1.Exploring Factors Affecting Patients’ Perceptions of the Interpersonal Work of Pharmacy Pharmacists
Chika KIYOZUKA ; Ryota KUMAKI ; Kimihiko SATO ; Naoko SUEISHI ; Minami WATANABE ; Hidehiko SAKURAI ; Keiko KISHIMOTO
Japanese Journal of Social Pharmacy 2024;43(1):22-30
In order for pharmacists to be collaboratively involved with patients in pharmacotherapy, there is a need to improve patients’ understanding of pharmacists’ involvement in extended pharmacotherapy, i.e., their interpersonal work. This study explores the factors that affect patients’ perceptions of pharmacists’ interpersonal work. A survey on patients’ perceptions of pharmacists’ interpersonal work was conducted among 450 patients aged 20 years or older who visited a pharmacy. Logistic regression analysis was performed with low and high patient perceptions of pharmacists’ interpersonal work as the objective variables. Valid responses were obtained from 350 participants. More than half of the respondents did not understand the nature of the interpersonal work of pharmacists. Patients who were unaware of pharmacists checking for side effects were more prevalent than those who were unaware of other interpersonal work. Explanations from the family pharmacist (OR=2.25, P=0.033) and trust in the pharmacist (OR=1.11, P=0.001) had a positive influence on patients’ perceptions of the pharmacist’s interpersonal tasks. As pharmacy pharmacists are increasingly becoming more involved with patients’ drug treatment and to ensure safe drug treatment practices for patients, it is considered important for pharmacists to actively explain their involvement in drug treatment to patients. This will be conducive to building trusting relationships, and for pharmacists to fulfil their function as family pharmacists.
2.Study of Factors Affecting Patients’ Intention to Provide Information to Pharmacists: Publicizing the Contribution of Pharmacists to Pharmacotherapy through Animation Video
Chika KIYOZUKA ; Ryota KUMAKI ; Hidehiko SAKURAI ; Keiko KISHIMOTO
Japanese Journal of Social Pharmacy 2023;42(2):75-88
Objectives: At the pharmacy, information obtained from patients by pharmacists is often inadequate. To motivate patients to provide information, we explored factors influencing their willingness to provide information and evaluated changes in their intention through informing of pharmacists’ contribution to pharmacotherapy. Methods: Four videos regarding pharmacists’ contribution to pharmacotherapy were created. A total of 600 participants who regularly visit pharmacies were targeted. One hundred and fifty participants watched one of the four videos and answered questions about their willingness to provide information to pharmacists before and after watching the videos. Key findings: The positive factors influencing the willingness to provide information were trust in the pharmacist and knowing pharmacists’ contribution to pharmacotherapy. After watching any of the videos, the willingness to provide information increased (P<0.001). In addition, when the participants were divided into two groups based on whether or not they had already known about the video content, the willingness of the participants in both aware and unaware groups to provide information improved (P<0.001). The factors that improved willingness in participants with low willingness were an explanation from their family pharmacist and trust in the pharmacist. On the contrary, having diabetes was a restraining factor. Conclusion: The study revealed that publicizing pharmacists’ contribution to pharmacotherapy increases the patients’ willingness to provide information to the pharmacist, regardless of their original level of awareness of the contribution. Furthermore, patient-pharmacist relationships based on trust in the pharmacist were influential.
