To consider what pharmacists can do to prevent patients from having leftover prescription drugs, we conducted a qualitative study about the various causes behind the unused drugs. We interviewed one male and four female home-care patients who had leftover prescription drugs that pharmacists detected via their home visiting service. The Grounded Theory Approach was used for analysis, and two types were identified as “exogenous factors that cause confusion for the patient” and “patient’s personal thoughts and feelings.” “Exogenous factors that cause confusion” involved eight factors, including unsuitable dosing schedule for lifestyle, complex timing for taking medicine, and inadequate support for enhancing patients’ compliance. These factors were divided into ［problems with prescription］ and ［difficult changes to manage］. In “patient’s personal thoughts and feelings,” 16 concepts were identified and their broader concepts comprised six categories: ［distrust of drugs］, ［taking a positive view about one’s own non-compliance］, ［psychological distance from medical staff］, and others. It was assumed that there would be a perception gap of compliance between patients and medical staff. Moreover, patients affirmed their poor compliance and they did not see the occurrence of leftover drugs as a problem. Additionally, psychological distance from medical staff prevents patients from consultation. Therefore, pharmacists should check patients’ compliance for each drug as well as any medical problems. Knowing patients’ inherent mind revealed by this study, the pharmacist can assist medication alongside patients and contribute to the early prevention of unused drugs.

In junior high school, educators with many different types of specialty jobs are involved in “education on the proper use of pharmaceutical products” and “drug-abuse resistance education”. Examples of these different jobs are physical education teachers, school nurses, school pharmacists. The aim of this study was to elucidate novel ideas and new directions in the future of medicine instructional education by clarifying the aims and thoughts of educators with different jobs on the education of pharmaceutical medicines and drug use. Based on the technique of Personal Attitude Construct (PAC) analysis, junior high school staff members involved in “education on the proper use of pharmaceutical products” and “drug-abuse resistance education” were interviewed regarding their aims and thoughts. Their responses were analyzed qualitatively. Five school pharmacists, five school nurses, and four physical education teachers were interviewed. The responses revealed that school pharmacists engaged in student education from the specialized perspective of pharmacology, school nurses engaged in student education from the perspective of imminent situations, and physical education teachers engaged in student education more from the perspective of student environment. This study suggested that “education on the proper use of pharmaceutical products” and “drug-abuse resistance education” should be a collaborative effort, so there were the different perspectives and aims of educators with different specialty jobs in the instruction of junior high school students on these subjects.

Approximately 14.1 million patients have dyslipidemia in Japan. Promotion of self-medication for the prevention of dyslipidemia is needed. After a change in law in 2014, residents of Japan are allowed to measure HbA1c, cholesterol, and triglyceride levels by self-blood sampling from the fingers under the guidance of pharmacists. In this study, we held an event to measure the lipid levels within a community and evaluated the usefulness of a simple measurement for the early detection of dyslipidemia. Furthermore, we surveyed community members’ knowledge of dyslipidemia by self-questionnaires. Of the 48 local residents who came to the event, 45 had their lipids measured and answered the questionnaires. In 12 applicants, HDL-cholesterol or non-HDL-cholesterol, which are not affected by meals, exceeded the standard range. In the questionnaire study, 89% of applicants selected arteriosclerosis as the main consequence of dyslipidemia. Additionally, over 82% of applicants selected blue-backed fish, dietary fiber, and soybeans as food items that inhibit the rise in lipid levels. However, only 31% of applicants recognized that fruits also affect lipid levels. Although it was disappointing that 60% of applicants did not know that they could measure HbA1c and lipids at community pharmacies, 62% desired measurement of those levels in the future. This study suggested that the simple lipid measurement is useful for the early detection of dyslipidemia but local residents need to be informed about it. Furthermore, improvement in the recognition of dyslipidemia by local residents is needed.

Objective: In the previous study, the CYP database was constructed in order to relate drug-drug interactions to the CYP metabolic information of the package inserts.  In this study, we evaluated the clinical usefulness of the CYP database by using the Pharmaceutical and Medical Devices Agency (PMDA) Drug Monitoring Information.
Methods: We examined the drugs in CYP isoform responsible for drug metabolism.  The age, sex, suspect drugs and co-administered drugs were extracted from 6,236 cases of the PMDA database of drug monitoring from January till November of 2008.
Results: Twenty-three percent of all cases had co-administered drugs.  Forty-five percent of these cases were metabolized both suspect and co-administered drugs by the same CYP isoform, and three fourths of these cases were able to be detected only by the CYP database.  In addition, the administration of substrate medicines in combination with substrate medicines was the largest (57%), followed by cases of substrate medicines in combination with inhibitor medicines (28%).  Seventy-seven percent of the suspect drugs that had a large number of reported cases of side effects were substrate medicines, and the frequency of co-administration with substrate medicines was very high.
Conclusion: These data suggest that the CYP database, being used together with package inserts, might be a clinically useful tool to avoid adverse events caused by drug-drug interactions.

Background: Although transferring drugs to a third party, even in a personal capacity, is illegal in Japan, many drug transactions are carried out via internet auction sites. Pharmacy consumers might not be aware of the illegality of transferring drugs to others due to various factors. To clarify pharmacy consumers’ awareness of this issue and its covariates, we carried out a questionnaire survey.Methods: A self-completed questionnaire, consisting of yes/no and multiple-choice questions, was used. The adult patients who visited Keio University Pharmacy were asked to fill out the questionnaire.Results and Discussion: One hundred and fifty-one response sheets were effectively collected from 173 responders. The subjects’awareness of the illegality of transferring drugs was significantly affected by the formulation (oral vs. patches) and pharmacological category of the drug, as well as the source of the drug (prescribed vs. over the counter). Patient education about the illegality of personally transferring drugs, especially patches, might be required to avoid illegal drug transfers, including via the internet.