Empirical Study on Promotion of Appropriate Pharmacotherapy in Patients with Seasonal Allergic Rhinitis / 社会薬学

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.

Study of Factors Affecting Patients’ Intention to Provide Information to Pharmacists: Publicizing the Contribution of Pharmacists to Pharmacotherapy through Animation Video / 社会薬学

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.

A Study of Factors That Promote Patients’ Provision of Information to Pharmacists and Evaluation Items for Evaluating Patients’ Willingness to Provide Information / 社会薬学

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 [　].

Trends and Issues in Patient Questions at Community Pharmacies: Validation with Data from Two Pharmacies with Different Patient Populations / 社会薬学

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.

An Empirical Study on Factors Affecting Medication Adherence in Outpatients with Depression: From the Perspective of Medication Support for Patients Using Pharmacies / 医薬品情報学

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.

Study on Evaluation of Efficiencies for Drug information by Video and Paper Media in Community Pharmacies / 医薬品情報学

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.

Survey on the Actual Condition of the Do-shoho Period of Antihypertensive Drugs for the Introduction of the Refill Prescription System in Japan / 社会薬学

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.

Perspectives on the Continuous Medication Monitoring Function of Pharmacies in the Community Health Care System: A Nationwide Survey in Japan / 日本補完代替医療学会誌

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.

Survey on Perceptions of Home Care Physicians and Nurses Regarding Home Medical Care and Expectations to Pharmacists / 社会薬学

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.

Evaluation by Students’ Self-assessment of a Curriculum for Fifth-year Pharmacy Students to Integrate Basic Science and Clinical Knowledge / 社会薬学

The core curriculum of the pharmacy education model was revised in 2013 based on the “Basic competencies required of a pharmacist” that should be developed by graduation. Specific behavioral objectives to acquire include competency in “The ability to implement pharmacotherapeutic management”, which involves gaining the ability to understand patient information, prescription design and proposal, as well as pharmacotherapeutic assessment. In order to improve this ability, it is necessary for students to acquire basic knowledge about pathology, pharmacology, and pharmacotherapy and to integrate and apply this knowledge to patients in practice. We introduced an integrated program called “Integrated Clinical Pharmacy” for fifth-year students at Hokkaido Pharmaceutical University. In this program, students take an objective test on the basic knowledge of pathology, pharmacology, and pharmacotherapy and learn how to design pharmaceutical care plans using individual patient cases. A self-evaluation questionnaire survey about the ability to develop care plan was conducted on students who completed the program. Based on the objective test and self-evaluation questionnaire results, we studied whether basic knowledge was fully established and whether the ability to utilize this knowledge was acquired through this program. We found that although the ability to select an individual component of care plan did improve, this ability wasn’t correlated with the degree of basic knowledge, and performance in summarizing care plan did not improve. These results suggested that it is necessary to understand the connection between components of the care plan and strategies to focus on improving the ability to integrate basic knowledge.

Evaluation by Students’ Self-assessment of a Curriculum for Fifth-year Pharmacy Students to Integrate Basic Science and Clinical Knowledge / 社会薬学

The core curriculum of the pharmacy education model was revised in 2013 based on the “Basic competencies required of a pharmacist” that should be developed by graduation. Specific behavioral objectives to acquire include competency in “The ability to implement pharmacotherapeutic management”, which involves gaining the ability to understand patient information, prescription design and proposal, as well as pharmacotherapeutic assessment. In order to improve this ability, it is necessary for students to acquire basic knowledge about pathology, pharmacology, and pharmacotherapy and to integrate and apply this knowledge to patients in practice. We introduced an integrated program called “Integrated Clinical Pharmacy” for fifth-year students at Hokkaido Pharmaceutical University. In this program, students take an objective test on the basic knowledge of pathology, pharmacology, and pharmacotherapy and learn how to design pharmaceutical care plans using individual patient cases. A self-evaluation questionnaire survey about the ability to develop care plan was conducted on students who completed the program. Based on the objective test and self-evaluation questionnaire results, we studied whether basic knowledge was fully established and whether the ability to utilize this knowledge was acquired through this program. We found that although the ability to select an individual component of care plan did improve, this ability wasn’t correlated with the degree of basic knowledge, and performance in summarizing care plan did not improve. These results suggested that it is necessary to understand the connection between components of the care plan and strategies to focus on improving the ability to integrate basic knowledge.

