薬剤師の在宅医療サービスによる残薬解消効果
Objective: To examine the effect of pharmacists’ visits to homebound patients on the elimination of unused drugs.Method: We conducted a survey with pharmacies throughout Japan that provided home-visit service, asking them questions regarding their work with up to five patients (the survey period was...
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| Published in | Iyakuhin Johogaku Vol. 17; no. 1; pp. 21 - 33 |
|---|---|
| Main Authors | , , , , , , , , , |
| Format | Journal Article |
| Language | English |
| Published |
一般社団法人 日本医薬品情報学会
2015
Japanese Society of Drug Informatics |
| Subjects | |
| Online Access | Get full text |
| ISSN | 1345-1464 1883-423X |
| DOI | 10.11256/jjdi.17.21 |
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| Abstract | Objective: To examine the effect of pharmacists’ visits to homebound patients on the elimination of unused drugs.Method: We conducted a survey with pharmacies throughout Japan that provided home-visit service, asking them questions regarding their work with up to five patients (the survey period was from January 15 through the end of February, 2013). Main survey questions were: (1) whether they managed unused drugs since the start of their home-visit, and (2) how they managed the unused drugs. For (2), we conducted case studies by asking the pharmacists to choose the case that impressed them most and describe the unused drugs involved, actions taken, and the results.Results: Data on 5,447 patients were collected from 1,890 pharmacies throughout Japan (collection rate: 56.9%). Pharmacists managed unused drugs from 2,484 patients (45.6%). 1,746 patients (3,590 cases) were qualified for analysis. In 2,332 cases (65.0%), pharmacist intervention eliminated the incidences of unused drugs. In 782 cases (21.8%), unused drugs were discarded, while the number of drug administration days was adjusted in 2,623 cases (73.1%). In 21 cases (0.6%), drugs were both discarded and had the number of days adjusted. There were others for 164 cases (4.5%). The total price of the eliminated unused drugs was approximately 6,920,000 yen (4,000 yen/person). Illnesses that benefited most from the elimination of unused drugs were chronic respiratory failure (16,306 yen/person), and Parkinson’s disease (4,803 yen/person).Conclusion: We confirmed the economic effect of eliminating unused drugs by pharmacists’ home visits. |
