Recently, in order to make chemotherapy, safer and more effective various forms of intervention by pharmacists are needed. In this paper, we report our experience in intervening in the administration of gefitinib to a patient with dysphagia. Chemotherapy with an intravenous drip injection to the 58 year-old woman admitted to our hospital for non-small cell lung cancer (NSCLC) was withdrawn due to severe pancytopenia after the first cycle of pharamcotherapy. Then, as an altermative, oral medication, of gefitinib was suggested by medical doctors. However, the oral administration was inappropriate to the condition of the patient. She was unable to keep taking gefitinib pills because she had been suffering from a progressive swallowing disturbance due to progressive non-small cell lung cancer. Thus, we proposed another oral administration method in which gefitinib was resuspended in thickening agents. This method made it possible for the patient to take gefitinib without any adverse events until the day before the patient died.
Patients ; Chemotherapy-Oncologic Procedure ; Non-small cell lung cancer ; Deglutition Disorders ; Needs

Although the Outpatient Cancer Chemotherapy (OCC) Unit was established with in Anjo-Kosei Hospital in 2006, its real worth remains to be elucidated. To address this, the following subjects were examined;effective usage of hospital beds changes in the number of outpatients given to chemotherapy, length of hospitalization, the number of patients transferred by ambulance to the hospital, hospital occupancy rate, and the number of frequently used chemotherapy regimens.Since the establishment of the OCC Unit, the number of patients transferred by ambulance has increased and length of hospitalization has gradually decreased, accompanied by the increase in the number of outpatients treated at the OCC Unit. Additionally, no significant change was observed in the hospital occupancy rate. Furthermore, of the frequently used chemotherapy regimens, nine regimens were available for 62.4% of the total number of outpatients of the OCC Unit.These results indicated the useful effect of the establishment of the OCC Unit on the usage of hospital beds, and provided significant information helpful in promoting the effective and safe chemotherapy for outpatients in the OCC Unit.
Chemotherapy-Oncologic Procedure ; Unit ; seconds ; Outpatients ; Malignant Neoplasms

To raise a level of safety and to enhance the effectiveness of complicated drug therapy, various drug monitoring programs have been implemented in these days. In the present study, we examined whether pharmaceutical care plans proposed by pharmacists contributed to drug therapy.The number of pharmaceutical proposals from pharmacists, which were adopted and put into poactice in the clinical stages, has increased annually and totaled 1,014 cases in the past four years. The number of proposals related to cancer chemotherapy increased remarkably. Moreover, most of the cancer-related proposals conserned drug dosage, suggesting that the pharmaceutical care by pharmacists may contribute to the safety management of drugs in drug therapy. Additionally, in the other clinical cases than cancer chemotherapy cases, there was an increase in the number of proposals based on patient's conditions and clinical examination data, which suggests frequent participation of pharmacists in drug therapy. Furthermore, it was found that 62.6% of the all pharmaceutical proposals were made by wards-resident pharmacists. This suggests that an increase in the numbrt of wards-resident pharmacists will contribute to more effective and safer drug therapy in the future.
pharmacotherapeutic ; Safety ; seconds ; Clinical ; Drug Monitoring

  In order to intervene in the management of pain of cancer from an early stage. Our palliative care team (PCT), including pharmacists, makes the ward rounds (screening rounds) of the patients receiving opioids at our hospital. The purpose of this study was to analyze the effects of screening rounds activity by the PCT and its current problems, and to explore how to resolve the problems. We retrospectively studied the records of 196 patients who had receivede interventions by the PCT, with regard to intervention status and prescription proposal (228 subjects) about drug therapy by us. Study groups were as follows: 103 patients to whom interventions were deliveed at the request of medical doctors (intervention request group) and 93 patients who had interventions by the PCT after PCT-screening rounds (screening group). PCT-screening rounds caused to increase the number of interventions by the PCT. After PCT-screening rounds, the cases of intervention started by the request of medical doctors, who had given no heed to PCT intervention, also increased in numher. In this study, some problems with palliative intervention were also brought to light. Even in the screening group where the PCT largely intervened, 33% of prescription proposal by the PCT was ignored. This problem may be, at least in part, due to inadequate communication between PCT and ward staff through an electronic medical recording card, leading to poor relationship between PCT and ward staff. In the future, the PCT needs to work cooperatively with ward staff through direct communication such as medical conference to perform better intervention.

　　Since February, 2012, Anjo Kosei Hospital has embarked upon a new scheme for efficiently handling narcotics during surgical operations. For the purpose pharmacists are allowed to enter the operating room for a while. At the same time, the implementation of digital record keeping for narcotics management tasks has started, making it possible to simplify the handling of a great number of patients. By reviewing the effects on narcotics handling and hours billed, we could determine the effectiveness of operating room pharmacist-led narcotics management at Anjo Kosei. Out of narcotics prescriptions (n＝647) handled in the operating room for one month, 84.7% (548/647) was accounted for by prepared narcotics and 99.8% (646/647) by post-operation management. The introduction of the digital record system resulted in a reduction from 53.3±9.6 minutes to 39.6±6.3 minutes for narcotics preparation, and a reduction from 66.8±16.1 minutes to 41.1±13.5 minutes for post-operation management (p<0.01). It has added to the work efficiency and simplification of operations. Moreover, due to the intervention of pharmacists in the operating room, 92.3% of narcotics prescriptions was performed using the new management system within a relatively short time (80.8±18.4minutes). These data show that the introduction of the new scheme has resulted in more efficient management of narcotics at Anjo Kosei.