Survey on Perceptions of Home Care Physicians and Nurses Regarding Home Medical Care and Expectations to Pharmacists / 社会薬学

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.

Investigation of the Potential Needs and Peace of Mind of Patients in Relation to Out-of-Hours Pharmacy Services / 社会薬学

This study aimed to investigate pharmacy service needs of patients and peace of mind of patients in relation to out-of-hours pharmacy services. For patients who came to the health insurance pharmacy, we conducted a survey on the patients’ attitudes toward composition and consultation needs and peace on mind in relation to out-of-hours pharmacy services to investigate the potential characteristic of the needs regarding pharmacy services. We also found that a factor that influenced their peace of mind with regard to services offered by pharmacies was out-of-hours dispensation services. We analyzed patient attributes and local and composition and consultation needs using chi-square test. As a result, significant difference was observed in a ratio of distribution of the composition needs in six items including “sex” and “age.” Similarly, significant difference was observed in four items including “sex.” In addition, in a patient with multiple factors that needs becomes higher, it was shown that composition and consultation had a big influence of “the living together with a child.” The patient attribute that composition and consultation became high in the needs together was “a woman”, “under 60 years old”, “the living together with a child” and “local region”. For analysis by Generalized Linear Model, the two factors of “consultation during holiday,” “nighttime dispensation” were extracted. Furthermore, in a crowd “a woman” and “local region”, “consultation during holiday” was extracted, and a difference was seen in influence in a case for the whole. In this study, it became clear that pharmacy service to give the peace of mind to a patient was a holiday and night composition. From the result, in the community medicine system, it was suggested that the improvement of these service offers was important.

The Public’s Evaluative Opinions on the Approval or Disapproval of Separation of Dispensing and Prescribing Functions ─A Mixed Method / 社会薬学

The purpose of this research was to clarify the factors influencing the approval or disapproval and evaluative opinions of the public concerning separation of dispensing and prescribing functions. We conducted a Web survey with 2006 participants (September 2016). We conducted multiple logistic regression analysis and quantitative analysis of freely recorded their reasons about approval or disapproval. The approval rating was 29.2％ in persons who had had some prior experience with at the pharmacies (n＝1,778) and 41.9% in participants who made regular clinic visits and always filled prescriptions at the pharmacy (n＝430). Multiple logistic regression analysis of the data of participants who visited pharmacies (n＝1,778), identified that compared to participants who experienced side effects (OR＝1.34), the frequency of used pharmacies (OR：Odds ratio＝1.47), the filling burdened by having to fill prescriptions at the pharmacy (OR＝0.19, 1/OR＝5.18), there was a significant positive association for the approval. Analysis of qualitative data of the group that approved identified many labels related to ‘quality of results’, however no labels related to ‘quality of results’ were generated in the group which disapproved. Public approval or disapproval of non-hospital based prescription is mainly determined based on the burden or inconvenience incurred (due to waiting times, mobility-incurred time and energy, inconvenience associated with travel, inconvenience of repeated visits) when filling prescriptions at the pharmacy rather than on opinions regarding the pharmacy’s drug therapy service. Measures are required to increase the level of merit compared to the burden experienced in the use of pharmacy.

Empirical Study on Influencing Factors for Evaluation of Medical Service and Intention to Revisit of Patient Perspective in Community Pharmacies / 医薬品情報学

