Study of pharmacist intervention in polypharmacy among older patients: Non-randomized, controlled trial.

AIM: We investigated the outcomes of interdisciplinary drug therapy interventions by pharmacists among older residents of special elderly nursing homes. METHODS: The study was designed as a non-randomized, parallel-group, controlled study. Four nursing homes were allocated in a 1:1 ratio to an intervention group (IG) or control group (CG). The participants of the study were residents taking five or more medications. The nursing homes in the IG were each visited by one pharmacist, who was charged with looking for potential problems in drug therapy. Activities in the CG were carried out as usual. The intervention period was 6 months. The primary end-points were the incidences of potentially inappropriate medication (PIM) and falls. The mean difference and proportion of participants were compared between groups. RESULTS: Data from 28 participants in the IG and 27 participants in the CG were analyzed. The number of PIM decreased from 2.64 at baseline to 2.39 after 6 months in the IG (P = 0.032). The proportion of participants in whom the use of PIM was reduced without problems was 17.9% in the IG and 3.7% in the CG (P = 0.094). The mean number of falls was 0.04 in the IG and 0.41 in the CG (P = 0.033). Falls occurred in 3.6% of participants in the IG and 22.2% of participants in the CG (P = 0.043). CONCLUSIONS: The results suggested a trend toward fewer PIM and falls in the IG. Geriatr Gerontol Int 2019; ••: ••-••.

[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.

How Patient-Pharmacist Communication Using the Drug Profile Book Relates to Patient's Behavior regarding Its Use.

This survey aimed to examine how patient-pharmacist communication using the drug profile book relates patient's behavior regarding its use. Among patients who visited one of the five pharmacies during the 4 months between July and October of 2013, 245 patients who had been prescribed antihypertensives were asked to complete a questionnaire. Items included patient attributes, whether the patient thought the drug profile book was useful to them ("sense of utility"), whether the patient has ever been questioned by a pharmacist while showing the drug profile book ("experience of being questioned by a pharmacist while showing the drug profile book"), and whether the patient has ever shown the drug profile book to the physician ("experience of showing the drug profile book to the physician"). In addition, pharmacists counted the frequency of patients bringing the drug profile book, and if so, the frequency of the sticker affix during the last 5 visits. 34.3% of responding patients answered that they had the "experience of being questioned while showing the drug profile book". Response rates of "frequency of bringing the drug profile book", "sense of utility", and "experience of showing the drug profile book to the physician" in the group with "experience of being questioned while showing the drug profile book" were significantly higher than those in the group without such experience. This survey indicated that experience of being questioned by a pharmacist while showing the drug profile book related patient's behavior regarding its use.