PREAVOID is pharmaceutical intervention that is utilized to illustrate pharmacists’ contributions to medical care.  Currently, there is a great need for pharmacists to provide good medical services to inpatients; as a result, many pharmacists conduct pharmaceutical management in hospital wards.  However, pharmacists who have limited experience in working in the ward do not know exactly what they should check with respect to pharmaceutical management.  To resolve this problem, we determined 16 pharmaceutical-management items based on PREAVOID that was conducted at Nagara Medical Center.  Moreover, we conducted a pre-questionnaire survey assessing whether pharmacists who had worked in the ward for fewer than 4 years attended to these 16 check items in their daily work prior to our introducing the list to them.  The results indicated that pharmacists who had fewer than 2 years of experience working in wards attended to the 16 check items less than those who had more than 2 years of experience, and approximately half of the pharmacists had not received adequate guidance before beginning work at the ward.  In addition, most pharmacists indicated that clear check points were useful for conducting pharmaceutical management and the 16 check items were useful for their daily work.  These results indicate that the 16 check items are a useful educational tool for enabling pharmacists to conduct high quality pharmaceutical management from the initial stage and that using the 16 check items is superior to pharmacists only gaining this ability via prolonged experience working in the ward.

Introduction: We perform our trials in Tsurumi ward, Yokohama city aiming at reducing the number of “cancer refugees” to zero. State: There are many patients who receive cancer therapy outside their hometown. Once their treatment is finished due to progressive disease or deteriorating condition, they are told to leave the hospital and to get palliative care in their district. And they become so-called “cancer refugees”. The beds of palliative care units are limited so the ability to accept patients in case of emergencies is poor. In Tsurumi ward, here are a lot of home care clinics providing palliative care but the place patients want to be or receive palliative care when their condition deteriorates isn't fixed. We organized the “Tsurumi Homecare Network” as the core of medical cooperation, and have worked on improving palliative care and increasing patients who die at home. Specifically, our hospital has played a central role as a special place for palliative care, we send out our original questionnaire to home care clinics to find out how they perform palliative care and introduce patients to the appropriate clinic. Patients who are in need of hospitalization are assured acceptance. On the other hand, we propose the cancer treatment hospitals to follow their patients together with us from their early stage of cancer treatment. Problem: To maintain a good relationship for regional palliative care, improving the management for outpatients, strict and timely backup system, advanced quality of homecare-supporting staff for palliative care and cooperation between home care clinic doctors are necessary.

Objective: Distigmine can cause cholinergic crisis as the side effect.  In 2010, the safety information of distigmine was announced and its dosage was changed up to 5 mg per day.  However, the malpractice that a pharmacist dispensed over dose of distigmine caused severe health damages in a community pharmacy.  Therefore, we made the protocol with the urologists for the appropriate use of distigmine, including contents of monitoring the side effects.  The purpose of this study was to measure using the protocol was useful for the propulsion of proper use of distigmine.
Methods: The protocol was introduced in 10 community pharmacies and 1 hospital pharmacy from December 2013 to April 2014, and the patients and pharmacists were filled out the answer to the questions that we have made.  The protocol consisted of five main checks; the dosage, lower urinary tract symptom, presence of renal disease, combined drugs, and signs of the side effects.  Each patient was filled out the checklist given by the pharmacist to monitor the signs of the side effects for 2 weeks.
Results: The 3 prescriptions of distigmine (18.8%) were more than 10 mg per day.  Although 2 patients were confirmed diarrhea and sweating etc., they were mild.  The pharmacists significantly more (p<0.05) answered that the protocol made their motivation to do the pharmaceutical interventions.  All of the patients answered that the pharmaceutical interventions made them relieved.
Conclusion: The use of protocol that we made supported pharmacists to do the pharmaceutical interventions and patients welcome them.

Introduction: During their clinical clerkship (CC), Japanese medical students’ literature searching skills were ambiguous. We conducted a questionnaire survey on students’ search processes to determine whether this skill improved after a lecture on conducting searches.　Method: This study was conducted from May to December 2019. The questionnaire survey was followed by a 90-minute lecture combining information and relevant activities. The questionnaire included students’ self-evaluation of their literature searching abilities, and references from their medical summaries and reports were compared to those of students from a 2018 group who did not attend the lecture.　Results: Sixty-seven students participated in the questionnaire survey and lecture. Questionnaire results demonstrated that the most frequently used search tool was PubMed. Regularly used types of literature were Japanese textbooks medical guidelines issued by the Japanese Medical Society, and English-language medical journal articles. The two major difficulties in conducting searches were the inability to critically appraise the literature and inadequate English reading skills.　The students’ satisfaction level regarding the lecture was found to be acceptable. After attending the lecture, students’ self-evaluation of their literature searching abilities improved significantly. Furthermore, compared to the 2018 group, references in students’ summaries and reports increased. Additionally, the number of English-language medical journal articles cited in reports was higher among students in the 2019 group than the 2018 group.　Conclusions: Although CC students can conduct literature searches, they struggle with critical appraisal and English-language comprehension. Interventions such as lectures may effectively improve their searching skills during CC.