Medical technologists at our hospital have begun to conduct tests before outpatient appointments for memory loss and dementia. They administer the Mini-Mental State Examination (MMSE) and the Geriatric Depression Scale (GDS-15), take patients' medical history, and perform auxiliary diagnostic tests for cognitive function. Technologists at our hospital assessed 365 patients (mean age 80 years; 172 men and 193 women) in this way between May 2018 and May 2019. We determined a cutoff value for the MMSE and tested the validity of the technologists’ assessments of these patients by comparing them against physicians' clinical diagnosis. Our hospital sees many patients with Alzheimer’s disease, and 85% of patients diagnosed with dementia had an MMSE score of 23 or lower. The MMSE is a highly reliable screening test for dementia, and technologists scored it similarly to physicians. Addition of the GDS-15 showed that outpatients with dementia had underlying anxiety symptoms and depression. It is important that technologists continue their involvement in outpatient care as certified dementia specialists while also continuing to consider which tests they should conduct.

Use of benzodiazepine (BZD) receptor agonists for delirious or elderly patients has occasionally been found as a result of inappropriate instructions for insomnia or restlessness, according to research of the dementia and delirium support team (DDST), which manages instructions on admission and during hospital rounds. We believe that one reason for this is the lack of hospital guidelines for managing insomnia and restlessness. When changing electronic medical record vendors, we took the opportunity to establish proper drug usage instructions. The percentage of available instructions for insomnia and restlessness at the time of admission and the prescribed medications were surveyed and compared before and after the vendor change. The prescription rate for insomnia was 88.6% (1,779/2,007) before and 91.9% (1,902/2,069) after the change, showing a significant increase. The prescription rate of benzodiazepine receptor agonist use was 47.7% (848/1,779) before and 41.6% (792/1,902) after the change, showing a significant decrease. The prescription rate for restlessness was 71.2% (1,429/2,007) before and 85.6% (1,771/2,069) after the change, showing a significant increase. The recommended drug usage instructions affected prescriptions for insomnia and restlessness at admission and prescriptions of BZD receptor agonist usage at admission. Our findings seem to suggest that setting drug usage instructions for insomnia and restlessness when changing the electronic medical record vendor will be useful for promoting proper medication use.