3.Empirical Study on Promotion of Appropriate Pharmacotherapy in Patients with Seasonal Allergic Rhinitis
Hidehiko SAKURAI ; Ayamo NAGAI ; Miki YAMASHITA ; Keiko KISHIMOTO ; Reiko MIZUTANI
Japanese Journal of Social Pharmacy 2023;42(2):89-98
The prevalence of seasonal allergic rhinitis (hereinafter “hay fever”) is increasing annually. While self-medication with over-the-counter (OTC) drugs is growing, some hay fever patients also use OTC drugs alongside medical visits. Issues arising from co-administration, such as excessive dosing and reduced quality of life (QOL) due to drowsiness, have been highlighted. However, no research has investigated the factors contributing to the concomitant use of prescribed and OTC drugs. Therefore, this study examined the following three patient groups: those using only prescribed drugs, those using only OTC drugs, and those using a combination of both. Initial analyses compared adherence, overuse extent, QOL (as measured by the Japanese Rhino-conjunctivitis Quality of Life Questionnaire [JRQLQ]), treatment satisfaction, lifestyle habits, and health literacy (as measured by the Communicative and Critical Health Literacy Scale [CCHL]) among the groups. Subsequently, a multinomial logistic regression analysis focusing on combination users identified factors associated with co-administration. The results revealed that combination users exhibited lifestyle issues and lower QOL compared to those using prescribed or OTC drugs only, although differences in CCHL were not significant. Furthermore, co-administration was linked to social life-related JRQLQ and excessive usage during symptom onset. In conclusion, patients with hay fever should avoid the concurrent use of prescribed and OTC drugs. Co-administration may not necessarily improve symptoms and might even lead to overuse risks. Thus, patients should be guided to consult medical professionals before purchasing OTC drugs, and lifestyle improvements should be emphasized as well.
4.An Empirical Study on Factors Affecting Medication Adherence in Outpatients with Depression: From the Perspective of Medication Support for Patients Using Pharmacies
Hidehiko SAKURAI ; Jun KUMAGAI
Japanese Journal of Drug Informatics 2022;24(1):17-29
Objective: This study aimed to elucidate the factors that affect medication adherence in outpatients with depression using multivariate analysis.Methods: A web-based survey on medication adherence, medication attitude (Drug Attitude Inventory-10; DAI-10), medication self-management, and satisfaction with the prescribing physician/pharmacy for outpatients with depression was conducted in January 2018. T-tests and path analysis were performed to evaluate comparisons of responses based on gender, high/low importance of medication guidance, high/low intention to consult, and high/low frequency of consultations.Results: For mean scores, no significant difference was observed between males and females according to a t-test. In terms of the importance of medication guidance, the high importance group had significantly higher prescribing physician/pharmacy satisfaction and better self-management. In terms of intention to consult, respondents with high intention to consult had significantly higher scores on the DAI-10, better self-management, and higher prescribing physician/pharmacy satisfaction. In terms of frequency of consultations, only pharmacy satisfaction was significantly higher in the high-frequency group. Path analysis revealed that, in general, adherence was influenced by medication attitude and self-management, and prescribing physician/pharmacy satisfaction and self-management were influenced by medication attitude. In the intergroup comparison, pharmacy satisfaction did not affect medication adherence in males or the group with low importance of medication guidance. In addition, medication attitude did not affect adherence only in the non-consultation group.Discussion: These results suggest that it is necessary to improve the medication support measures at pharmacies for outpatients with depression. Furthermore, in order for the measures to improve medication attitudes and adherence to be effective, it is necessary for patients to understand the benefits and importance of using pharmacists effectively, including medication support and consultation, and to be actively involved in the maintenance and promotion of patients' health.
5.Trends and Issues in Patient Questions at Community Pharmacies: Validation with Data from Two Pharmacies with Different Patient Populations
Takahiro HEMMI ; Yuzuki SUGAI ; Hiroyuki MIURA ; Hideaki TANI ; Mitsuru OKETANI ; Hidehiko SAKURAI
Japanese Journal of Social Pharmacy 2022;41(1):2-9
In Japan, based on the Ministry of Health, Labour and Welfare’s “Pharmacy Vision for Patients” (2015), there has been a growing need to shift from “drug-centered, physical work” to “patient-centered, interpersonal work.” Medication counseling is one of the most important tasks of pharmacists. In the present study, we focused on the questions asked by patients during medication counseling, and statistically analyzed the content of the questions and the patient attributes obtained from the patient medication profile. The study was conducted from 2018 to 2019 on patients who visited two pharmacies. Data from a total of 3,300 patients was collected, of which 859 asked questions during medication counseling, accounting for about 26% of the total. Attributes that significantly influenced the asking of questions included gender, new prescriptions, and who was being instructed, especially for women and parents of infants. In terms of topic, questions about the duration and timing of taking the medication and about the medication itself were common in all departments. In terms of medication effects, there were many questions about topical and central nervous system medications, but there were also questions about non-medication matters such as tests. When providing medication counseling, it is expected that pharmacists will actively provide instructions to resolve patients’ questions based on the characteristics of each pharmacy and on patient demographics, as well as improve the quality of interpersonal services according to the patient’s background.
