Investigation of Universal Drug Information in a Hospital in Japan / 医薬品情報学

<b>Objective: </b>We aimed to integrate drug information (DI) documents universally necessary in most hospitals in Japan and share the DI documents nationwide.  For this purpose, we planned to collect details (e.g., types of document, contents, sources of information used for preparing documents) regarding the DI documents prepared by the DI service section of each hospital.<br><b>Methods: </b>(1) Preliminary research: We searched Ichushi-Web (from January 1977 to December 2015) for cases in which DI documents were prepared by the DI service section of each hospital.  (2) Questionnaire survey: We conducted the survey in DI section of 300 hospitals in Japan that were selected randomly.  We asked the types of DI documents they have, sources of information used for preparing documents, and time needed for preparing documents.<br><b>Results: </b>(1) Forty titles, including those related to preoperative medication management, simple suspension methods of tablets, and list of dosing with renal impairment, were found.  (2) In total, 148 hospitals (49.3%) responded to the survey.  The main contents were as follows: preoperative medication management (130), the influence of a tube and a filter give to stability of injection medicine (67), list of high-risk medicines (54), suspension or porphyrization information on tablets (37), and others.  The source of information used for preparing these documents was common in several hospitals.<br><b>Conclusion: </b>It was confirmed that similar DI documents are prepared by several DI sections of hospitals and some sources of drug information are common.

An Immediately Accessible Search System for Interaction Information Using Databases from Both Japan and the United States: Construction and Application in Responding to Work-Related Questions / 医薬品情報学

<b>Objective: </b>When responding to questions regarding drug-drug interaction by the medical staff of our hospital, pharmacists previously collected information using some drug databases from Japan and the United States.  The aim of this study was to construct a search system for interaction information using drug databases from both Japan and the United States for streamlining questions and answers regarding drug-drug interaction.<br><b>Methods: </b>Using the drug databases from Japan and the United States, we collected information on the interaction pertaining to drugs prescribed at Kobe University Hospital.  This information was further assessed for consistency.  Furthermore, we constructed an original search system for interaction information for streamlining questions and answers regarding drug-drug interaction.<br><b>Results: </b>The difference between information obtained from the databases from Japan and the United States was apparent.  Thus, we concluded that it was necessary to obtain interaction information via a database search that included information from both the countries.  Therefore, our original interaction search system was reconstructed with interaction information collected using databases from both the countries.  We compared the response to questions regarding the previous and present methods using our original search system for interaction information; the time required to obtain the responses was 5.89 and 3.09 min, respectively, and it took lesser time for providing responses than the previous method.<br><b>Conclusion: </b>We evaluated the usefulness of the original search system for interaction information.  We found that the original system provides a more rapid response to questions compared with the previous method.  We are considering a further upgrade and update for the original system by adding information on drugs not prescribed by our hospital.

Regarding multidisciplinary education: / 医学教育

　Healthcare professionals need to understand the operational mechanisms that drive the team-care model. Although such concepts should be integrated into the education of healthcare students, but current methods of teaching such a model of care are unsatisfactory. In 2007 the Faculty of Medicine and Health Science of Kobe University introduced an early clinical exposure program focusing on team care for first-year students. In 2008, students of the school of pharmacy joined this program. We have developed a collaborative program, the Interprofessional Work tutorial program, for the fourth year of the undergraduate curriculum. As the history of collaborative education for healthcare students is relatively short, we faculty members continuously discuss how to develop this tutorial program. Simulated multidisciplinary team conferences have been introduced into this program to increase students’ understanding of the scenario. During the course of this program, students, as well as faculty members, come to understand the roles of other professionals and to consider collaboration to be fundamental for patient-centered treatment and care. Interprofessional education is essential for human resource development and for preparing future healthcare professionals to participate in interdisciplinary team care. We must integrate the community-based aspects of health and welfare into interprofessional education for health professional students.