<b>Objective: </b>As a “family pharmacy and pharmacist,” high-quality medical service is demanded.  Many patient satisfaction investigations are performed to evaluate community pharmacies, but it has been impossible until now to do so using an improvement index of the medical quality.  Therefore, I investigated the influence and evaluation structure of two evaluation concepts regarding quality of medical service and patient satisfaction and intention to use again, which becomes the important key as a “family” pharmacy.<br><b>Methods: </b>I used anonymous patient survey data gathered for the purpose of duties improvement in July 2009.  I subjected the responses to factor and covariance structure analyses.<br><b>Results: </b>Dates for four dimensions were obtained for factor analysis.  As a whole, covariance structure analysis showed that, in terms of privacy and only for service quality, entertainment primarily influenced satisfaction.  The ingestion instruction had a big effect on both sides.  General satisfaction was also substantially influenced by service quality.  The difference in influence degree was confirmed at each parameter.<br><b>Conclusion: </b>It was found that not only satisfaction but also quality of service were equally demanded in community pharmacies.  It is necessary to increase these because most are influenced by ingestion instruction as a factor in service quality.  However, future investigation is necessary to clarify the detailed ingestion instruction contents.

The Relationship between Medication Adherence and Medical-service Evaluation among Chronically-diseased Outpatients under the Separation of Prescribing and Dispensing: An Empirical Study Aiming at Reducing Unused Medicines and Promoting Family Pharmacies / 社会薬学

In addition to the notion of promoting generic drugs to lower pharmaceutical costs, another approach that has gained attention as vital to policy reform is that of utilizing health insurance pharmacies to decrease over-prescription and surplus of drugs. Such a move would perforce require separating medical and dispensary practices. There is increased need for more efficient provision of pharmaceuticals, including proper inventory control, outpatient clinics that function as family pharmacies, and support of home-bound patients’ medication regimens. However, chronic ailments in particular tend to lack subjective symptoms, and decreased intake of medication and surplus medication compound to make these larger policy issues difficult to solve. This has led to the Revised Dispensing Service Fee changes in 2012 and 2014 putting stricter controls on medication regimens and checks of surplus medication. This research examines in parallel the issues of patient satisfaction and loyalty alongside adherence to medication regimens, issues that have been previously treated in isolation in the existing literature. By comparing their respective inter-relationships and influencing factors, we conducted a re-analysis of the relationship between insurance pharmacies and patients. We collected data from patients with diabetes and high blood pressure via an Internet survey. Responses on loyalty, patient satisfaction, overall perceived quality, and degree of medication adherence were obtained, as well as responses on the factors believed in a cross-sectional sense across research disciplines to contribute to the above, and the results measured on a quantitative scale. Path analysis was then used, with a model defined using overall perceived quality as a parameter and measuring the degree of satisfaction, loyalty, and medication adherence. In addition, a multiple-group analysis was simultaneously performed. Although there was variance by ailment in terms of patient satisfaction and loyalty, factors contributing to perceived quality were the strongest, followed by the rating of the prescribing doctor. However, for adherence, only self-efficacy and prescribing doctor rating contributed. Ultimately, no correlation was found between patient satisfaction, loyalty, and adherence, and the contributing causes were found to vary, so improving these various vectors would seem to require respectively differing strategies. In terms of medication adherence, the results suggested the need for strategies to increase patients’ self-efficacy, partner with prescribing doctors, and improve the perceived rating of prescribing doctors; different quality improvements are needed by medical area, whether medicine or dispensary practice.

Evaluation of the Factors Influencing Medicine-taking Behavior for the Patients Taking Oral Medication / 社会薬学

The purpose of this study was to assess the negative effects of some factors on medicine-taking behavior. For the patients taking oral medication who visited a health insurance pharmacy, we enacted the actual situation of medication and conducted an attitude survey on the feeling of burden and resistance of taking the drugs. The survey also covered the factors that can influence medicine-taking behavior and the extent of the influence. For differences in each factor such as patient characteristics, lifestyle, and medication status, we used the 2 test to analyze the association with medicine-taking behavior. We found significant differences in age, dietary habits, occupation, periodic consultation with the pharmacy/doctor, and unpleasant experiences. In addition, in patients with multiple factors that cause noncompliance with medication, we observed a strong influence of age and occupation. From the factor analysis, we obtained data on time, quantity, and pharmaceutical factors (three factors called regular factors). These factors negatively influenced the use of medication by the patients. Next, in the covariance structure analysis, the influence of time and the quantity factor on medication-related stress was the observed to be the strongest, whereas the influence of the regular factors was not significant. Furthermore, there were differences in the influence of these factors depending on patient characteristics.

