Effectiveness of a Camera Support System for the Prevention of Occupational Anti-cancer Drug Exposure / 社会薬学

During the preparation of anti-cancer drugs, mutual verification with another pharmacist is performed to prevent preparation mistakes. In a small-to-medium sized hospital with relatively few pharmacists, it is common for nurses to perform verifications. The nurses approach the safety cabinet only lightly protected by their clothing. Thus, occupational exposure to anti-cancer drugs, which are hazard drugs is a concern. To prevent occupational exposure, we implemented and investigated the effectiveness of an “anti-cancer drug preparation camera support system”, which allowed two-way communication and video recording between an anti-cancer drug preparation room and a pharmacy preparation room at different locations. The amount of exposure to anti-cancer drugs was defined as the time required to verify the anti-cancer drug. The average daily exposure time was calculated based on the number of verifications and the average time for each verification. This value was then compared with the exposure time when the camera system was implemented. In addition, the frequency of work interruption when a pharmacist verified, after the introduction, was assessed. The effectiveness of the camera supported system was validated, the verification time for anti-cancer drugs was reduced from 48.9±9.3 minutes/day to 4.4±0.9 minutes/day. This means that the occupational exposure time of 48.9±9.3 min/day for nurses was reduced to zero and the occupational exposure time for dispensing pharmacists was reduced to 4.4±0.9 min/day. In addition, it allowed pharmacists to properly confirm anti-cancer drugs preparations.

Survey on Accumulated Drug Information by Pharmaceutical Companies about Crushed or Simply Suspended Internal Medicines / 医薬品情報学

Objective: We conducted a survey on drug information accumulated by pharmaceutical companies about the adequacy of administration of crushed or simply suspended internal medicines through enteral feeding tube, examination methods to confirm adequacy and inquiries from medical institutions to pharmaceutical companies about the adequacy of these methods.Methods: We sent a questionnaire to 162 pharmaceutical companies that sell internal medicines to collect information. The survey was conducted from May 1, 2016 to March 31, 2017.Results: The questionnaire response rate was 61% (99 companies responded). Eighty and 90 percent of the companies possessed information about the drug crushing methods and simple suspension methods used for administration of internal medicines,respectively. The type of information and examination methods used varied among the companies, was very limited, and was often limited to new drugs. The information acquisition rate about crushing methods was 69.3% in original examination methods of pharmaceutical companies. On the other hand, 90.3% of the information about simple suspension methods was obtained by the unified method of Hand Book of Simple Suspension Method.Conclusions: In the future, medical practice and patients will benefit if examination methods to confirm the adequacy of crushing and administration through feeding tubes are commonly and consistently obtained by pharmaceutical companies. Furthermore, it would be very useful for information of crushing methods and simple suspension methods to be included in package inserts and interview forms.

Examination Regarding the Simple Suspension Method using Oral Anticancer Drugs / 社会薬学

To administer oral anticancer drugs safely, the simple suspension method has been introduced in many hospitals. Therefore, concerning drugs for which it is unclear whether or not this method is applicable, testing must be able to be conducted at any time. In this study, we investigated 20 oral anticancer drugs to expand information on the application of the simple suspension method. Disintegration/suspension and permeability tests were conducted, as described in the 3rd version of the Tube Administration Handbook for Oral Drugs. All products were disintegrated/suspended after 10 minutes. On permeability tests, there was no residue in any tube for tubal feeding. On the final evaluation, the products were regarded as suitable (grade 1). Bicalutamide tablets (80 mg, TCK and KN), which were analyzed in this study, were regarded as suitable (grade 1) on the final evaluation. On the other hand, the simple suspension method is not applicable for a brand-name drug, Casodex^® tablets (80 mg). This may be related to the different additives. Furthermore, the results suggest that, even when the simple suspension method is not applicable for a brand-name drug, it may become applicable for generic drugs. This may provide a new merit for promoting the use of generic drugs.

Systematic and stepwise interprofessional education in Showa University / 医学教育

　At Showa University, which consists of the Schools of Medicine, Dentistry, Pharmacy, and Nursing and Rehabilitation Sciences, systematic interprofessional education for the purpose of training staff who can contribute to the medical team has been introduced with the cooperation of all 4 schools and through all undergraduate years. In the lower years, students study the basics of medical team care through a 4-school joint curriculum of experiential learning （such as early exposure） and problem-based learning inside and outside of the university. In the upper years, to acquire practical skills, students study the practice of medical team care through a joint curriculum of participatory learning in hospitals and the community. Through this curriculum, I expect that the medical staff to promote patient-centered team medical care in a variety of medical fields will grow in the future.

Creating a List of Oral Anticancer Drugs using the Simple Suspension Method for Appropriate Therapy / 社会薬学

In cancer chemotherapy, it is very important to take into account the patient’s background. In recent years, a simple suspension method has attracted increased attention as a method that prevents changes in the stability and safety of various drugs. However, of 135 oral anticancer drugs, only 28 have been examined using this method, as of April 2013. In this study, we carefully investigated whether 53 oral anticancer drugs could be adapted to the simple suspension method, except for the 28 drugs that had already been previously reported. The results showed that most of these oral anticancer drugs could be adapted to the simple suspension method. Of seven drugs that were not adapted, six were generic drugs. In addition, it was clear that the evaluation of bicalutamide tablets was significantly different from our expected results. In conclusion, we were able to qualitatively assess all 53 oral anticancer drugs. This is equivalent to half of 107 untested drugs. These results provide useful information to cancer patients using oral anticancer drugs prepared using the simple suspension method.