Objective: Finger-tip unit (FTU) has been used in Western countries to apply a specific amount of steroid ointment available in tube form.  Although prescription ointments for treating skin disorders are available in Japan, there are no indications for patients regarding the amount to be used.  Therefore, we investigated the factual assessment of patient compliance instructions on using the ointments given by pharmacists and conducted a comparative test on the amount of ointment in 1 FTU using commercially available ointment tube products.
Methods: We conducted a questionnaire survey for 21 hospital pharmacists on patient compliance instructions for ointments.  Using six types of ointments, we measured the aperture area of ointment tube, weight of 1 FTU and squeezing number of tube.
Results: Fewer than 50% of pharmacists explained the application methods and amounts for one-time use when they provided patient compliance instructions.  There were many patients who used an ointment inadequately.  The most were problems about the quantity of application.  Wide variations were found among the amount of ointment in 1 FTU weight and number of available uses.
Conclusion: The survey results demonstrated that the methods used to apply the ointments are items that must also be emphasized by pharmacists when providing patients compliance instructions.  Furthermore, the patient compliance instructions should include the amount of ointment in 1 FTU and number of available uses within pharmaceutical products.

Objective: We conducted a meta-analysis on the suppressive effect of resistant maltodextrin on post-prandial blood glucose elevation, which is approved in Japan as food for specified health use, and the following is allowed to be indicated on the label “it is suitable for consumption by those who are concerned about their post-prandial blood glucose levels because the absorption of sugars is abated by the action of dietary fiber (resistant maltodextrin).”
Method: Our literature search covered Ichushi-Web (Japan Medical Abstracts Society), Japan Science and Technology Information Aggregator, Electronic (J-stage), Google Scholar, and PubMed databases and extracted English and Japanese publications on randomized, double-blind, controlled studies comparing resistant maltodextrin and a control in Japanese subjects for the reduction of areas under the blood glucose response curves at 30, 60, and 120 min after eating as an efficacy index.
Result: Among these publications, four articles with a Jadad score (an assessment of the quality of randomized controlled studies) of ≥ 3 were included in the meta-analysis.  Significant inhibitory effects were confirmed from areas under the blood glucose response curves at 30, 60, and 120 min after eating in the meta-analysis that was performed to evaluate the effects of resistant maltodextrin on post-prandial blood glucose elevation in Japanese individuals.
Conclusion: However, we were not able to test for publication bias because the number of extracted publications was small, and thus, additional research and case studies are warranted.

To assess the changes in attitudes toward smoking after the smoking-prevention classes presented by Kumamoto Tobacco-Free Forum, this study administered a questionnaire survey to first-year junior high school students before and after a smoking-prevention class at a junior high school. The questionnaire that was used to pre and post comparison comprised thirteen items, ten from the Kano Test for Social Nicotine Dependence (KTSND-Youth) and three as follows: “I think I will be a smoker in the future,” “I think I will smoke about once,” and “What do you think of people around you who smoke tobacco?” The results of this pre- and post-class questionnaire indicate that attitudes toward seven items improved in a statistically significant way. These included four from KTSND-Youth: “Smokers cannot stop even if they want to,” “Smoking is adult-like and cool,” “Smoking is enjoys taste and a fragrance,” and “If it’s a place with an ashtray, it’s okay to smoke.” The smoking-prevention classes significantly decreased total KTSND-Youth scores. Furthermore, the analysis has clarified that the KTSND-Youth items: “Smoking is adult-like and cool” and “Doctor and school teachers say, ‘Tobacco is no good too much”, as well as the item “What do you think of people around you who smoke tobacco?” are significantly influencing factors for the item “I will be a smoker in the future.” These results indicate that the smoking-prevention classes presented by Kumamoto Tobacco-Free Forum were effective for decline in social nicotine dependence of the first-year students in junior high school.

We implemented a questionnaire survey targeting mothers who are in child care and had participated in consultations regarding drugs and diseases. We examined the future roles of community pharmacists by exploring the mothers’ concerns and, anxieties about child cares and their backgrounds, and their expectations for profession of community pharmacist. Mothers have listed anxiety and concerns of child care about “dermatitis such as rash and atopic eczema”; “food allergies”; “infectious diseases such as measles, chicken pox, and mumps”; and “side effects of vaccination”. In addition, most of them indicated their own concerns and anxiety about “solutions to children’s illnesses.” Despite their anxieties and concerns, however, approximately 60% of the mothers have never consulted with community pharmacists. Among them, approximately a half of them indicated the following three reasons why they have never consulted with pharmacists: “I have nothing to talk about,”, “I do not know what I should talk about,”, and “I was not sure if it was alright to talk about my concerns.”. From these results, we concluded that community pharmacists in the future should improve their communication skills and inform their availability to consult about medicine and disease to local residents.

Objective: Difficulty in extracting tablets from a press through pack (PTP) is believed to reduce prescription drug compliance.　This is a particularly serious issue for the elderly or for those who have physical disabilities affecting the fingers.　In this study, the squeezing force necessary to extract tablets from PTPs was measured for 33 commercial tablet products using a force gauge (FG).　Additionally, a sensory test was conducted to determine the degree of difficulty in extracting tablets from PTPs by squeezing, and the correlation between the difficulty measure and squeezing force was evaluated.Methods: The squeezing force for 33 products was measured by FG.　The sensory test was conducted with 64 subjects.　Four products, each with a different squeezing force, were used for the sensory test.　In the test, each subject ranked the products in order according to the amount of force required to extract the tablets.　Each product's total score was used in the statistical analysis.Results: The average squeezing force of the 33 products was 33.1 ± 6.9 〔N〕, and significant differences were observed among the products.　The sensory test revealed that each subject could significantly distinguish the amount of force required to extract the tablets from each product.Conclusion: A positive correlation was observed between the squeezing force obtained using FG and the results from the sensory test.　This suggests that squeezing force can be used as an indicator for the usability of the product.　Therefore, the degree of difficulty in extracting tablets from PTPs should be considered when selecting drugs for the elderly.

Objective: Eye drops may contain certain preservatives, and there is concern in patients who use them on a daily basis for the treatment of diseases, including corneal epithelial disorder and glaucoma. PF eye drops (Rohto Nitten Co., Ltd.) are used widely; however, their usability may be difficult in patients prescribed these medications for the first time. Therefore, fact-finding was performed on the usability of PF eye drops, particularly the difficulty in squeezing out these eye drops. Methods: The squeezing forces for various eye drops in 11 different shapes were determined. A sensuality evaluation examination on “the easiness of pushing out the eye drops” was performed in addition to a questionnaire survey targeting patients who used eye drops at a community pharmacy. Results: The squeezing forces ranged from 2.0 to 17.1 N. This study showed that the squeezing force tended to increase as the drop got closer to the opening of the container. Significant differences in the sensuality examination scores were found: 3.09 points for Santen Pharmaceutical Co., Ltd.; 3.07 points for Senju Pharmaceutical Co., Ltd.; 2.47 points for Sawai Pharmaceutical Co., Ltd.; and 1.37 points for PF eye drops for any place other than Santen and Senju (p<0.001). Conclusion: When eye drops were prescribed for an elderly individual, the pharmacist considered it necessary to suggest an alternative agent to the doctor depending on body function. In addition, it is important to explain to the patient that an additional squeezing force is required to push out the drop as it gets closer to the opening of the container.