An Investigation on Evaluation Structure of the Patient for Ingestion Instruction in Community Pharmacies / 医薬品情報学

<b>Objective: </b>Many studies on patient satisfaction are conducted in community pharmacies.  In contrast, the present study assess the community pharmacy function and to the best of our knowledge, appears to be the first to evaluate the professional functions of pharmacists.<br><b>Methods: </b>In September 2010, in 1 week, we conducted a survey that focused on pharmacists’ professional abilities.  I subjected the responses to factor analysis and covariance structure analysis.<br><b>Results: </b>We obtained 2,506 effective responses (appropriately completed and returned questionnaires) of the 4,633 questionnaires originally distributed.  Data of seven dimensions were obtained for factor analysis.  In all, the various information provision services rendered by a pharmacist were not significant.  According to the covariance structure analysis, “safety” (a pharmaceutical management item) and “responsiveness” (a complimentary element) were significant factors.  Differences in the degree of influence were confirmed for each parameter in the analysis, depending on the parameter.  In addition, the information provision services were significant during the acute period.<br><b>Conclusion: </b>Because the information provision services were not significant, the influence of “asymmetric information” warrant further analysis according to the specialty.  I believe that it is necessary to examine asymmetric information in greater detail in the future.  In addition, I think that an interventional study that is based on these results is also necessary.

The Perception and Utilization of a Prescription Record—A Survey with Community Pharmacists and Patients— / 社会薬学

A “Okusuri-techo,” which refers to a prescription record, is utilized in medical institutions as an information tool necessary for the prevention of side effects, drug-interaction, and/or in case of emergency medication. However, the record is not shared sufficiently between patients and pharmacists and thus remains underutilized. To explore how the record could be used more effectively, a survey was conducted with the pharmacists of 73 community pharmacies that were members of the Otaru Pharmaceutical Association, and patients who received prescriptive medicines from these pharmacies. A total of 148 pharmacists and 157 patients responded. Approximately 80.9% of the patient group responded that the prescription record was useful, whereas 100% of the pharmacists answered that it was helpful. In the cross-analysis of the patients’ responses, the presentation of the prescription record to medical staff was correlated with the degree of helpfulness of the record. It was suggested that the function and effective usage of the record were rarely shared between patients and pharmacists. Sufficient understanding of the value and effective usage of such a record will therefore promote its active utilization among patients and pharmacists.

A Quantitative Analysis of Factors Affecting Dispensing Errors in Community Pharmacies / 医薬品情報学

<b>Objective: </b>This study quantitatively analyzes the factors causing dispensing errors in community pharmacies and explores the characteristics of these factors and their order of importance.<br><b>Design and Methods: </b>We collected data records on the contents and causes of dispensing errors as reported between April and July 2009 by a total of 320 pharmacists at 56 stores of two pharmacy chains (15 stores in Hokkaido and 41 stores in the Kansai area).  We focused on the following three types of dispensing error: 1) “measurement error”, 2) “wrong drug dispensing error” and 3) “wrong dosage form specification error”.  We conducted multiple regression analyses and discriminant analyses with occurrence frequency of each type of error as dependent variables and count frequency of each causal factor as independent variables.<br><b>Results: </b>The result of the multiple regression analyses indicated that the primary causes of the three types of errors in order of strength of the regression coefficients were as follows.  For “measurement error”: 1) pharmacist’s wrong assumption and 2) calculation error; for “wrong dosage form specification error”: 1) insufficient confirmation of prescription and 2) pharmacist’s wrong assumption; for “wrong drug dispensing error”: 1) pharmacist’s wrong assumption and 2) insufficient confirmation of prescription.  The results of the discriminant analysis indicated that only for the discriminant coefficient between “wrong dosage form specification error” and “wrong drug dispensing error” no significant difference in the mean was found (<i>p</i>=0.539).<br><b>Conclusions: </b>Results show that partly different factors cause “measurement error” as compared with the two other types of dispensing errors.  In addition, while basically the same factors were found to cause “wrong drug dispensing error” and “wrong dosage form specification error,” there was a difference in the order of importance of these factors.  This study uncovered differences in terms of causal factors affecting each dispensing error type.