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
The number of diagnosed hypertensive patients in Japan is estimated to be 9.93 million according to a 2017 patient survey, and the potential number of actual hypertensive patients is estimated to be 43 million. The purpose of the present study was to clarify the actual condition of the Do-shoho (refill of the previous prescription) period for antihypertensive drugs prescribed for a long duration, and to obtain basic data for considering the introduction of a refill system in Japan. Data were collected from the patient medication profile of patients who were prescribed amlodipine OD tablets (Chemiphar®) from July 2012 to December 2019, and the Mann-Whitney U test or Kruskal-Wallis test were performed with the Do-shoho period as the test variable. A generalized linear model was used to analyze the items for which significant differences were obtained. The results of the analysis showed that the factors affecting the duration of the Do-shoho were the prescribing source, diagnosis, and the maximum number of prescription days. Of the patients surveyed (N=321), 199 (62.0%) had a Do-shoho duration of 6 months or longer, which was more than half of the total number of patients. The results suggest that many patients may be eligible for the refill prescription system if pharmacists are able to properly assess the continuation of prescriptions.