Objective: The delivery of medicines by the postal service from pharmacies to patients' homes has increased to address medicine supply shortages. However, owing to recent abnormal weather conditions, medicines may be delivered in harsh environments exceeding 40℃. Therefore, this study aimed to measure the temperature at which medicines were mailed in the summer and investigate whether the interview form contained evidence that could guarantee the quality of the medicines mailed under those temperature conditions.Methods: Between August 5 and September 11, 2024, medicines were mailed from 15 postbox locations using a service provided by the Japan Post. The mailing environment was assessed via mean kinetic temperature (MKT) with reference to the United States Pharmacopeia (USP). The medicines in shortage were identified based on information published by the Japan Pharmaceutical Manufacturers Association.Results: Approximately 87.5% of the medicines mailed had an MKT above 25℃ (maximum 28.0℃), which deviates from the USP standard. Some medicines temporarily reached a maximum temperature of 47.5℃. Moreover, the results of the stress tests at temperatures above 40℃ were not listed in the interview form for 78.3% of the medicines that were likely to be mailed due to inventory shortages.Conclusion: To guarantee the medicines quality when mailed in the summer, it is important to consider appropriate measures to protect medicines from excessive heat, even medicines stored at room temperature. Furthermore, it is important to assess the medicine stability by referring to the stress tests (50℃) results listed on the interview forms for the product in question and the original and longlisted drugs. To resolve dissatisfaction between pharmacies and patients due to supply instability, it is necessary to actively publish the results of stress tests on interview forms and make appropriate efforts.

Objective: This study aimed to elucidate how the physical properties of containers and formulations of glaucoma eyedrops contribute to differences in squeezing force and drop volume among products within the same pharmacological class. This study seeks to generate valuable insights for product selection, patient guidance, and formulation improvement.Design: Physical measurements of multiple glaucoma eyedrop products were made under various conditions, followed by comparative analyses of the data and the characteristics of each product's container and solution. The study determined how the product selection and instillation technique affected the squeezing force and drop volume.Methods: Eyedrop products commonly used as first-line treatments were evaluated, including all brand-name drugs and high-usage generic drugs. Based on the clinical guidelines and NDB open data, 17 products were selected, consisting of prostanoid receptor-related drugs and beta blockers. Each product was tested at various angles to measure squeezing force and drop volume. These measurements were combined with basic container characteristics, including the material, design, and size, to compare and identify trends. Multivariate regression analysis was conducted to examine the factors affecting squeezing force.Results: The squeezing force varied significantly among the products (0. 68-1. 57 times the average), whereas the drop volume exhibited relatively minor differences (0.79-1.12 times the average). Some products showed marked variability in squeezing force and drop volume between drops, depending on residual volume and container angle. Additionally, containers with smaller finger-contact areas, made of materials other than polyethylene, non-cylindrical designs, and formulations with higher viscosity were estimated to require greater squeezing force.Conclusion: Squeezing force and drop volume vary significantly by product and instillation technique, which highlights the importance of understanding these differences when prescribing and guiding patients. Further systematic studies on other eyedrop products should be carried out to enhance appropriate drug use and inform the development of user-friendly formulations.

Objective: This study evaluated the practical utility of Microsoft Copilot PRO®, a GPT-4-based generative AI tool, in addressing diverse medication inquiries at a hospital's drug information center.Design: We conducted an observational study in which three experienced drug information pharmacists independently evaluated the AI-generated responses and rated their overall utility using a three-point scale.Methods: A total of 330 inquiries drawn from 11 predefined categories (e.g., dose conversion, pharmacokinetics, and administration during pregnancy) were selected from five years of archived queries. Each question was entered verbatim into Copilot's "GPT-4 Strict" mode to generate one response per query. The raters classified the answers as "useful," "not useful," or "uncertain".Results: A total of 44.9% of the 330 answers were deemed "useful." Among the 11 categories, the highest proportion of "useful" responses was observed for pregnancy-related inquiries (58. 9%), while the lowest occurred for questions on admixture stability (15.6%).Conclusion: Although Microsoft Copilot PRO® achieved a 44.9% "useful" rating overall, its performance varied across inquiry categories, with particularly low usefulness for admixture-related questions. Despite presenting reference links that allow pharmacists to scrutinize supporting evidence, concerns remain regarding the limited agreement among evaluators, especially for "uncertain" cases. Further refinement of AI tools and increased availability of high-quality online drug information may enhance the reliability of the copilot. Future studies should examine the reproducibility, explore optimal prompt designs, and involve larger multicenter samples. Although Copilot shows promise, it cannot replace critical human judgment in drug information services, underscoring the need for ongoing evaluation.

