Pharmacist Barriers to Handling Patients with Adverse Drug Events at Community Pharmacies / 医薬品情報学

<b>Objective: </b>To clarify the barriers pharmacists face in handling patients with adverse drug events at community pharmacies and to propose solutions.<br><b>Design: </b>Cross-sectional study.<br><b>Methods: </b>One hundred-twenty-one pharmacists, who worked and experienced to work at community pharmacies (76.0%), hospitals (22.3%), or elsewhere, participated in this study.  All of them were divided into 12 groups and asked to note the barriers, and abstract and structure them through discussion in each group according to the KJ-method.  On the other hand, workers at community pharmacies including people with experience were also asked to fill out a prepared questionnaire on barriers.<br><b>Results: </b>Six groups structured the barriers from the perspective of professional flow as pharmacists and the other groups structured them from the perspective of a medical care team.  The barriers emerging from both structures were (a) difficulty in identifying adverse drug reaction and assessing its grade at community pharmacies, (b) lack of standardized protocols for informing physicians from community pharmacies, (c) not being informed about a physician’s assessment of suspicious adverse drug reactions, and (d) difficulty in explaining adverse events to patients and their families.  Those barriers were reported by a high percentage of respondents to the questionnaire.<br><b>Conclusion: </b>The barriers are all crucial in order to avoid health damage caused by medication at community pharmacies and should be urgently solved.

Strategy for the effective management of adverse drug reactions / 医薬品情報学

<b>Abstruct</b><br>  Effective method for the management of information on adverse reactions is not uniformly in place, due to differences among medical facilities.  We have been developing a strategy for the effective management of adverse drug reactions on the transition of clinical records from paper to electronic media.<br>  We have taken a forward-thinking approach after 4 years identifying each year’s main target, predicted problems and how to address them in every year.  The targets for the four 1-year periods were: enabling the collection and analysis of information on adverse reactions from paper-based clinical records, standardized handling of adverse reactions in situations where paper records are still in use, transition of adverse reaction information to electronic records, and sharing of information on adverse reactions where electronic records are in use.  The Committee on Adverse Events conducted analysis of information on adverse reactions which were collected regardless of seriousness, disseminated useful information to all medical staff, and determined the degree to which each period target was achieved.<br>  The transition to electronic form of information on adverse reactions achieved 0% success within the target period.  Establishing effective management of adverse reactions will require 5 years, with as yet unresolved issues remaining.  During 5 years, 767 incidents of adverse reactions were reported, 73.1% by physicians, the proportion by nurses increasing from 6.7% to 22.3%.<br>  Strategic approach will help to establish a effective management of adverse reactions, which contribute to the adequate use of drugs and safety management of patients.