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: Continuous medication management is demanded from community pharmacists, including mandatory follow-ups (FUs) during the medication period. To improve their efficiency and quality, a software application (app) is being introduced. We investigated the use of the app for FUs by comparing it to the use of phone calls.Design: This was a retrospective studythat collected FU records from participating pharmacies.Methods: FU records of an automated question-and-answer post-dispensing app and phone calls made at 10 pharmacies in June-July 2021 were collected. Differences in the work time and contents of each FU tool were evaluated.Results: Of the 138 eligible cases, 69 (50.0%) used the app and 62 (44.93%) used phones. There was 1 case of FU interruption using the app and 12 for those using phone calls. Preparation time to initiate FU was shorter using the app than phone calls (0.28 ± 0.96 min vs. 5.06 ± 5.44 min). Moreover, there were more cases of pharmaceutical problems identified using the app than phone calls (69.57% vs. 35.48%).Conclusion: The FU app maybe a more efficient tool for identifying problems than phone calls. Further studies are needed to optimize the tool according to patient characteristics.

Objective: To clarify challenges and strategies to execute pharmaceutical care by community pharmacists and obtain pragmatic implications for further improvement. Design: Cross-sectional study.. Methods: We conducted a nationwide internet-based questionnaire survey about pharmaceutical care by the Japanese community pharmacists in June and July 2016. Using text data of 161 respondents, we investigated their challenges and strategies in implementing pharmaceutical care. The text data were reviewed and determined for categorization through stepwise process and reconciliation between reviewers. Results: Fourteen categories were retrieved and integrated into 4 domains (pharmacists, patients, other medical professionals, and environment) from 2 dimensions (challenges and strategies). In the challenge dimension (total n＝142), communication capability (n＝26), participation in medical team (n＝17), patients’ understanding of pharmacists’ work (n＝14), lack of timeand staff (n＝14),patient- and people-centered viewpoint (n＝13). Whilein thestrategy dimension (total n＝72), communication capability (n＝21),lack of patients’ medical information (n＝18), patient- and people-centered viewpoint (n＝11), lack of timeand staff (n＝9), and self development (n＝5). As strategies for the communication capability, attitude of acceptance and collaboration, brief explanation,utilization of visual aids, adoption of objective evaluation, various acquisition of patients’ information, active listening, and sharing patients’ information were retrieved as subcategories. The highest level of attention to communication capability implies that community pharmacists certainly recognize their expected responsibility described in the government document titled “Vision for patient-centered pharmacies”. Conclusion: Community pharmacists face many challenges but have some practical strategies. Although part of such challenges is not for pharmacists themselves but for patients, other medical professionals, or entire health system, improving essential skills of pharmacists may havepositiveinfluenceto theother challenges.