Objective: We investigated the health-related quality of life (HRQoL) of patients with chronic diseases in community pharmacies in Japan and examined its relationship to patient attributes, an area that has not been previously studied.Method: We surveyed 1,500 participants with chronic diseases and 1,500 from the general population without chronic diseases (Free-GP) using the EuroQol (5-dimension, 5-level) questionnaire. Patient attributes included the number of drugs used, duration of medication, number of chronic conditions, perceived disease severity, and perceived treatment importance. Logistic regression analyses assessed how these attributes influenced the likelihood of reporting “full health” (no problems on all HRQoL questions) among patients with chronic disease. An exploratory decision tree analysis was performed to identify patient attributes that might decrease HRQoL.Result: The HRQoL score of patients (0.856) was lower than that of Free-GP (0.942). The HRQoL of patients tended to increase with aging. Among patients, the mean HRQoL score was 0.781 for polypharmacy, which decreased with the addition of disease severity perception (even lower for those in their 20s-40). Even in the absence of polypharmacy, the average HRQoL score decreased when patients were in their 20s with multimorbidity. The HRQoL scores of non-polypharmacy patients in their 30s or older were higher than the mean scores of patients with chronic disease.Conclusion: To provide extensive care for patients with reduced HRQoL in community pharmacies, it is necessary to focus on polypharmacy. Reduced HRQoL should be considered in younger patients with multimorbidity, even in the absence of polypharmacy.

With the expanding responsibilities of pharmacists, the time required to create medical records has become a significant burden, highlighting the need for efficiency improvements. Among text input methods, speech recognition offers a faster alternative to keyboard input and is expected to reduce workload. This study evaluated the utility of a speech recognition tool in generating medication management instruction records. First, ward pharmacists rated subjective changes in their workload before and after using the tool on an 11-point scale (ranging from −5 for deterioration to ＋5 for improvement). The median score was 0 (range: −4 to ＋2), indicating no perceived improvement. Next, two sample texts (349 and 605 characters) were transcribed using both the speech recognition tool and keyboard input, with input times measured. Speech recognition required 186±15 and 395±24 for the first and second texts, respectively, compared to 252±19 and 511±26 s for keyboard input, demonstrating a significant reduction in time. Although no subjective decrease in workload was observed, these findings suggest that speech recognition tools may enhance efficiency in record creation. Further research in this area is warranted, encouraging audience engagement in the ongoing scientific process and fostering a sense of shared responsibility.

Objective: The side effects of drug therapy are not only directly attributable to the drugs taken but may also be caused by psychological phenomena. One such phenomenon is the nocebo effect, wherein adverse effects are triggered by the patient’s recognition of symptoms. The patient’s development of side effects may be influenced by the pharmacist’s explanation of side effects, but it is not known how many pharmacists are actually aware of the nocebo effect. Therefore, this survey aimed to clarify pharmacists’ awareness of the nocebo effect and the extent to which they utilize their knowledge of this phenomenon when providing medication guidance, and to determine whether their awareness influences explaining of the side effects at medication guidance.Methods: A questionnaire survey was conducted using Google Forms. After defining the nocebo effect, the respondents were asked what points they note when explaining side effects, whether they were aware of the nocebo effect, and in what types of patients they tend to be aware of it. Simple tabulations were performed for each item, and subgroup analyses were performed according to the level of awareness of the nocebo effect.Results: Of the 100 participants, 65did not know the term “nocebo effect”. However 82 provided medication guidance considering the nocebo effect phenomenon, and many pharmacists who were familiar with the nocebo effect responded that it should be taken into consideration when providing drug guidance. Side effects of particular concern related to the nocebo effect are subjective symptoms such as nausea and vomiting, anxiety and depression, and drowsiness and somnolence; patients with neurotic tendencies or high anxiety also require special attention.Conclusion: Although the term “nocebo effect” is not well known by pharmacists, the phenomenon itself is widely recognized. Many pharmacists reported that understanding the nocebo effect when explaining the side effects, therefore medications leads to improved therapeutic efficacy.