6.A Study of Factors That Promote Patients’ Provision of Information to Pharmacists and Evaluation Items for Evaluating Patients’ Willingness to Provide Information
Keiko KISHIMOTO ; Ryota KUMAKI ; Chika KIYOZUKA ; Hidehiko SAKURAI
Japanese Journal of Social Pharmacy 2022;41(1):45-55
The purpose of this study was to identify patient-side factors that facilitate their provision of information to pharmacists (Survey A) and identify questions to assess their willingness to provide information to pharmacies (Survey B). Two web-based surveys were conducted among individuals aged 50-79 years who regularly brought their prescriptions to pharmacies. Survey A was conducted in February 2020 with 540 respondents. Multiple regression analysis was conducted, with “patients’ provision of information to pharmacies” as the objective variable. Survey B was conducted in November 2020 with 126 respondents for each three patterns of questions regarding “patients’ provision of information to pharmacies.” The distribution of responses was compared. More than half of the respondents were willing to provide information to pharmacists on the contents of the initial questionnaire. In contrast, less than half of the respondents were willing to provide information about the physician’s explanation of drug treatment, history of the disease, concerns and consultations about medication, blood tests results, and unusual symptoms. Factors on the patients’ side that promoted the provision of information included having a family pharmacist, a sense of trust in the pharmacist, recognition as a medical professional, and understanding the pharmacist’s work. As an indicator to evaluate the increase in patients’ willingness to provide information, the questionnaire statement “I will actively tell the pharmacist about [ ].” was found to be appropriate. Words such as a physician’s explanation of drug treatment, history of the disease were included in [ ].
7.Study on Evaluation of Efficiencies for Drug information by Video and Paper Media in Community Pharmacies
Susumu SASHIMA ; Yurika ASAI ; Keiko KISHIMOTO ; Hidehiko SAKURAI
Japanese Journal of Drug Informatics 2021;22(4):207-213
Objective: While pharmacies focus on interpersonal work, patients need to process a lot of information. Therefore, it is important for the pharmacy to provide information according to the situation. This study was conducted for the purpose of providing a video and paper media, and clarifying that it is useful to provide information in various mediums about the method of administering the powdered medicine, which requires an understanding of the operation.Method: Conducted a survey for those who brought prescriptions for infants from March 2016 to about a year and a half. We compared and verified the understanding of the medication method for infants between the paper medium group and the moving image medium group.Results: Differences in the background between the two media use groups were clarified, and path analysis confirmed differences in the factors that affect the reliable administration of each medium to infants. It was revealed that the evaluation of moving image media was higher than the comparison between the groups in terms of usability. Although there was no difference in the ability to use the medium at his own pace, the moving images were significantly higher in understanding the motion.Discussion: There is a limit to the understanding of motions with a single explanation at the pharmacy counter. It was confirmed in this study that information provision using a medium that can be used depending on the situation of the patient is useful as a complementary role in medication instruction. Providing information while appropriately combining information provision in various media is thought to reduce the burden on patients and contribute to improved adherence.
