Objective: To examine the effect of pharmacists’ visits to homebound patients on the elimination of unused drugs.
Method: We conducted a survey with pharmacies throughout Japan that provided home-visit service, asking them questions regarding their work with up to five patients (the survey period was from January 15 through the end of February, 2013).  Main survey questions were: (1) whether they managed unused drugs since the start of their home-visit, and (2) how they managed the unused drugs.  For (2), we conducted case studies by asking the pharmacists to choose the case that impressed them most and describe the unused drugs involved, actions taken, and the results.
Results: Data on 5,447 patients were collected from 1,890 pharmacies throughout Japan (collection rate: 56.9%).  Pharmacists managed unused drugs from 2,484 patients (45.6%). 1,746 patients (3,590 cases) were qualified for analysis.  In 2,332 cases (65.0%), pharmacist intervention eliminated the incidences of unused drugs.  In 782 cases (21.8%), unused drugs were discarded, while the number of drug administration days was adjusted in 2,623 cases (73.1%).  In 21 cases (0.6%), drugs were both discarded and had the number of days adjusted.  There were others for 164 cases (4.5%).  The total price of the eliminated unused drugs was approximately 6,920,000 yen (4,000 yen/person).  Illnesses that benefited most from the elimination of unused drugs were chronic respiratory failure (16,306 yen/person), and Parkinson’s disease (4,803 yen/person).
Conclusion: We confirmed the economic effect of eliminating unused drugs by pharmacists’ home visits.

Anti-signal recognition particle myositis (ASRPM) is a steroid-resistant disease that develops in approximately 5-8％ of patients with dermatomyositis, polymyositis, or other types of myositis. It restricts the patient's activities of daily life (ADLs), mainly owing to muscle weakness of the trunk and proximal lower extremities. We report a case of ASRPM treated at a Kaifukuki rehabilitation ward (KRW；a type of inpatient rehabilitation ward in Japan). A female ASRPM patient in her eighties underwent treatment at the KRW twice, with an interval of 18 months between treatments. During each hospital stay, concentrative and graded exercise therapy was performed under continuous administration of steroid and tacrolimus hydrate. The severity of ASRPM was evaluated using periodic measurement of creatinine kinase (CK) levels. After each KRW treatment, the patient gained the ability to walk and perform instrumental ADLs to live alone. The details of exercise therapy for ASRPM and the management of ASRPM and steroid-induced osteoporosis and its complications (for e.g., lumbar compression fracture) are also discussed.

Anti-signal recognition particle myositis (ASRPM) is a steroid-resistant disease that develops in approximately 5-8％ of patients with dermatomyositis, polymyositis, or other types of myositis. It restricts the patient's activities of daily life (ADLs), mainly owing to muscle weakness of the trunk and proximal lower extremities. We report a case of ASRPM treated at a Kaifukuki rehabilitation ward (KRW；a type of inpatient rehabilitation ward in Japan). A female ASRPM patient in her eighties underwent treatment at the KRW twice, with an interval of 18 months between treatments. During each hospital stay, concentrative and graded exercise therapy was performed under continuous administration of steroid and tacrolimus hydrate. The severity of ASRPM was evaluated using periodic measurement of creatinine kinase (CK) levels. After each KRW treatment, the patient gained the ability to walk and perform instrumental ADLs to live alone. The details of exercise therapy for ASRPM and the management of ASRPM and steroid-induced osteoporosis and its complications (for e.g., lumbar compression fracture) are also discussed.

Objective: This study aimed to elucidate the sense of self-usefulness among patients with advanced cancer receiving chemotherapy in ambulatory care. Methods: Semi-structured interviews were conducted with 20 patients regarding their desire to contribute to others, their everyday lives, and changes in their roles. The text was subjected to qualitative content analysis. Result: Five themes as the sense of self-usefulness finally emerged: “contribution to others,” “approval from oneself and others,” “value given to existence,” “maintenance of independence,” and “integration of life.” Conclusion: The findings suggest that the sense of self-usefulness among patients with advanced cancer who are undergoing chemotherapy is complex. It involves concerns about their independence being threatened and their awareness of the limited time remaining, alongside the looming specter of death amid the worsening and progression of their disease.