Factors that Lead to Stagnation in Direct Patient Reporting of Adverse Drug Reactions: An Opinion Survey of the General Public and Physicians in Japan.

OBJECTIVE: Data collection from patients regarding adverse drug reactions (ADRs) in Japan have greatly stagnated. To examine the factors underlying this stagnation, we investigated the awareness of and opinions about the direct ADR reporting system among the general public and physicians. METHODS: We conducted questionnaire surveys of general citizens and physicians throughout Japan and included the following topics: (1) awareness of the direct patient ADR reporting system, (2) attitude toward this system, (3) reasons for negative opinions of this system, (4) awareness of the physician ADR reporting system, and (5) respondent demographics. RESULTS: Responses were received from 845 citizens and 300 physicians. Most citizens (83.7%) were unaware of the direct patient ADR reporting system. While many citizens supported the idea of the system, 26.7% expressed negative/hesitant opinions. Prominent reasons for negative/hesitant opinions included the patient burden for reporting their own ADRs and expectations that physicians would make reports. Among the general public, the physician reporting system was better known (43.6%). In contrast, many physicians were aware of the direct patient ADR reporting system (65.0%). However, only 46.7% of physicians had supported this system; prominent reasons for disapproval included skepticism toward patients' judgment and the regulatory authorities' assessment. CONCLUSION: Our survey suggests that stagnation in the reporting system is affected by the attitudes of the general public and physicians. In addition to government measures to improve awareness and eliminate reporting hurdles, the involvement of medical staff in patient reporting needs to be improved.

Caspase inhibition in select olfactory neurons restores innate attraction behavior in aged Drosophila.

Sensory and cognitive performance decline with age. Neural dysfunction caused by nerve death in senile dementia and neurodegenerative disease has been intensively studied; however, functional changes in neural circuits during the normal aging process are not well understood. Caspases are key regulators of cell death, a hallmark of age-related neurodegeneration. Using a genetic probe for caspase-3-like activity (DEVDase activity), we have mapped age-dependent neuronal changes in the adult brain throughout the lifespan of Drosophila. Spatio-temporally restricted caspase activation was observed in the antennal lobe and ellipsoid body, brain structures required for olfaction and visual place memory, respectively. We also found that caspase was activated in an age-dependent manner in specific subsets of Drosophila olfactory receptor neurons (ORNs), Or42b and Or92a neurons. These neurons are essential for mediating innate attraction to food-related odors. Furthermore, age-induced impairments of neural transmission and attraction behavior could be reversed by specific inhibition of caspase in these ORNs, indicating that caspase activation in Or42b and Or92a neurons is responsible for altering animal behavior during normal aging.