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| AbstractList | Objective: To examine the effect of pharmacists’ visits to homebound patients on the elimination of unused drugs.Method: We conducted a survey with pharmacies throughout Japan that provided home-visit service, asking them questions regarding their work with up to five patients (the survey period was from January 15 through the end of February, 2013). Main survey questions were: (1) whether they managed unused drugs since the start of their home-visit, and (2) how they managed the unused drugs. For (2), we conducted case studies by asking the pharmacists to choose the case that impressed them most and describe the unused drugs involved, actions taken, and the results.Results: Data on 5,447 patients were collected from 1,890 pharmacies throughout Japan (collection rate: 56.9%). Pharmacists managed unused drugs from 2,484 patients (45.6%). 1,746 patients (3,590 cases) were qualified for analysis. In 2,332 cases (65.0%), pharmacist intervention eliminated the incidences of unused drugs. In 782 cases (21.8%), unused drugs were discarded, while the number of drug administration days was adjusted in 2,623 cases (73.1%). In 21 cases (0.6%), drugs were both discarded and had the number of days adjusted. There were others for 164 cases (4.5%). The total price of the eliminated unused drugs was approximately 6,920,000 yen (4,000 yen/person). Illnesses that benefited most from the elimination of unused drugs were chronic respiratory failure (16,306 yen/person), and Parkinson’s disease (4,803 yen/person).Conclusion: We confirmed the economic effect of eliminating unused drugs by pharmacists’ home visits. |
| Author | 安田, 実央 荒川, 行生 高田, 百合菜 今井, 博久 春日, 美香 岡本, 夏実 恩田, 光子 下村, 真美子 七海, 陽子 田中, 有香 |
| Author_FL | Nanaumi Yoko Takada Yurina Okamoto Natsumi Onda Mitsuko Tanaka Yuka Kasuga Mika Yasuda Mio Imai Hirohisa Arakawa Yukio Shimomura Mamiko |
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| References | 13) ファイザー株式会社. 処方薬の飲み残しに関する意識・実態調査. http://www.pfizer.co.jp/pfizer/company/press/2012/documents/20121113.pdf(2014.9.30アクセス 26) Bloom BS. Daily regimen and compliance with treatment. BMJ 2001; 323: 647. 35) 清水敦哉. 慢性疾患における薬剤アドヒアランスを向上させる工夫 3) 高血圧患者. Prog Med 2013; 33: 1293-8. 14) 小柳香織, 窪田敏夫, 小林大介ら. 節約バッグ運動 外来患者の残薬の現状とその有効活用による医療費削減の取組み. YAKUGAKU ZASSHI 2013; 133: 1215-21. 9) 中村美喜子. 在宅での服薬支援を充実する. 調剤と情報 2012; 18: 995-9. 25) Barr RG, Somers SC, Speizer FE, et al. Patient factors and medication guideline adherence among older women with asthma. Arch Intern Med 2002; 162: 1761-8. 27) Okuno J, Yanagi H, Tomura S. Is cognitive impairment a risk factor for compliance among Japanese elderly in the community ?. Eur J Clin Pharmacol 2001; 57: 589-94. 8) 森 昌平. 「残薬」から考える薬剤師への社会的期待と評価. 調剤と情報 2013; 19: 156-61. 29) Payne KA, Esmonde-White S. Observational studies of antihypertensive medication use and compliance: is drug choice a factor in treatment adherence ?. Curr Hypertens 2000; 2: 515-24. 12) 五十嵐中. 残薬をめぐる諸問題 誰にとって「もったいない」？. 調剤と情報 2013; 19: 172-5. 15) 日本薬剤師会. 平成19年度老人保健事業推進費等補助金 後期高齢者の服薬における問題と薬剤師の在宅患者訪問薬剤管理指導ならびに居宅療養管理指導の効果に関する調査研究報告書, 2008. 