Objective: Contrast media side effects range from minor ones such as itching and vomiting to life-threatening ones such as hypotension and loss of consciousness. The purpose of this study was to determine how contrast media side effects are actually managed in hospitals nationwide, as well as to identify opportunities for the pharmacy department to be involved in contrast media administration, and pharmacists’ awareness of the risk of contrast media side effects. Methods: A self-administered, unmarked questionnaire survey was conducted in the pharmacy departments of 2,000 hospitals nationwide. The survey asked about the existence of internal rules and manuals regarding contrast media at each facility, how to deal with patients at risk for side effects, opportunities for intervention with patients by the pharmacy department, and opportunities for discussion among pharmacists and other professionals regarding the administration of contrast media. Results: Of the 2,000 facilities, 96 responded to the questionnaire, among which 69 had internal regulations or manuals. In those with manuals, the manuals stipulated measures such as not administering contrast media or administering premedication in the case of patients with a history of contrast media side effects. In facilities where the manual recommended premedication, it was found that premedication was administered in both inpatient and outpatient settings. Regarding the role of the pharmacy department, it was found that intervention in all items related to risk factors for adverse drug reactions was achieved for only about 10% of the outpatients. Conclusion: This study revealed that many facilities are involved in the management of contrast media side effects. The results indicate that there is scope for pharmacy departments to intervene more proactively in outpatient settings to ensure appropriate contrast media use in the future.

Objective: Adverse reactions are sometimes induced by contrast media used for medical imaging and can be life-threatening. Thus, appropriate management is important for patient safety. The purpose of this study was to clarify the actual management of adverse reactions induced by contrast media in hospitals, the opportunities for intervention by hospital pharmacy departments and the attitudes of hospital pharmacists regarding the risk of adverse reactions.Methods: A self-administered questionnaire survey was conducted in the pharmacy departments of 16 hospitals (approximately 200 to 1,000 beds) located in the Tokyo metropolitan area of Japan. The survey asked about the presence or absence of internal rules or manuals regarding contrast media administration at each hospital, the management status of patients with risk factors for adverse reactions, the opportunities for interventions by pharmacists, and the opportunities for discussion regarding contrast media administration among pharmacists and other professionals.Results: Of the 16 hospitals, 10 responded to the questionnaires, and 7 of them had internal rules or manuals. These rules or manuals stipulated actions such as “do not administer contrast media” to patients with risk factor(s) for adverse reactions. For inpatients, there were opportunities for pharmacist interventions, such as drug management and guidance services and initial interviews upon hospital admission. However, for outpatients the opportunities for interventions were limited. At 5 of the 10 hospitals, pharmacists discussed contrast administration with physicians, radiologists, and other healthcare professionals.Conclusion: The present study reveal that many hospitals take great care in deciding on the administration of contrast media to patients at risk of adverse drug reactions. Our results indicate that the limited opportunities for “outpatient intervention" is an issue in the hospital pharmacy department's participation for proper use of contrast media.

Objective: To prevent the mis-prescription of drugs that differs from the true intention, it is important to understand the factors underlying mis-prescription. In this study, we focused on drug prescription errors caused by drug name similarities and compared drug dispensing errors by pharmacists to clarify their characteristics.Methods: We extracted cases of drug prescription and dispensing errors caused by drug name similarity from "near-miss events from pharmacies" reported from March 2020 to October 2022, which were curated by the Japan Council for Quality Health Care. By comparing the characteristics of pairs of "drugs intended to be prescribed or dispensed" and "drugs that were mis-prescribed or misdispensed" (called as drug name pairs), we analyzed trends in drug prescription errors caused by drug name similarity. Specifically, we evaluated drug name similarity (calculated using m2-Visually Weighted Head and Tail-weighted Fragmentary Pattern-Based Measure; m2-vwhtfrag), the number of initial common characters, and drug efficacy similarity (evaluated by drug efficacy classification number) in drug name pairs and assessed their occurrence among drug prescribing and dispensing error cases.Results: From the "near-miss events from pharmacies," 234 cases of prescription errors and 152 cases of dispensing errors caused by drug name similarity were extracted. Drug prescription errors exhibited higher drug name similarity (i.e., higher values of m2-vwhtfrag) and more initial common characteristics than drug dispensing errors. In contrast, drug prescription errors showed a lower consistency in drug efficacy similarity.Conclusion: In this study, we found that prescription errors by physicians were more likely to be influenced by drug name similarity and less likely to be influenced by drug efficacy similarity compared to the dispensing errors by pharmacists. These findings are reasonable, considering the characteristics of the prescription ordering systems.