Background: This study aimed to clarify the association between the co-existence of possible sarcopenia (PS) and dysphagia in patients with acute stroke and the functional outcomes 12 months after stroke. Methods: This multicenter retrospective cohort study was conducted on patients with stroke admitted to two acute care hospitals in Japan between November 2020 and October 2023. PS was defined based on grip strength (males <28 kg, females <18 kg) and calf circumference (males <34 cm, females <33 cm) on admission. Dysphagia was defined as a Functional Oral Intake Scale score of less than 4. The outcome was defined as a composite of either poor functional outcome (modified Rankin Scale [mRS] score of 3–6) or failure to recover to the premorbid mRS at 12 months after stroke onset. Modified Poisson regression analysis was used to examine the association between the co-existence of PS and dysphagia and poor functional outcomes. Results: This study included 604 patients (median age 76 years; 367 men). Compared with the non-PS and non-dysphagia group, the PS and dysphagia group had a higher proportion of poor functional outcomes. Subsequently, modified Poisson regression analysis was performed. The interaction between PS and dysphagia was significantly associated with poor functional outcomes (risk ratio=4.348, 95% confidence interval 2.683–7.046). Conclusion In patients with acute stroke, the co-existence of PS and dysphagia was associated with poor functional outcomes 12 months after stroke. Future multicenter prospective interventional studies are required to clarify the effectiveness of multifaceted intervention programs in high-risk patients.

Objectives: First steps to promote the proper use of medicines in remote islands and rural areas are as follows: (1) recognition of the profession of “pharmacist” from secondary-remote-island residents who do not have a pharmacy or drugstore or the opportunity for pharmacist contact and (2) an understanding by remote-island residents of the advantages of having a “family pharmacist.”
Methods: Repeated “medicine information and consultation sessions” for secondary-remote-island residents of Japan’s Nagasaki Prefecture were held.  Residents were then surveyed for changes in awareness of or demand for pharmacists and the nature of such changes.
Results: Before the information sessions, 29.7% of residents did not recognize the profession of pharmacy, but the extent of their recognition increased after information sessions were concluded.  They were asked “Who explains medicines in a way that is easy to understand ?”; more than half responded “doctors” before the information session, but after information sessions were concluded, those who said “pharmacists” increased.
Conclusion: Conducting “medicine information and consultation sessions” for residents of secondary-remote islands and rural areas enabled them to understand the profession of pharmacy.  The initiatives in the present study are first steps toward promoting proper use of medicines by residents of remote islands and rural areas who use “family pharmacies/pharmacists.”