19) 厚生労働科学研究費補助金医薬品医療機器等レギュラトリーサイエンス総合研究事業 地域医療における薬剤師の積極的な関与の方策に関する研究(代表: 今井博久)平成25年度総括・分担研究報告書, 2014年3月. 23) 田島 治. ベンゾジアゼピン系薬物の処方を再考する. 臨床精神医学 2001; 30: 1065-9. 11) 松岡紗代, 三木晶子, 佐藤宏樹ら. NSAIDS貼付剤の処方に対する患者意識と自宅残薬の取扱い実態. 医療薬学 2012; 38: 592-8. 22) 今井浩光. ベンゾジアゼピン系抗不安薬の継続処方の功罪. 医薬ジャーナル 2002; 38: 65-70. 7) 原崎大作. 患者1人ひとりに寄り添う残薬解消へのアプローチ. 調剤と情報 2013; 19: 162-5. 37) 庄司雅紀, 恩田光子, 岡田 浩ら. 保険薬局来局患者の経口血糖降下薬の服薬条件とアドヒアランスの関連について. 薬と糖尿病 2013; 2: 104-8. 20) 今井博久. 高齢者に避けたい薬剤例～日本版ビアーズ基準を作成して. コミュニティケア臨時増刊号 2011; 13: 22-7. 36) 鈴木一成, 中野博司. 慢性疾患における薬剤アドヒアランスを向上させる工夫 4) 糖尿病. Prog Med 2013; 33: 1301-4. 16) Onda M, Imai H, Kataoka Y, et al. Preliminary study about the relationship between workload and the outcomes of community pharmacists’ home visiting service. Jpn J Soc Pharm 2013; 32: 2-7. 28) Monane M, Bohn RL, Gurwitz JH, et al. The effects of initial drug choice and comorbidity on antihypertensive therapy compliance: results from a population based study in the elderly. Am J Hypertense 1997; 10: 697-704. 5) 吉松美津代, 赤間美恵子, 和田和子. 薬剤師に知ってほしい在宅服薬管理の現状. 月刊薬事 2013; 55: 1653-7. 3) 畑中典子, 伊藤貴文, 石幡真澄ら. 在宅患者のアドヒアランスに及ぼす背景因子の解析—真の服薬率とヘルパーの推定する服薬率の比較—. YAKUGAKU ZASSHI 2009; 129: 727-34. 31) Kerse N, Buetow S, Mainous AG III, et al. Physician-patient relationship and medication compliance: a primary care investigation. Ann Fam Med 2004; 2: 455-61. 33) Van Wijk BL, Klungel OH, Heerdink ER, et al. Generic substitution of antihypertensive drugs does it affect adherence ?. Ann Pharmacother 2006; 40: 15-20. 1) 人口推計(平成24年10月1日現在)平成25年4月16日公表 結果の概要(全国年齢別人口). http://www.stat.go.jp/data/jinsui/2012np/pdf/gaiyou2.pdf(2014.2.20アクセス 4) 高見千恵. 在宅高齢者の服薬の実態 多剤併用者を対象に. 川崎医療福祉学会誌 2000; 10: 373-9. 30) Martin RF, Rodriguez MM. Family support of treatment compliance in essential arterial hypertension. Salud Publica Mex 2001; 43: 336-9. 18) 庄司雅紀, 恩田光子, 岡田 浩ら. 薬局薬剤師が2型糖尿病患者から受ける質問内容に関するテキストアナリシス. 日本健康教育学会誌 2014; 22: 50-6. 32) Harris LE, Luft FC, Rudy DW, et al. Correlates of health care satisfaction in inner-city patients with hypertension and chronic renal insufficiency. Soc Sci Med 1995; 41: 1639-45. 21) Nanaumi Y, Onda M, Mukai Y, et al. Factors related to medication adherence of cognitively impaired patients in community pharmacy. Pharmacol Pharm 2012; 3: 376-88. 34) 田地広明, 寺本信嗣. 慢性疾患における薬剤アドヒアランスを向上させる工夫 5) 呼吸器疾患—気管支喘息、COPDなど—. Prog Med 2013; 33: 1305-9. 17) 恩田光子, 櫻井秀彦, 早瀬幸俊ら. 成人気管支喘息における吸入指導の課題. 薬剤疫学 2009; 14: 69-77. 24) Tanaka K, Obara T, Kobayashi M, et al. Medication compliance and intentional discontinuation of taking medication among outpatients. Res Drug Interact 2009; 32: 131-7. 6) 藤森真紀子. 在宅における残薬確認の重要性. 調剤と情報 2013; 19: 166-70. 10) 辻野靖彦, 三木晶子, 堀 里子ら. 患者宅における残薬の保管状況調査のための手法の開発と予備的調査. 新薬と臨牀 2013; 62: 520-9. 2) 在宅医療における薬剤師業務について. 厚生労働省. http://www.mhlw.go.jp/stf/shingi/2r985200000127vk-att/2r9852000001283s.pdf(2014.2.20アクセス |
