1.Medical Economic Research on Pharmaceutical Inquiries Made by Hospital Pharmacists about Prescriptions for Inpatients
Yoshiaki Shikamura ; Yuki Kikuchi ; Junichi Takahashi ; Kenichi Negishi ; Masayo Komoda ; Masataka Mochizuki ; Hiroshi Terada
Japanese Journal of Drug Informatics 2014;16(2):41-52
Objective: To examine the usefulness of inquiries made by hospital pharmacists.
Methods: This study was conducted a survey about the actual condition of inquiries at 5 hospitals.
Results: The prescriptions subjected to inquiry accounted for 1.5% of the inpatient prescriptions and 0.3% of the injection prescriptions. In cases of “Incomplete entry in the prescription” for the subcategory of “Question about safety,” drug costs without the impact of pharmaceutical inquiries were calculated on the assumption that the concerned drugs should have been generally prescribed. Our results showed that the total savings in medical costs were 30,673 yen for the inpatient prescriptions and 159,212 yen for injection prescriptions, which suggested that pharmaceutical inquiries are effective for saving medical costs for either type of prescriptions. In the case of patients in whom adverse drug reactions (ADRs) might have occurred without prescription changes, medical cost savings realized by preventing ADRs were estimated using the Diagnosis Procedure Combination/Per-Diem Payment System (DPC/PDPS). Our results showed that the savings were 1,428,710 yen for inpatient prescriptions (6 patients), which indicated that a large amount of medical costs was saved.
Conclusions: Our results suggested that similar to pharmaceutical inquiries made by community pharmacists, those made by hospital pharmacists not only result in the proper delivery of drug therapy but also are useful in terms of medical economics.
2.Effective Use of Over-The-Counter (OTC) Drugs during a Disaster:
Yoshiaki Shikamura ; Aika Tanaka ; Kenichi Negishi ; Hideo Shimodaira ; Susumu Wakabayashi ; Toshio Tsukahara ; Kaori Nomura ; Keiji Izushi ; Choichiro Miyazaki ; Mayumi Mochizuki ; Naoki Kamimura
Japanese Journal of Drug Informatics 2017;18(4):242-250
Objective: For effective use of over-the-counter (OTC) drugs that are provided as relief supplies during a disaster, we aimed to develop a list of OTC drugs that can be used during a disaster.
Methods: We obtained information about OTC drugs useful during a disaster by examining results of previous studies and lists of drugs used during a disaster. We analyzed this information with the expert pharmacist of disaster support and established a rationale for our list and developed “the List of Useful OTC Drugs During a Disaster” and “the Information Card on Useful OTC Drugs During a Disaster.”
Results: We developed our list of OTC drugs based on the following parameters: (1) while people with severe disorders (e.g. renal failure) are treated by medical teams, those with minor physical conditions are treated using OTC drugs and (2) those OTC drugs that can be used as substitutes for prescription drugs were preferably selected. The List of Useful OTC Drugs ()—During a Disaster (containing 56 items) was developed for use mainly by medical professionals. Further, pharmacists from disaster-relief medical teams may not always be available in disaster-stricken areas; therefore, the Information Card on Useful OTC Drugs During a Disaster was developed to enable disaster victims to independently make a certain level of decision. The information card contained pictograms to call the attention of the disaster victims.
Conclusion: Our results can provide a common tool for drug suppliers, medical professionals engaging in relief works in disaster-stricken areas, and disaster victims.
3.Development of a Clinical Practice Guideline Utilization System to Support Pharmacist Prescription Proposals:
Itsuko Ohno ; Nobuyo Suzuki ; Shihori Kawahara ; Yoshiaki Shikamura ; Yasunari Mano ; Tsugumichi Sato ; Shuji Shimada ; Keita Akagi ; Yoshi Shigeno ; Mitsue Saito ; Naoko Sugihira ; Masayo Komoda
Japanese Journal of Drug Informatics 2017;19(2):50-58
Objective: Pharmacists need to know at what positioning a drug is recommended in clinical practice guidelines when they make prescription proposals. However, the format of guidelines and the definition of recommendation grades differ between academic societies, making it difficult to comprehensively extract only the information one needs. Therefore, we developed a guideline utilization system to support prescription proposals by pharmacists.
Methods: We built a database comprised of clinical practice guidelines on pharmacological therapy for breast cancer and breast cancer-related conditions. FileMaker®was used in the development of the system.
Result: This system allows the comprehensive extraction of clinical questions and recommendations from multiple guidelines by means of standardized keywords.
Conclusion: This system supports prescription proposals by pharmacists when generating pharmacological therapy protocols or when in discussions with healthcare professionals as information on the positioning of therapeutic agents in different guidelines and recommended drugs is readily available.
4.Validating the Utilization of the Patient Compliance Instruction Support System “FollowNavi” for Follow-up Inhalation Instructions
Shumpei HARIGAI ; Rei TANAKA ; Shu SEKIYA ; Yoshiaki SHIKAMURA
Japanese Journal of Drug Informatics 2021;23(2):72-81
Objective: Following the amendment of the Pharmaceutical and Medical Device Act in December 2019, continuous follow-up of patients during treatment has been mandated for pharmacists. The follow-up methods may involve contacting patients via telephone and social networking services (SNS). The SNS is advantageous over telephone, because patients can respond to the pharmacists at their convenience. Therefore, we developed a patient compliance instruction support system “FollowNavi” using LINE. We prepared a content of inhalation drugs used to treat bronchial asthma for assessment using FollowNavi and conducted questionnaire surveys among patients and pharmacists to validate its utility.Methods: FollowNavi was used from May1 to July 31, 2020, to follow up patients diagnosed with bronchial asthma for whom long-term control medicine (inhalation drugs) was prescribed for the first time or prescriptions were changed from other inhalation drugs. Subsequently, when the patients revisited the pharmacy, we conducted a questionnaire survey regarding the usability of FollowNavi. We also conducted a questionnaire survey among the pharmacists.Results: Seven and five responses were received from patients who were followed up via FollowNavi and pharmacists who used FollowNavi, respectively. Furthermore, 28.6% of the patients responded “I could solve the problem through LINE” and 71.4% responded “I did not have anything in particular that I could not understand.” As for pharmacists, 60.0% responded that they could obtain sufficient information from the patients through FollowNavi.Conclusion: The results suggest that follow-up after providing inhalation instructions using the inhalation drug content of FollowNavi may be useful for both patients and pharmacists.