A questionnaire survey was conducted with 62 doctors from Itoigawa General Hospital to identify the content doctors would prefer in questions about prescriptions. A questionnaire was prepared based on the core pharmacy curriculum, and respondents were asked to choose the following ranked answers: “most welcomed”, “acceptable”, “unsure”, and “not welcomed”. The average rank was obtained for each of 32 items. The overall average rank was 989.5 ± 98.5. Items with a significantly lower average rank were “safety of drugs (adverse reactions and adverse events)” with an average rank of 711.3 and “actions of drugs (pharmacological action and drug interactions)” with an average rank of 754.8. In contrast, “medication and therapy policy” had the highest average rank (1194.7). These results reveal that doctors would greatly prefer to receive questions about prescriptions that are related to safety and pharmacological actions of drugs. It is anticipated that the results of this study will encourage pharmacists to ask doctors about prescription, thereby contributing to improved safety of medical care.

The objective of this study was to investigate the knowledge physicians expect pharmacists to have when discussing the safety of medicines. Survey questionnaires were distributed to 81 physicians working at 2 general hospitals in the Jōetsu region of Niigata Prefecture, Japan. The survey instrument included 22 knowledge items, and for each item physicians were asked to select either “Necessary knowledge” or “Knowledge that should be understood” for pharmacists. We obtained 71 valid responses (response rate: 87.7%). Results showed that “Package inserts” were selected by most physicians: 95.8% for specialist-related inserts and 85.9% for non-specialist inserts, followed in order by “Guidelines in Japan”, “Interview forms”, “Blue letter and yellow letter”, and “Recent topics in academic meetings in Japan”. Knowledge of specialty-related fields was significantly more likely to be expected of pharmacists than non-specialty fields: 48.0% and 36.5%, respectively (p < 0.001). Overall, physicians in this study suggested that when pharmacists share information with physicians, their communications may be enhanced by referring to Japanese guidelines and relevant topics that have previously been discussed at academic meetings.

This study was performed to assess the impact of sputum acid-fast bacilli (AFB) smear in predicting pulmonary tuberculosis (TB). We retrospectively identified sputum AFB smear specimens over a 6-year period in our hospital. A total of 1814 specimens were included: 26 were culture-positive for TB, and 116 were for nontuberculous mycobacterium (NTM). NTM were more frequently isolated than TB (odds ratio: 4.7, 95% confidence interval (95% CI); P <0.001). Sensitivity, specificity, and positive likelihood ratio of sputum AFB smear for TB were 42.3% (95% CI 23.4-63.1), 94.5% (95% CI 93.3-95.5), and 7.64 (95% CI 4.69-12.45), respectively. Although there was a statistical significance in the positive likelihood ratio, sputum smear test had a positive predictive value of 0.100 (95% CI 0.051-0.172). These data suggest that the diagnostic yield of sputum AFB smear for pulmonary TB might be substantially low in our clinical setting. Physicians should pay attention to interpretation of sputum smear results especially in areas with high prevalence of NTM.

We have performed optional screening tests for the detection of pancreatic and biliary duct lesions since 2010 at Itoigawa General Hospital in Niigata, Japan. Here, we report the test results over a 10-year period. In total, 79 participants (51 male, 65%; mean age, 64 years) were screened. Fifteen participants were positive for antinuclear antibodies. Elevated serum IgG4 was found in 1 participant. None had positive antimitochondrial antibody. On magnetic resonance cholangiopancreatography, there was no evidence of pancreatic and biliary duct autoimmune disorders or cancer, but we suspected branch-duct intraductal papillary mucinous neoplasia in 1 participant. Because of potential selection bias in the characteristics of the participants who choose to undergo screening, an important question is how to identify those who might have malignancy and should undergo more sensitive imaging examinations. Performing antibody tests for biliary autoimmune diseases needs to be reconsidered.