[The Effectiveness of Counseling Using Preventative Informational Sheets with Climate and Environmental Data from Insurance Pharmacies in Preventing Worsened Asthma Symptoms].

We investigated the possibility that having pharmacists give asthma patients informational sheets on climate and environmental changes at insurance pharmacies during patient counseling might prevent the worsening of asthma symptoms. Patients with hyperlipidemia were comparative subjects. We created informational sheets about climate and environmental changes and their influence on asthma. During patient counseling, pharmacists gave them to all asthma patients who visited insurance pharmacies over a period of 2 months, between November and December 2017. Based on previous studies, we called days which showed certain climate or environmental changes as compared to the previous day "change days". We compared the number of visiting patients on change days after preventative information was provided (between January and March 2018) with the number before information was provided (between January and March 2017). In addition, we compared those numbers with the number of patients who visited the target pharmacies between January and March 2016 in order to examine the influence of yearly climate change. The same procedure was used with hyperlipidemic patients. The number of visiting asthma patients after information was provided significantly decreased (5.1±2.1, p=0.03) compared with the number before information was provided, between January and March 2017 (6.1±2.8). The number of aforementioned visits compared to those between January and March 2016 also significantly decreased (p=0.01). Our results suggest that preventative information about climate and environmental changes provided by pharmacists during patient counseling might influence the number of asthma patient visits and prevent the exacerbation of their symptoms.

[Outcomes of Pharmacists' Involvement with Residents of Special Nursing Homes for the Elderly].

　The current study aimed to examine the outcomes of pharmacists' involvement with elderly people in special nursing homes. We analyzed 58 cases involving regular visits by community pharmacists to 41 residents. The residents' mean age was 87.8±6.9 years, and 68.3% were prescribed 6 or more types of medication. Antipsychotic and insomnia medication was taken by 24.4% and 31.8% of residents, respectively. Pharmaceutical consultation following medication use accounted for 60.3% of pharmacists' involvement with residents. The outcomes of these consultations included improvements in prescription content; the identification and prevention of adverse drug events; improvement in activities of daily living; and improvement in test results, sleep, and urination/bowel control. The results also suggested that pharmacists' intervention reduced drug costs. Information that facilitated involvement was most frequently acquired via conversations (67.2%) and conferences (24.1%) in the facilities. The most common information sources were care workers (72.4%), followed by nurses (37.9%), physicians (6.9%), and functional training instructors (6.9%). Information was also acquired from patients (3.4%) and their family members (5.2%). The findings indicated that regular visits by pharmacists to facilities for elderly people and conversations between residents, their family members, and physicians, nurses and various other professionals improved various pharmacotherapy outcomes.

Evaluation of solute penetration across the polysulfone membrane with vitamin E coating.

Vitamin E (vit E) is coated on polysulfone (PS) dialysis membrane for antioxidative purpose. The membrane, however, has not yet been evaluated from the mass transfer point of view. We investigated this PS membrane with and without vit E coating in vitro ultrafiltration experiments to identify whether or not the coating influences the mass transfer. Dialyzers that included PS membrane with and without vit E coating were investigated. Aqueous test solution of various solutes including vitamin B12 (VB12 , MW1355), chymotrypsin (chymo, MW25000), and albumin (alb, MW66000) was prepared, and normal ultrafiltration experiments were performed at 310 K. Reverse ultrafiltration experiments in which test solution was filtered from outside to inside the hollow fiber were also performed. Sieving coefficients (SC) were computed for evaluation. SC for VB12 was the same regardless of vit E coating; however, chymo was 0.82 ± 0.01 and 0.86 ± 0.01, respectively, for the membrane with and without vit E. Thus, it would be understood that vit E coating reduces the pore size of the membrane, resulting the reduced transport of larger solutes. Like other PS membrane, SC for alb was decreased over time regardless of vit E coating. More importantly, although the steady-state SC for alb was almost identical in two membranes, PS without vit E showed much greater decrease for the first 2 h, while that with vit E showed very little decrease over time, which suggested the reduced fouling effect due to vit E coating. All the SC values found in reverse ultrafiltration were higher than those found in normal ultrafiltration; moreover, the degree of increase with chymo was approximately 5%, whereas that with alb was approximately 430%, which may be explained by a new model in which wedge effect is taken into consideration for the membrane transport. Vit E coating not only has antioxidative effect but also reduces the fouling that is usually caused by various proteins.