Evaluation of Polypharmacy and Inappropriate Prescription among Elderly Inpatients at the Department of General Internal Medicine at Sendai Medical Center / 日本プライマリ・ケア連合学会誌

Introduction: Polypharmacy is the practice of prescribing many medications. In this study, we assessed the current status of polypharmacy among elderly patients and cases of inappropriate prescription (IP) at the Department of General Internal Medicine (GIM) at Sendai Medical Center.Methods: We retrospectively surveyed 136 inpatients who were over 65 years old between April 2015 and March 2016 at the Department of GIM.We examined the patient's current medications and used the STOPP (screening tool of older person's potentially inappropriate prescriptions) criteria version 2 to analyze potentially inappropriate medication (PIM) cases.Results: Of 136 study patients, 77 (56.6%) patients were taking more than 6 medications. For patients over 75 years old, the average number of current medications increased.In addition, 33 cases of PIM were confirmed and the number increased in proportion to the number of current medications. Furthermore, there were 4 cases of adverse reactions in which the STOPP criteria version 2 were not applied.Conclusion: In this study, we confirmed polypharmacy in the examined patients.In order to solve the problem of polypharmacy, all medical staff must cooperate and review the prescriptions of individual patients.General physicians should assume the leading role in the distribution and improvement of polypharmacy and IP.

3. Evaluation of the education for clinical clerkship in hospitals outside the university, / 医学教育

<p>Objective: To inquire about how evaluation of physician supervisors is performed, and whether or not incentives to guide comprehensive community-based clinical clerkship for them are provided, in hospitals outside Sapporo Medical University.</p><p>Methods: We conducted field surveys using questionnaires distributed to physician supervisors and hospital directors, focusing on the evaluation of physician supervisors and whether they are provided with incentives. From the survey, we examined the attitude toward educational awareness of the physician supervisors.</p><p>Results: The number of hospitals where evaluations for physician supervisors were performed and incentives were provided was limited. In addition, 54.2% of the physician supervisors responded that incentives were unnecessary. Many of them considered that incentives for a hospital are more preferable than for individual supervisors.</p><p>Conclusion: These results suggest that with respect to community-based clinical clerkship outside the university, an appropriate method for providing incentives, including whether or not they are necessary, should be considered.</p>