The large gap between customer expectations and actual explanations of supplements by pharmacists / 日本プライマリ・ケア連合学会誌

<b><i>Abstract</i></b><br><b>Objective</b> : In this study, we conducted a survey on both the use of supplements by customers and information provided by pharmacists, to clarify customer understanding. We also sought to ascertain the actual current state of information provided by pharmacists to customers, as well as investigating both how, and to what extent, pharmacists should be involved in customers 'use of supplements.<br><b>Methodology</b> : During regular pharmacy visits, pharmacists used a questionnaire to interview 1,253 customers, in 14 community pharmacies, in Tokyo and Hokkaido, respectively. A different questionnaire, designed for pharmacists, was also given to 289 pharmacists who were either working in those same pharmacies, or who attended the Conference on Pharmaceutical Sciences in Hokkaido (2011, Sapporo).<br><b>Results</b> : The results of the survey showed that approximately 50％ of consumers greatly desired the provision of safety and efficacy information about supplements by pharmacists. However, few pharmacists answered customers' questions satisfactorily (only 7.3％ of total responses).<br> The results also indicated that only 30％ of pharmacists actively gathered information about supplements, despite the fact that 67.5％ of pharmacists were aware that they were expected to do so by customers, in their roles as primary information providers regarding such treatments. Furthermore, even those pharmacists who checked information regarding supplements depended mostly on information acquired from the Internet.<br><b>Conclusion</b> : There is a large gap between customers' expectations for explanation of supplements and the reality of such explanations, and the information actually provided by pharmacists. In order to live up to their customers' expectations, pharmacists should foster both wider dissemination and better understanding of evidence-based information about supplements. Pharmacists should also provide integrated management of drugs and supplements for patients.

Gingyo Gedokusan vs Oseltamivir for the Treatment of Uncomplicated Influenza and Influenza-like illness : An Open-label Prospective Study / General Medicine

<b>Background:</b> Gingyo-gedoku-san (GGGS) is an herbal medicine approved for upper respiratory infections in Japan. We conducted an open-label, multi-center, prospective trial, comparing GGGS with oseltamivir in patients with influenza and influenza-like illness (ILI) as a pilot study.<br><b>Methods:</b> Subjects were healthy persons aged between 16 and 40, and were enrolled from January 12, 2010 to March 24, 2011. Fifteen patients were enrolled in this trial (8 and 7 for GGGS and oseltamivir, respectively). RT-PCR was positive for pandemic influenza A (H1N1) in 10 patients. The patients were provided with either GGGS or oseltamivir for 5 days. The primary outcome was mortality and/or hospitalization 7 days after the initial diagnosis. Body temperature and other clinical characteristics were also evaluated.<br><b>Results:</b> All patients recovered from illness without complication or hospitalization. The mean time to resolve symptoms for the GGGS and oseltamivir groups was 3.9 days and 3.3 days, respectively (p=0.43). The GGGS group appeared to have a smaller symptom score AUC than the oseltamivir group, (p=0.26). Time to recover activity level appeared to be shorter in the GGGS group (p=0.10), with shorter time to recover health status (p=0.02). Sub-group analysis on patients with positive PCR showed similar results between the two groups.<br><b>Conclusion:</b> GGGS was associated with symptom improvements resembling oseltamivir for both influenza and ILI. Randomized controlled trials involving larger sample sizes are needed to confirm these results.

Practical Training at a Hospital Pharmacy Improved the Drug Information Literacy of Pharmacy Students / 医薬品情報学

<b>Objective: </b>Drug information literacy is necessary for pharmacists.  This study investigated the effect of practical training on the drug information literacy of pharmacy students.<br><b>Methods: </b>We conducted practical training in the drug information room of hospital pharmacy.  Then we asked the students two questions before and after the training.  We scored the drug information responses of students using four-point rating scales based on objective criteria.  We compared the scores obtained before and after training.  In addition, we researched the realization of several secondary and tertiary sources using a visual analog scale (VAS).  We then compared VAS findings before and after the training.<br><b>Results: </b>The score for drug information responses was significantly improved.  For sources other than MEDLINE (Pub Med), the VAS score also improved.  The students were aware of the information on package inserts before training.  There was significant improvement in awareness of books about pregnancy and lactation (e.g. Drugs in Pregnancy and Lactation) after training.  However, there were significant individual differences in awareness of MEDLINE, Up To Date, and the Cochrane Library.<br><b>Conclusion: </b>This practical training experience improved the drug information literacy of pharmacy students.  Before training, there were significant deficiencies in the process of literature search.  Therefore, this training was effective for advancement in drug information literacy of pharmacy students.