomitant use of so many drugs is a problem and a rule for diminishing returns recently adopted as a reimbursement policy of health insurance system has been applied to prescriptions with ten drugs or more. Further studies are needed to examine possible adverse outcomes and other characteristic features of multiple therapy.

Abstract
Purpose : We provided a lecture on medical expenses related to the “dispensing fee” for health insurance pharmacies for the local residents in order to determine if there was a change in their preferred community pharmacies' pre- and post-lecture.
Methods : Questionnaires were provided to 34 participants, pre- and post-lecture, with responses analysed from 29 participants who completed the questionnaires in full.
Results : The percentage of respondents who had not observed receipts with National Health Insurance points was 34.5％, while 25.0％ responded that they had paid with the foreknowledge of the existence of such points. Following completion of the lecture, “drug administration guidance” showed an increase of 55.2％, and “dispensing” , “medication history management” and “pharmaceutical inquiry to the doctor” had also increased to 27.6％, 27.6％ and 20.7％, respectively.. Reasons for the selection requirements of participants' preferred community pharmacies' showed a decrease of 37.9％ related to there being “a pharmacy in the vicinity of a hospital” , whereas “a pharmacy with good administration guidance” and “a pharmacy with good counseling” increased by 72.5％ and 20.7％, respectively.
Conclusion : Through the provision of explanation of the medical insurance “dispensing fee” as explained by community pharmacists to local residents, this may induce favorable effects on their selection requirements for use of community pharmacies.

As of 2011, about 12.8 million people in Japan had osteoporosis, which is a social issue in that it increases the number of patients who are bedridden or require residential care and its poor prognosis increases the mortality rate. We delivered a presentation on osteoporosis prevention to residents;the presentation consisted of ultrasound bone densitometry readings followed by a slide show, based on the readings. This report summarizes the presentation and considers whether it was effective in enhancing awareness of osteoporosis. The presentation was given to 39 residents, who were asked to complete a questionnaire before and after it. Of the 31 female respondents, 16.1 percent had bone density in the “low or caution” range;for all eight male respondents, it was “sufficient” or “average.” After the presentation, over 90 percent of respondents selected “agree” or “slightly agree” in response to the statements “I want to have regular exercise and participate in sports,” “I want to eat nutritionally sound meals,” and “understanding one’s bone density is useful for the prevention of osteoporosis.” In addition, 97.4 percent of the residents responded that the lecture was “useful” or “somewhat useful,” and 94.9 percent indicated satisfaction with it. The presentation was considered to be useful in enhancing residents’ awareness of osteoporosis.