Factors influencing changes in medication-taking and driving behavior after warnings about prescription medications that prohibit driving: an online survey.

BACKGROUND: This study examined warning messages as a strategy for preventing automobile crashes by drivers on medications. We investigated the degree of awareness regarding the effects of medication on automobile driving and changes in medication-taking and driving behavior. We also assessed associations between socio-environmental factors and the driving and medication-taking behavior adopted by individuals after being warned about driving-related risks. METHODS: Responses to an online questionnaire from 1200 people with a driving license who were taking prescription medications at the time of inquiry (March 2019) were collected and analyzed. The items surveyed were sex, age, educational history, health literacy, current medications, and medication-taking and driving behavior after being warned. RESULTS: Of the total respondents, 30% were taking medicine that prohibited driving. Of those taking prohibited medications, 25.7% did not receive a warning about driving from healthcare professionals. Most respondents taking prohibited medications received euphemistic warnings, such as "practice caution" (30%), "refrain from calling attention" (29.4%), and "avoid driving" (19.8%); 16% of the direct warnings were about not driving. Medication's effects on driving were recognized by 80% of the total respondents. The degree of awareness was significantly higher among respondents taking medications that prohibit driving than among those taking medications that did not prohibit driving or those taking unknown medications. Awareness of medicine's influence on driving was associated with health literacy. No association was found between age, gender, health literacy, history of side effects, and driving and medication-taking behavior. Approximately 22% of respondents adjusted their medication use at their discretion and 39% maintained treatment compliance but continued driving. Among respondents taking medications that prohibit driving, whether driving was required for work was a significant factor in their driving and medication-taking behavior after being warned. CONCLUSIONS: Healthcare professionals do not always fully inform patients about the driving-related risks of medications. To encourage patients who are taking medications that have a significant impact on their driving to either stop driving or consult a healthcare professional, healthcare professionals must first understand the patient's social environment, such as whether driving is required for work, and then create an environment conducive to advice-seeking.

[Improvement of Medication Adherence in Psychiatry and Mental Health Literacy Education].

In Japan, the number of patients with mental illness is increasing; therefore, the need for national measures, such as suicide prevention measures and measures against alcohol health disorders, and multiple social concerns and needs, such as depression and dementia problems, are increasing. As such, measures for mental health are emphasized. Mental health is a common issue; however, there is still prejudice regarding mental illness, and its understanding and awareness by local residents and medical staff need to be improved. The author introduced a medication self-management module in the psychiatric ward to improve medication adherence, and constructed a program for mental health literacy education in the faculty of pharmacy. This paper outlines these studies.

Risk awareness, medication adherence, and driving behavior as determined by the provision of drug information to patients.

OBJECTIVE: The study identifies appropriate risk expressions by healthcare professionals in communicating the risks of driving-impairing medicine to patients, gauging changed patient behavior, preventing traffic accidents due to drugs, and improving drug adherence. METHODS: An online questionnaire survey was conducted on participants' perception of driving-related risks, and risk awareness, as well as reports of healthcare professionals' expressions and warning messages regarding driving-impairing drugs. RESULTS: Approximately 80 % of participants were aware of the effects of pharmaceutical drugs on driving ability, and 50 % responded that they had received an explanation from their respective health professionals. As reported by participants, although healthcare professionals typically used more indirect expressions, direct warning messages were associated with high-risk awareness. CONCLUSION: The content of the explanatory sentences and debriefing influenced risk perception among participants. Direct expressions were more desirable for appropriate risk perception by participants. Providing information from healthcare professional about the degree of risks and patients' determining their influence on driving behavior based on risk perception was necessary to clarify the predictors of driving behavior. PRACTICE IMPLICATIONS: Health professionals should be aware that their warning messages could have a significant impact on patients' risk perception and driving behavior.

Effect of a Japanese drug alert pictogram on medication-taking/driving behavior.

Objective: This study aimed to determine the usefulness and effects of a pictogram for alerting patients about drugs that affect driving in order to prevent traffic injury and maintain good adherence.Method: The participants comprised 600 men and 600 women aged 20-79 (49.58 ± 16.21) years, registered with an Internet research company. All were licensed to drive a car and were taking prescribed medication. The outcome measures were: 1) awareness of existing pictogram, 2) perceived driving risk after viewing the pictogram, 3) usefulness of the pictogram, and 4) medication-taking and driving behavior after viewing the pictogram.Results: Few respondents (5.4%) were aware of the Japanese pictogram issued by the Council for Appropriate Drug Use. Participants evaluated their driving risk as moderate-to-high (3.51 ± 0.69) after viewing the pictogram, and risk perception was higher among respondents in their 50 s and 60 s than among those in their 20 s. Across all respondents, the pictogram was rated as follows (on a 5-point Likert scale): effective for warning, 3.79 ± 0.90; informative, 3.75 ± 0.84; understandable meaning (comprehensibility), 3.90 ± 0.96; simplicity, 3.71 ± 0.95; and eye-catching, 3.60 ± 0.98. We defined the following as positive behavior: taking medication according to the instructions of a medical professional (good compliance), stopping driving, and consulting medical professionals. The positive behavior rate was 63.2%. Being shown the pictogram might lead to more positive medication-taking and driving behavior among respondents who are female and have lower driving frequency, higher levels of risk perception, and higher evaluation of the pictogram compared to their counterparts.Conclusion: A pictogram is a potentially useful and effective tool for communicating risk and supporting decision-making by supplying drivers with tailored information. However, we assume that some people who drive frequently must drive for work, go to the hospital, etc. It is essential, in these cases, for medical professionals to be more deeply involved with the patients and to maintain lines of communication by listening to patients' descriptions of their everyday life. By adding these pictograms to the labeling of potentially driver-impairing medications (such as by putting them on the outer packaging, package inserts, and inner medicine containers), it is expected that they can better inform users regarding safe behavior and promote medication adherence.

