ABSTRACT
<b>Objective: </b>In Japan, the healthcare authority encourages physicians to prescribe generic drugs in order to reduce the copayments by the patients for pharmaceutical expenses and to improve the financial status of the national medical insurance system. In accordance with this governmental policy, we have been actively involved in switching original to generic formulations. Thus, Utemerine® 50 mg injection was replaced with Ritodrine hydrochloride 50 mg intravenous injection produced by Nichiiko. There have been some reports on adverse events caused by the generic formulations of Ritodrine hydrochloride. Factors contributing to these adverse effects may include different additives and/or vehicles and the exemption of demonstrating some conditions for approval, including clinical trials. Therefore, in order to assess the efficacy and safety of a generic formulation of Ritodrine hydrochloride injection formulation compared with the original formulation and to decide on its continued use, we carried out a retrospective cohort study.<br><b>Methods: </b>We carried out a retrospective cohort study in order to assess the efficacy and safety of a generic formulation of Ritodrine hydrochloride injection formulation compared with the original formulation.<br><b>Results: </b>There were no significant differences in the length of hospital stay, rate of emergency transport to other institutions, gestational week of delivery, rate of stillbirth, rate of abortion, or incidence of adverse events between the two formulations.<br><b>Conclusion: </b>Our results may contribute to the safe and secure use of the generic formulations of Ritodrine hydrochloride in the current situation of the increasing use of generic drugs in health care. Although there are some limitations in our study, the results suggest that there are no particular problems with the continued use of Ritodrine hydrochloride 50 mg intravenous injection produced by Nichiiko.
ABSTRACT
Persons who are abused often have serious problems in a complicated life situation. We studied this issue and considered ways in which medical social workers (MSWs) handle these social problems. We collected data in 16 cases of elderly abuse that were managed by staff at our hospital from 2010 to 2013 and compared the characteristics in these cases with those of 23 cases of child abuse during the same period. Data analysis revealed 3 characteristics of abused persons: insufficient use of long-term care insurance service; mental disorder such as dementia or mental illness; and financial problems. Further detailed analysis found that intervention for elderly abuse cases was requested only in more difficult cases when abuse was easily identified by our staff. Therefore, staff’s awareness and motivation to become more involved in cases of elderly abuse may be low compared with cases of child abuse. Hospital staff are in a position where they should be able to readily identify maltreatment of aged persons. We need to develop a mechanism for the early detection of elderly abuse so staff can intervene easily in mild cases of elderly abuse, and ask for assistance from MSWs in more difficult cases. It is important to ensure that all employees have access to MSWs in the hospital.