An Evaluation of Community Pharmacists' Knowledge and Experience regarding Dementia with Lewy Bodies: / 医薬品情報学

Objective: Owing to inconspicuous memory impairment during early disease stage, patients with dementia with Lewy bodies (DLB) are often diagnosed with mental disorders according to depressive symptoms and visual hallucinations. Severe sensitivity to antipsychotic agents, a DLB characteristic, increases mortality. Herein, we reviewed current challenges and approaches for early DLB detection and appropriate drug use by evaluating pharmacists' ability to recognition of DLB and their level of involvement in medication consultation with dementia patients.Designs: This is a cross-sectional study in Japan.Methods: We provided an anonymous self-administered survey questionnaire to 372 community pharmacists. Descriptive statistics,chi-square test (attributes, recognition, and experiences with medication consultation), and content analysis (free description of drug hypersensitivity) were used for data analysis.Results: The recognition rates for questions on DLB symptoms were as follows: visual hallucinations, 76%; delusion, 63%; other symptoms, including those categorized as core clinical features, such as fluctuating cognition, and REM sleep behavior disorder,＜40%. The rate of other symptoms was similar to that of false recognition of Alzheimer's disease symptoms. The recognition rate of certain DLB symptoms varied depending on pharmacists' experience in medication consultation with dementia patients and drug-induced evaluation during delirium/cognitive decline over the previous month. Approximately 65% of the participants did not respond to open questions on symptoms suggestive of drug hypersensitivity, whereas 55% of those who responded referred to allergic symptoms such as rashes.Conclusion: Owing to their lack of recognition of DLB symptoms, the current contribution of pharmacists to early DLB detection and proper drug use is limited. Thus, it is important to provide patients' observation points and method of questioning during interviews so that pharmacists can easily recognize DLB symptoms. It is critical to clarify that DLB drug hypersensitivity is attributed to mechanisms different from that of drug allergy.

Comparison Paper Medium and Moving Image Medium to Explain the Usage of the Device for Inhalation / 医薬品情報学

Objective: It has been recognized that most medical institutions preferred the printed medium for their information sheets for patient education of inhaler usage. However, some questions have arisen. In a case where patients are not sufficiently informed of drug administration guidance due to limited information with only pictures and text, they might not be able to obtain a proper understanding. Contrarily, it is assumed that video medium, with audio and visual elements, is a format for education conveying a larger amount of information. We conducted comparative research regarding patient’s degree of understanding of inhalation guidance, comparing two groups of print- and video-medium-based instructions for inhaler usage and examined how effective two types of media explanations were on patients.Methods: Research participants were thirty persons visiting Jinjo Pharmacy, who were randomly assigned to the print medium group and the video medium group. After one group read and saw an explanation sheet of an inhaler where the maker wrote inhalation instructions and the other group watched an instruction video, the two groups practiced inhaler usage. Evaluation was performed with specified items and comprehensive assessment, and in addition, the time required for inhalation was measured.Results: Score of the evaluation score was statistically significantly higher in the video medium group than in the print medium group in score of specified items and score of comprehensive assessment, and was also significantly shorter in the operation time of the inhaler.Conclusion: This study clarified that the video medium group had fewer improper inhalation occurrences and shorter operation time and, therefore, showed the effectiveness of the video medium. It is recommended that the video medium should be actively utilized,which could improve patient medication adherence. Accessibility is required for patient education to achieve inhaler techniques by watching video-based instruction.

Effective Use of Over-The-Counter (OTC) Drugs during a Disaster: / 医薬品情報学

<b>Objective: </b>For effective use of over-the-counter (OTC) drugs that are provided as relief supplies during a disaster, we aimed to develop a list of OTC drugs that can be used during a disaster.<br><b>Methods: </b>We obtained information about OTC drugs useful during a disaster by examining results of previous studies and lists of drugs used during a disaster.  We analyzed this information with the expert pharmacist of disaster support and established a rationale for our list and developed “the List of Useful OTC Drugs During a Disaster” and “the Information Card on Useful OTC Drugs During a Disaster.”<br><b>Results: </b>We developed our list of OTC drugs based on the following parameters: (1) while people with severe disorders (e.g. renal failure) are treated by medical teams, those with minor physical conditions are treated using OTC drugs and (2) those OTC drugs that can be used as substitutes for prescription drugs were preferably selected.  The List of Useful OTC Drugs ()—During a Disaster (containing 56 items) was developed for use mainly by medical professionals.  Further, pharmacists from disaster-relief medical teams may not always be available in disaster-stricken areas; therefore, the Information Card on Useful OTC Drugs During a Disaster was developed to enable disaster victims to independently make a certain level of decision.  The information card contained pictograms to call the attention of the disaster victims.<br><b>Conclusion: </b>Our results can provide a common tool for drug suppliers, medical professionals engaging in relief works in disaster-stricken areas, and disaster victims.

Medical Economic Research on Pharmaceutical Inquiries Made by Hospital Pharmacists about Prescriptions for Inpatients / 医薬品情報学

<b>Objective: </b>To examine the usefulness of inquiries made by hospital pharmacists.<br><b>Methods: </b>This study was conducted a survey about the actual condition of inquiries at 5 hospitals.<br><b>Results: </b>The prescriptions subjected to inquiry accounted for 1.5% of the inpatient prescriptions and 0.3% of the injection prescriptions.  In cases of “Incomplete entry in the prescription” for the subcategory of “Question about safety,” drug costs without the impact of pharmaceutical inquiries were calculated on the assumption that the concerned drugs should have been generally prescribed.  Our results showed that the total savings in medical costs were 30,673 yen for the inpatient prescriptions and 159,212 yen for injection prescriptions, which suggested that pharmaceutical inquiries are effective for saving medical costs for either type of prescriptions.  In the case of patients in whom adverse drug reactions (ADRs) might have occurred without prescription changes, medical cost savings realized by preventing ADRs were estimated using the Diagnosis Procedure Combination/Per-Diem Payment System (DPC/PDPS).  Our results showed that the savings were 1,428,710 yen for inpatient prescriptions (6 patients), which indicated that a large amount of medical costs was saved.<br><b>Conclusions: </b>Our results suggested that similar to pharmaceutical inquiries made by community pharmacists, those made by hospital pharmacists not only result in the proper delivery of drug therapy but also are useful in terms of medical economics.