ABSTRACT
Objectives: A refill-prescription system startedin April, 2022 in Japan. Refill-prescriptions can be usedrepeatedly, but pharmacists are required to check patients' medication and determine whether refills are appropriate. This study aimed to clarify the actual status of community pharmacies' treatment of prescription refills and pharmacists’ concerns about them.Design: Questionnaire survey.Methods: A self-administered questionnaire survey was conducted for pharmacists at community pharmacies from June to July, 2022, shortly after the refill-prescription system was launched, focusing on handling of prescription refills in community pharmacies, and concerns and challenges about refill-prescriptions.Results: Responses were obtainedfrom 377 pharmacists in 34 prefectures throughout Japan. Among them, 30.8% had received refill-prescriptions. Many pharmacists checked medical histories, changes in patients' symptoms, and medication and medical examination status when determining the appropriateness of refills, but few reviewed past laboratory values or laboratory values measuredby patients themselves at the time of their pharmacy visit. Moreover, 34.8% of the pharmacies had internal rules for dealing with refills, and 39.8% had equipment to measure laboratory values. Many pharmacists were concerned about how to share patients’ information with other pharmacies. Challenges that were identified included “Determining whether the refill is appropriate for the patient” and “Establishment of a pharmacy system to receive refill-prescriptions”.Conclusion: This study clarified the actual status of community pharmacies handling of prescription refills, and pharmacists' concerns or challenges about them. Potential improvements include increasing the number of devices that can measure laboratory values at pharmacies, improving home-use measuring devices, creating guidelines to determine the appropriateness of prescription refills and improving pharmacists' skills.
ABSTRACT
In order to find an effective way to detect bacteria responsible for respiratory tract infections in children, we first examined as pharyngeal swabs, epi-pharyngeal swabs and nasal aspirates obtained from children hospitalized at our pediatric service during these five months from December 1997 to April 1998. In the rate of bacterial infection, it was found that nasal aspirates came out on top with 92.6%(25/27), followed by epipharyngeal swabs with 71.6%(53/74) and pharyngeal swabs with 26.2%(38/145). Single-species bacteria were found in 78.9%(30/38) of pharyngeal swabs, where as 45.3% of epi-pharyngeal swabs (24/53) and 52.0% of nasal aspirates (13/25) proved mixed infections with two-or three-defferent species. Thus it was suggested that nasal aspirates and epi-pharyngeal swabs would be far more adequate than pharyngeal swabs to detect bacteria with accuracy.<BR>Next, based on the efficiency of bacterial detection, we compared culture media for the specimen obtained from in-patients and out-patients at our pediatric service. The rate of isolation of gram-negative rods was as low as 0.3%(1 of 314 strains) even when BTB agar plate, a selective medium for these bacteria, was employed. The sensitivety was not much different from those observed with nonselective blood agar plate. These results suggest that the conventional blood agar media can substitute for the more expensive type of BTB agar medium for the diagnosis of infections diseases of the airwaysin children.