Production cross sections of ytterbium and thulium radioisotopes in alpha-induced nuclear reactions on natural erbium.

Activation cross sections of alpha-induced reactions on natural erbium were measured using a 50.9-MeV alpha-beam at the RIKEN AVF cyclotron. Well-established methods for the measurements, the stacked-foil activation technique and gamma-ray spectrometry, were used. Production cross sections of 166,169Yb and 165,166,167,168,170,173Tm were determined. This is the first measurement of the cross sections of 166,170Tm. The integral yield of the medical radionuclide 169Yb was derived from the measured excitation function.

[Base in four types of lidocaine preparation (formulated in hospital)].

PL cream (combination of lidocaine and procaine) was launched on the market in April 2012 in Japan. We investigated differences in the anesthetic effect by employing two types of base: Carbopol and methylcellulose. Electron microscopy showed a distinct difference in appearance: densely-scattered, fine particles for Carbopol and sparse, large particles for methylcellulose. Accordingly, the extensibility of the cream was significantly greater at 4 and 25 degrees centigrade for methylcellulose, but was greater at 34 degrees centigrade for Carbopol. The steady flow viscosity (1 s(-1)) was greater for the Carbopol than methylcellulose base. The difference in the cutaneous permeability between the two bases increased over time: the methylcellulose base was removed at 90 min after application and, 30 min later, showed a significant difference. These results suggest that the methylcellulose base has a superior anesthetic effect in clinical settings.

Illness self-management for individuals in acute psychiatric care settings in Japan: cross-cultural adaptation of an American program.

OBJECTIVE: To examine whether the challenges of a cross-national adaptation of an American, evidence-based, illness self-management module for people with serious mental illnesses could be met. The UCLA Medication Management Module was adapted for use in Japan with individuals experiencing short-stay, acute care in an inpatient setting. METHOD: Two evaluations were conducted with 37 and 63 persons diagnosed as having schizophrenia and bipolar disorder, respectively, to test the feasibility and impact of the module as an intervention for illness self- management in an academic, Japanese psychiatric unit. RESULTS: The short-term feasibility was demonstrated by consumers' enhanced comprehension of the value and benefits of antipsychotic medication as well as their gaining positive, therapeutic attitudes toward use of medication. A second evaluation of the module revealed that consumers who participated in the skills training developed better understanding of the purposes of medication, more positive attitudes toward medication, and superior coping skills in dealing with medication side effects than their counterparts who received standard treatment. The greater benefits achieved from participating in the module persisted for 7 months postdischarge. CONCLUSIONS AND IMPLICATIONS FOR PRACTICE: While preliminary, these studies suggest the applicability of the Medication Management Module for illness management for Japanese hospital practice.

[Establishment of a practical training program in smoking cessation for use by pharmacists using cognitive-behavioral therapy and the motivational interview method].

We established a practical training program to nurture pharmacists who can give smoking cessation instructions. The program was provided to 85 interns (45 males and 40 females) in Teikyo University Hospital. The one-day practical training was provided to groups comprised of five members each. The training consisted of studies on the adverse effects of smoking, general outlines of the outpatient smoking cessation service, experiencing Smokerlyzer, studies about smoking-cessation drugs, studies about a smoking cessation therapy using cognitive-behavioral therapy and motivational interviewing, and case studies applying role-playing. Before and after the practical training, we conducted a questionnaire survey consisting of The Kano Test for Social Nicotine Dependence (KTSND) and the assessment of the smoking status, changes in attitudes to smoking, and willingness and confidence to give smoking cessation instructions. The overall KTSND score significantly dropped from 14.1±4.8 before the training to 8.9±4.8 after the training. The confidence to give smoking cessation instructions significantly increased from 3.4±1.9 to 6.2±1.3. Regarding the correlation between the smoking status and willingness and confidence to give smoking cessation instructions, the willingness and confidence were lower among the group of interns who either smoked or had smoked previously, suggesting that smoking had an adverse effect. A total of 88.2% of the interns answered that their attitudes to smoking had "changed slightly" or "changed" as a result of the training, indicating changes in their attitudes to smoking. Given the above, we believe that our newly-established smoking cessation instruction training is a useful educational tool.