The demand for pharmacy services has increased recently, and the skills required for pharmacists have also advanced. Therefore, it is important to implement a working system in which experienced pharmacists can continue working full-time when they require child care or nursing care. In September 2016, we conducted a survey of hospital pharmacists on their work-life balance at a symposium of the 26th annual meeting of the Japanese Society of Pharmaceutical Health Care and Sciences. The purpose of this survey was to examine the current trends and issues of hospital pharmacists’ experience of work-life balance in Japan. A total of 84 responses were included for analysis. Overall, 68.4% of pharmacists reported that they were not satisfied with their work-life balance, and 65.8% reported that they were not satisfied with their working environment. In addition, 90.4% of hospital pharmacists reported they worked overtime, and 76.3% reported that their workload level at their place of practice was high; therefore, they could not complete their duties within regular work hours. Seventy four percent of hospital pharmacists answered that they will not able to continue working if they encounter life events such as childbirth and caring for children or parents. These results show that a majority of hospital pharmacists was not satisfied with their work-life balance, and they were concerned about continuing their pharmacy career when they encountered certain life events. As such, it is critical that each work place implement policies on work-life balance to further help support their pharmacists.

Prophylaxis is sometimes offered to inpatients who share a room with, or individuals who have been in close contact with, patients who have contracted influenza. In our hospital, 5-day prophylactic oseltamivir has been used as a standard procedure. Here, we investigated the effectiveness of this post-exposure prophylaxis for inpatients and healthcare professionals, as well as its effect on hospital management. The study period was 5 years from fiscal year 2013 to fiscal year 2017, and the effectiveness outcome was the secondary infection rate. Medication costs for this prophylaxis were compared with those for oseltamivir used according to the package insert. The secondary infection rates were 3.0% and 0.5% in 133 inpatients and 434 healthcare professionals who had received post-exposure oseltamivir, respectively. The medication costs were reduced by 50% compared with the estimated costs for 10-day oseltamivir administration. The effectiveness of 5-day prophylactic oseltamivir was similar to or higher than that reported previously, indicating that this prophylaxis was effective. Moreover, 5-day post-exposure prophylactic oseltamivir is expected to reduce the prolongation of hospital stay and influenza outbreaks and thus contribute to hospital management.

Objective: This study conducted a survey of the status of medicine adoption and appropriate use in hospitals. We compared the findings with 2015 survey results to evaluate the changes over time. We also evaluated the impact of changes in the current health care environment, including local community collaboration and the COVID-19 pandemic.Methods: The survey included 500 randomly selected hospitals with more than 200 beds, over 50% of which are general ward beds, as well as 175 hospitals that were randomly selected from the respondents of the 2015 survey. The survey questionnaire included the number of medicines, availability of medication lists, adoption decisions, and impacts of local collaboration efforts and the COVID-19 pandemic on drug adoption and appropriate use.Results: A total of 260 responses were collected from 675 hospitals (39% response rate). Of the 260 respondents, 90 were regional medical care support hospitals, 23 were special functioning hospitals, 143 were general hospitals other than those specified, and 4 were other hospital types. The average number of adopted medicines was 644 for oral medicines, 234 for topical medicines, and 228 for injectable medicines. Ninety-five percent of the hospitals used package inserts or interview forms when adopting medicines, but 15% used original articles. About 36% of the hospitals used standardized methods (hospital formulary management or protocol-based pharmacotherapy management), indicating a lack of pharmacists with pharmaceutical evaluation skills. As for local community collaboration regarding adopted medicines, the most common example was providing information to community pharmacists’ associations, and the most common method was sending information by e-mail, regardless of the hospital type. Regional collaboration meetings were few. The COVID-19 pandemic changed the method of obtaining drug information from pharmaceutical companies.Conclusion: For hospital pharmacists, the selection of adopted medicines is one of the tasks of pharmaceutical management. There are urgent needs for the use of standardized methods and the training of pharmacists involved in the selection of adopted medicines. The establishment of a system to provide appropriate use of medicine to patients by standardizing the method of medicine adoption and information sharing is desirable.

The demand for pharmacy services has increased recently, and the skills required for pharmacists have also advanced. Therefore, it is important to implement a working system in which experienced pharmacists can continue working full-time when they require child care or nursing care. In September 2016, we conducted a survey of hospital pharmacists on their work-life balance at a symposium of the 26th annual meeting of the Japanese Society of Pharmaceutical Health Care and Sciences. The purpose of this survey was to examine the current trends and issues of hospital pharmacists’ experience of work-life balance in Japan. A total of 84 responses were included for analysis. Overall, 68.4% of pharmacists reported that they were not satisfied with their work-life balance, and 65.8% reported that they were not satisfied with their working environment. In addition, 90.4% of hospital pharmacists reported they worked overtime, and 76.3% reported that their workload level at their place of practice was high; therefore, they could not complete their duties within regular work hours. Seventy four percent of hospital pharmacists answered that they will not able to continue working if they encounter life events such as childbirth and caring for children or parents. These results show that a majority of hospital pharmacists was not satisfied with their work-life balance, and they were concerned about continuing their pharmacy career when they encountered certain life events. As such, it is critical that each work place implement policies on work-life balance to further help support their pharmacists.

Introduction: Calciphylaxis is a rare disorder characterized by painful ischemic skin ulcers. There is currently no approved therapy and its pain management is often challenging. Case: A 40-year-old female was diagnosed with calciphylaxis seven years after starting hemodialysis. Despite the administration of sodium thiosulfate intravenous and intralesional combination therapy, the ulcers progressed on both lower limbs and buttocks. She suffered from terrible and opioid refractory pain due to ulcers. After careful consideration of the appropriateness, a lumbar sympathetic ganglion block (LSGB) was performed. Six months later, all the ulcers had re-epithelialized and she was relieved of pain. Conclusion: While the appropriateness of LSGB must be carefully evaluated, it could be a treatment option for patients with central-type calciphylaxis.