Objective: With the Internet serving as a major source of medical information, the abundance of pharmaceutical content across media and digital platforms raises concerns about the impact of inappropriate or misleading information on public health. This study aimed to develop a comprehensive, practical evaluation indicator to assess the reliability and quality of pharmaceutical websites, targeting general consumers in Japan.Methods: We systematically reviewed existing domestic and international criteria for health information quality to develop evaluation indicators. Based on this review, a preliminary set of indicators was drafted and refined using a modified Delphi process involving six experts in pharmaceutical and medical communications. This process incorporated established frameworks, including the Health on the Net (HON) Code, JAMA Benchmarks, and the Japanese eHealth Ethics Code. A validated set of indicators was finalized after four iterative rounds of review and feedback.Results: The final tool comprises 16 evaluation items across three categories: (1) Screening Criteria (4 items), which eliminate websites with misleading content, public indecency, or political/religious affiliations; (2) Website Evaluation Criteria (5 items), assessing operational transparency, contact availability, advertisement distinction, and policy disclosure; and (3) Content Evaluation Criteria (7 items), addressing clarity, accuracy, update frequency, source citation, legal compliance, and balanced risk-benefit information. Each item was rated using a primarily binary (yes/no) scale with intermediate options, such as “partially applicable” or “not applicable.” The tool reflects expert consensus and complies with Japan’s ethical and regulatory standards.Conclusion: This tool facilitates the appropriate dissemination of pharmaceutical information and supports users in identifying trustworthy sources. By explicitly incorporating legal compliance and editorial transparency as evaluation criteria, it encourages higher standards among healthcare professionals and information providers, potentially improving the quality of pharmaceutical communication.

Objective: The package inserts of over-the-counter (OTC) drugs may contain yojokun (precepts for health care) that are helpful for preventing illnesses and improving symptoms. However, it is unclear whether yojokun actually catch the attention of users and serve as a useful information resource for self-medication. With the aim of contributing to the promotion of self-medication, this study investigated the status of yojokun inclusion in package inserts and the level of awareness among users, and considered the future utilization of yojokun. Methods: The package inserts of OTC drugs listed on the website of the Pharmaceuticals and Medical Devices Agency were searched by pharmacological classification, and the inclusion of yojokun was checked. Additionally, questionnaire surveys of OTC drug purchasers, pharmacists/registered sellers, and OTC drug sales companies were conducted.Results: Of the 7,508 OTC drugs surveyed, 654 (8.7%) had yojokun listed in the package insert. The contents included a concise, bulleted list of tips for daily living to prevent symptoms from worsening and to heal quickly, with illustrations and other information. The awareness rate of yojokun was 22.0% among OTC drug purchasers and 38.8% among pharmacists/registered sellers, and 91.4% of pharmacists/registered sellers answered that yojokun are useful for self-medication. Regarding sales companies, 61.5% stated that they would like to include yojokun in package inserts, but they lacked the ability to prepare evidence-based yojokun and secure space for them in the package inserts. Conclusion: For OTC drug users, yojokun provide useful information to promote appropriate self-medication. However, the awareness of OTC drug users and pharmacists/registered sellers is low, and the information is not fully utilized. In the future, it will be necessary to further disseminate yojokun and establish a system for providing standardized yojokun.

Aims: The search for signals of drug-induced adverse events using spontaneous reporting databases are used in clinical practice and pharmacovigilance research. However, it is difficult for pharmacists unfamiliar with programming to analyze large databases. Therefore, we developed an analysis method that does not require user programming.Methods: An analysis flow was created using KNIME, which allows for intuitive operation of the R language. In addition, the time required to calculate the signal scores was compared for the three personal computers (PCs) with different specifications.Results: The KNIME workflow for this analysis was created using as little R programming as possible and, in principle, only the functions contained within KNIME. Therefore, the KNIME workflow is redundant. However, the analysis results can be obtained instantly on PCs of any specifications. Furthermore, unlike previously reported applications for calculating safety signal scores from spontaneous reporting databases, the signal scores can be calculated using Bayesian statistical methods. Signal scores can be calculated for the Information Component, a measure for single drugs, and for the Ω shrinkage measure, a measure for drug-drug interactions.Conclusion: KNIME can be implemented at a low cost and can be used by users who are unaware of R language programming to calculate signal scores. Furthermore, hawse have demonstrated sufficient scalability of KNME to allow for a more advanced analysis compared with previously reported applications.

Objective: The learning system "KimBen pharma" was introduced into pharmacy education at Okayama University to improve the quality of pharmacy education in accordance with the revision of the Model Core Curriculum for Pharmacy Education.Methods: In this study, we conducted a questionnaire survey of third- to fifth-year pharmacy students as of 2023 to investigate their satisfaction with the learning system and survey on students' awareness following its introduction.Results: Overall, 79% of the students accorded a score of 4 or higher for the item "satisfaction with using KimBen pharma." In addition, 95.2 and 91.9% of the students scored 4 or higher in the "I could feel the clinical pharmacist's point of view" and "I could imagine that what I learned at the university would be useful in the clinical setting" sections, respectively.Conclusion: Pharmacy education using KimBen pharma is highly satisfactory for students, and the system is considered a desirable educational tool across all grade levels from third to fifth year. Additionally, "KimBen pharma" helps students understand the perspective of pharmacists in clinical settings and assists them in concretely visualizing how the content learned at university can be applied in real-world clinical practice.