Objective: It is very important that, to avoid, pharmacists-check medication being taken by patient.  In the Hokkaido University Hospital we used commercial drug identification software at the start of outpatient prescription identification duty and reported the outcome.  Furthermore, we filled in another hand-written check sheet with the drug’s name, whether or not it is used in our hospital, alternative drugs, and the dosage and administration.  Because of the risk of drugs being entered by mistake, we built a database for drug identification and distinguished the outpatient’s prescriptions.  With this system it is possible integrate identification reports and check sheet using one style, automatically.  We also to smoothly rationalize duties by planning correct communication between the medical staff.  At the same time, we analyzed the case that was able to intervene in reasonable use of medical supplies with a past identification report as a result of pharmacists distinguishing outpatient prescriptions.
Design and Methods: This system was constructed using Microsoft® Access, which is a general-purpose database software.  Also, the medical supply database that we used for this system uses “Drugs in Japan Ethical Drugs DB (supervised by Drugs in Japan Forum)” published by JIHO Co., Ltd.
Results: By using this system, we were able to reduce the time required to identify the drugs and make the report.  The result of a questionnaire carried out on doctors and a nurses and medical staff revealed that more than 90% of the respondents claimed, “the report is easy to refer.”  Likewise, we analyzed a report of the previous year and recognized that medical staff could not find the inappropriate use of prescriptions for outpatients in about 17.5%.
Conclusion: This system improved the efficiency of outpatient prescriptions practices, and it became clear that it could be used convincingly as a tool to share appropriate drug information between medical staff and pharmacists, more precisely.  In addition, feedback from medical staff suggested that it might prevent the risk of problems surrounding outpatient prescriptions, from the viewpoint of the pharmacist.

Background: and Purpose To assess the long-term outcomes of intracranial dural arteriovenous fistula (DAVF) treated with stereotactic radiosurgery (SRS) alone or embolization and SRS (Emb-SRS) and to develop a grading system for predicting DAVF obliteration. Methods: This multi-institutional retrospective study included 200 patients with DAVF treated with SRS or Emb-SRS. We investigated the long-term obliteration rate and obliteration-associated factors. We developed a new grading system to estimate the obliteration rate. Additionally, we compared the outcomes of SRS and Emb-SRS by using propensity score matching. Results: The 3- and 4-year obliteration rates were 66.3% and 78.8%, respectively. The post-SRS hemorrhage rate was 2%. In the matched cohort, the SRS and Emb-SRS groups did not differ in the rates of obliteration (P=0.54) or post-SRS hemorrhage (P=0.50). In multivariable analysis, DAVF location and cortical venous reflux (CVR) were independently associated with obliteration. The new grading system assigned 2, 1, and 0 points to DAVFs in the anterior skull base or middle fossa, DAVFs with CVR or DAVFs in the superior sagittal sinus or tentorium, and DAVFs without these factors, respectively. Using the total points, patients were stratified into the highest (0 points), intermediate (1 point), or lowest (≥2 points) obliteration rate groups that exhibited 4-year obliteration rates of 94.4%, 71.3%, and 60.4%, respectively (P<0.01). Conclusions SRS-based therapy achieved DAVF obliteration in more than three-quarters of the patients at 4 years of age. Our grading system can stratify the obliteration rate and may guide physicians in treatment selection.