The Evaluation of the Role of Pharmacist Using Text Mining Analysis in an Interdisciplinary Pain Center / 社会薬学

We evaluated the role of pharmacists in an interdisciplinary pain center using text mining analysis. We investigated 28 patients who visited an interdisciplinary pain center from May 2014 to July 2015. All patients were interviewed by a pharmacist. Further, we performed morphological analysis of medical records; classification of appearing words into “medicines/side effects,” “diagnosis/disease name,” “pain site,” “pain characteristics/concomitant symptoms,” “life/environment,” and “mental”; and correspondence analysis. The frequently appearing words “pain characteristics/concomitant symptoms” and “medicines/side effects” were used by 47.2% doctors and 35.3% pharmacists, respectively. In the correspondence analysis, doctors frequently referred to “pain characteristics/concomitant symptoms,” pharmacists frequently referred to “medicines/side effects,” and nurses frequently referred to “life/environment” and “pain site.” The fact that the three occupations used distinguishing phrases suggests that each is specialized in a distinct area. At an interdisciplinary pain center, we interviewed a nurse, a pharmacist, and a doctor, and shared information from various angles. The pharmacist focused on listening to the “medicines/side effects,” which is information related to his profession. Pharmacists contribute to medical care by recording information in medical records and sharing the information with other occupations. It is necessary to continue to provide information related to our specialized profession, respect each other, and provide high-quality medical care.

A Study on the Safety of Long-Term Magnesium Oxide Administration in Elderly Patients with Impaired Renal Function / 医薬品情報学

Objective: Risk factors for hypermagnesemia due to magnesium oxide (MgO) include advanced age, decreased renal function, and long-term administration; however, no study has evaluated patients that present all of these factors. This study was aimed to evaluate the safety of long-term MgO administration in elderly patients with impaired renal function.Methods: We investigated changes in serum Mg in patients aged 65 years or older, who had been taking oral MgO and presenting a glomerular filtration rate (eGFR) ＜60 mL/min/1.73 m2 for 6 months or longer.Results: Thirty patients were surveyed. Their median age was 81 years (range, 68-92). No significant change in patient background was observed before and after initiating MgO administration, with no change in serum Mg detected. Furthermore, the oral dose of MgO was divided into groups taking ＜1,000 mg and ≥ 1,000 mg; no change in serum Mg was observed in either group. Based on renal function, the analysis was divided into a mildly decreased group (60＞ eGFR ≥ 45) and a moderately to severely decreased group (45＞ eGFR ≥ 15), and no change in serum Mg was observed in either group.Conclusions: We targeted elderly patients with renal dysfunction who were taking long-term MgO, a known risk factor for hypermagnesemia, indicating that MgO can be safely continued.

A Study on the Effect of Changing the Dose on the Package Insert of Distigmine on Cholinergic Syndrome Onset Using the Japanese Adverse Drug Event Report (JADER) Database / 社会薬学

Distigmine has reversible and persistent cholinesterase (ChE) antagonism, and is used for the dysuria due to low activity bladders such as the neurogenic bladder dysfunction widely postoperatively, but fatal cases were reported by cholinergic syndrome. Therefore a dose was limited to 5mg only for adaptation of “the dysuria due to hypotonic bladder such as after surgery and the neurogenic bladder dysfunction” in March, 2010. In the current study, we examined a ministerial policy in the package insert revision using Japanese Adverse Drug Event Report database (JADER). Using a side effect report registered with JADER from January, 2004 to June, 2016, we calculated Reporting Odds Ratio (ROR) which was the index of the safe signal of the medical supplies adverse event and we compared number of reports and ROR of the cholinergic syndrome by the distigmine in approximately the measure in March, 2010 and evaluated it. The number of reports of the cholinergic syndrome by the distigmine was 138 cases before March 2010 and 65 cases after March 2010. After a measure, the number of reports decreased. The possibility that the package insert revision of the distigmine contributed to a decrease in cholinergic syndrome onset was suggested. Whereas monitoring careful sequentially needs the onset of the cholinergic syndrome in constant frequency to be found.