ABSTRACT
Objective: Sodium glucose cotransporter 2 inhibitors (SGLT2i) are widely used for diabetes, chronic heart failure, and chronic kidney disease. However, the incidence of volume depletion in patients when pharmacists implement risk-minimization strategies is unknown. Risk factors for volume depletion requiring further treatment have not been investigated in detail. Therefore, we retrospectively investigated the occurrence and risk factors of volume depletion in patients taking SGLT2i. Methods: This study included patients 18 years or older using SGLT2i between November 2014 and December 2021. Patients prescribed an SGLT2i at another hospital who were referred to our clinic where their initial SGLT2i prescription was a continuation prescription, patients who were referred to another medical institution during their 52-week follow-up, patients who discontinued their visits to our clinic or unknown reasons were excluded. The pharmacist provided patients with risk management plan literature at their first provision of an SGLT2 inhibitor. The endpoints were the rate of patients on SGLT2i who experienced volume depletion, rate of hospitalization to treat volume depletion, discontinuation rate, and risk factors. Results: SGLT2i caused volume depletion in 12 patients (0.5 %) and hospitalization in 1 patient (0.04 %), 83.3% of them occurred within 3 months after starting treatment. Risk factors for volume depletion were identified as age ≧ 75 years, renal dysfunction with eGFR less than 60 mL/min/1.73 m2, history of chronic heart failure, and chronic kidney disease. Conclusion: This study revealed risk factors associated with SGLT2i-induced volume depletion, but further investigation is required with an increased number of cases.
ABSTRACT
Objective: The success rate of third-line treatment for Helicobacter pylori (H. pylori) infection has been reported to depend on the use of antibacterial agents, potassium-competitive acid blockers, and proton pump inhibitors. However, there is insufficient information on the success rate of H. pylori treatment due to the differences in the clinically used drugs. Here, the factors influencing the success rate of third-line treatment for H. pylori infection was investigated.Methods: Patients aged 20 years or older, who had received third-line treatment for H. pylori infection from January 2013 to December 2021 at the Kameda Medical Center were included. The exclusion criteria were as follows: patients with unknown treatment results and discontinuation of treatment. The primary endpoint was treatment success rate, based on the differences in the treatment regimen and drug choice, which was retroactively investigated from medical records. Confounding factors were adjusted by multivariate logistic regression analysis.Results: Treatment regimens containing sitafloxacin resulted in higher treatment success rates (p<0.05). Multivariate logistic regression analysis showed that the administration of sitafloxacin was the only statistically significant factor influencing treatment success. However, vonoprazan also tended to influence treatment success.Conclusion: Treatment with sitafloxacin and vonoprazan increases the success rate of third-line treatment against H. pylori infection.
ABSTRACT
Objective: Providing patients with information and medication instruction regarding direct oral anticoagulant (DOAC)antagonists is becoming increasingly important. Comprehensive knowledge of DOAC antagonists can expedite the transportation and treatment of emergency cases, such as bleeding with antagonists, in hospitals. We investigated the awareness of idarucizumab and whether the information provided in the Risk Management Plan was reflected in the actual provision of information and medication instruction.Methods: Pharmacists in dispensing pharmacies and Kameda Medical Center were included in the survey conducted from May 2022 to June 2022. Using a web-based questionnaire, we obtained answers to questions related to idarucizumab awareness. Respondents answered a series of questions regarding idarucizumab awareness, sources of information, patient information, and medication instruction.Results: We received responses from 1,118 people. In all, 25.9% pharmacists were aware of idarucizumab, and 10.3% provided information and medication instruction on DOAC antagonists to patients. Pharmaceutical companies, books, drug information departments, workshops, and wholesalers were the sources of information on idarucizumab for 24.8, 21.0, 19.0, 10.7, and 3.1% of the pharmacists, respectively.Conclusion: Pharmacists had knowledge of DOAC antagonists and provided information and instructions to patients infrequently. Improved awareness will lead to prompt response during the occurrence of adverse events such as bleeding.