8.Survey on the Actual Condition of the Do-shoho Period of Antihypertensive Drugs for the Introduction of the Refill Prescription System in Japan
Takahiro HEMMI ; Masaya ISHISHITA ; Hideaki TANI ; Mitsuru OKETANI ; Hidehiko SAKURAI
Japanese Journal of Social Pharmacy 2021;40(2):105-112
The number of diagnosed hypertensive patients in Japan is estimated to be 9.93 million according to a 2017 patient survey, and the potential number of actual hypertensive patients is estimated to be 43 million. The purpose of the present study was to clarify the actual condition of the Do-shoho (refill of the previous prescription) period for antihypertensive drugs prescribed for a long duration, and to obtain basic data for considering the introduction of a refill system in Japan. Data were collected from the patient medication profile of patients who were prescribed amlodipine OD tablets (Chemiphar®) from July 2012 to December 2019, and the Mann-Whitney U test or Kruskal-Wallis test were performed with the Do-shoho period as the test variable. A generalized linear model was used to analyze the items for which significant differences were obtained. The results of the analysis showed that the factors affecting the duration of the Do-shoho were the prescribing source, diagnosis, and the maximum number of prescription days. Of the patients surveyed (N=321), 199 (62.0%) had a Do-shoho duration of 6 months or longer, which was more than half of the total number of patients. The results suggest that many patients may be eligible for the refill prescription system if pharmacists are able to properly assess the continuation of prescriptions.
9.Perspectives on the Continuous Medication Monitoring Function of Pharmacies in the Community Health Care System: A Nationwide Survey in Japan
Yasunori OSANAI ; Hidehiko SAKURAI
Japanese Journal of Complementary and Alternative Medicine 2020;17(2):111-118
Objective: The objective of this study was to identify the perceived importance of various pharmacy functions among residents in the community health care system.Methods: We conducted an online survey of nationwide panelists enrolled by a research company to assess the perceived degree of importance of having a pharmacy that performs various functions in the community health care system (i.e., “comprehensive importance”).Results: “Comprehensive importance” was compared among 2,400 respondents disaggregated into several groups. The results revealed that “encouragement for medical consultations at medical institutions” had a strong effect on “comprehensive importance”.Conclusion: The results of this survey highlight the need for preventive medical care and a further expansion of the consultation function at pharmacies in the future.
10.Survey on Perceptions of Home Care Physicians and Nurses Regarding Home Medical Care and Expectations to Pharmacists
Hitomi YANAGUIMOTO ; Hidehiko SAKURAI ; Seiichi FURUTA ; Nahoko KUROSAWA
Japanese Journal of Social Pharmacy 2018;37(2):91-101
Objective: We search valuable information in home medical care settings that impede smooth collaboration among pharmacists, home care physicians, and home care nurses. Methods: We conducted an online survey on 120 physicians and 118 nurses on “areas perceived as overloaded with tasks,” “quality of life (QOL) evaluation of patients,” and “expectations to pharmacists.” We analyzed data using the Mann-Whitney U test and conducted the customer satisfaction (CS) analysis on “stress.” Results: Physicians answered that they had a significantly higher stress on “at night-time/holidays and weekends works” than nurses (p < 0.05). Nurses experienced significantly more stress during “inter-professional collaboration” than physicians (p < 0.01). CS analysis revealed that nurses experienced more stress for items such as “having patients with dementia self-inject correctly,” etc. Both physicians and nurses evaluated QOL items at a high frequency. Majority of physicians and nurses held high “expectations to pharmacists,” particularly for the eight items related to providing information, managing drugs, and making pharmacological judgments. Nurses had significantly high expectations to pharmacists for “management of supplements taken by the patient” (p < 0.01), “explaining drug effects” (p < 0.001), and “explaining the necessity of prescription revision” (p < 0.01). Discussion: Pharmacists should utilize information on physicians and nurses’ stress as well as understand their expectations to pharmacists to facilitate stronger coordination between both professions and contribute to patient care. In particular, many items were found to cause stress, indicating that support for nurses, who have many expectations to pharmacists, needs to be enhanced.


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