| References_xml | – reference: 34) 田地広明, 寺本信嗣. 慢性疾患における薬剤アドヒアランスを向上させる工夫 5) 呼吸器疾患—気管支喘息、COPDなど—. Prog Med 2013; 33: 1305-9. – reference: 26) Bloom BS. Daily regimen and compliance with treatment. BMJ 2001; 323: 647. – reference: 25) Barr RG, Somers SC, Speizer FE, et al. Patient factors and medication guideline adherence among older women with asthma. Arch Intern Med 2002; 162: 1761-8. – reference: 23) 田島 治. ベンゾジアゼピン系薬物の処方を再考する. 臨床精神医学 2001; 30: 1065-9. – reference: 4) 高見千恵. 在宅高齢者の服薬の実態 多剤併用者を対象に. 川崎医療福祉学会誌 2000; 10: 373-9. – reference: 18) 庄司雅紀, 恩田光子, 岡田 浩ら. 薬局薬剤師が2型糖尿病患者から受ける質問内容に関するテキストアナリシス. 日本健康教育学会誌 2014; 22: 50-6. – reference: 22) 今井浩光. ベンゾジアゼピン系抗不安薬の継続処方の功罪. 医薬ジャーナル 2002; 38: 65-70. – reference: 29) Payne KA, Esmonde-White S. Observational studies of antihypertensive medication use and compliance: is drug choice a factor in treatment adherence ?. Curr Hypertens 2000; 2: 515-24. – reference: 17) 恩田光子, 櫻井秀彦, 早瀬幸俊ら. 成人気管支喘息における吸入指導の課題. 薬剤疫学 2009; 14: 69-77. – reference: 2) 在宅医療における薬剤師業務について. 厚生労働省. http://www.mhlw.go.jp/stf/shingi/2r985200000127vk-att/2r9852000001283s.pdf(2014.2.20アクセス) – reference: 9) 中村美喜子. 在宅での服薬支援を充実する. 調剤と情報 2012; 18: 995-9. – reference: 21) Nanaumi Y, Onda M, Mukai Y, et al. Factors related to medication adherence of cognitively impaired patients in community pharmacy. Pharmacol Pharm 2012; 3: 376-88. – reference: 28) Monane M, Bohn RL, Gurwitz JH, et al. The effects of initial drug choice and comorbidity on antihypertensive therapy compliance: results from a population based study in the elderly. Am J Hypertense 1997; 10: 697-704. – reference: 13) ファイザー株式会社. 処方薬の飲み残しに関する意識・実態調査. http://www.pfizer.co.jp/pfizer/company/press/2012/documents/20121113.pdf(2014.9.30アクセス) – reference: 19) 厚生労働科学研究費補助金医薬品医療機器等レギュラトリーサイエンス総合研究事業 地域医療における薬剤師の積極的な関与の方策に関する研究(代表: 今井博久)平成25年度総括・分担研究報告書, 2014年3月. – reference: 15) 日本薬剤師会. 平成19年度老人保健事業推進費等補助金 後期高齢者の服薬における問題と薬剤師の在宅患者訪問薬剤管理指導ならびに居宅療養管理指導の効果に関する調査研究報告書, 2008. – reference: 24) Tanaka K, Obara T, Kobayashi M, et al. Medication compliance and intentional discontinuation of taking medication among outpatients. Res Drug Interact 2009; 32: 131-7. – reference: 14) 小柳香織, 窪田敏夫, 小林大介ら. 節約バッグ運動 外来患者の残薬の現状とその有効活用による医療費削減の取組み. YAKUGAKU ZASSHI 2013; 133: 1215-21. – reference: 31) Kerse N, Buetow S, Mainous AG III, et al. Physician-patient relationship and medication compliance: a primary care investigation. Ann Fam Med 2004; 2: 455-61. – reference: 20) 今井博久. 高齢者に避けたい薬剤例～日本版ビアーズ基準を作成して. コミュニティケア臨時増刊号 2011; 13: 22-7. – reference: 8) 森 昌平. 「残薬」から考える薬剤師への社会的期待と評価. 調剤と情報 2013; 19: 156-61. – reference: 10) 辻野靖彦, 三木晶子, 堀 里子ら. 患者宅における残薬の保管状況調査のための手法の開発と予備的調査. 新薬と臨牀 2013; 62: 520-9. – reference: 32) Harris LE, Luft FC, Rudy DW, et al. Correlates of health care satisfaction in inner-city patients with hypertension and chronic renal insufficiency. Soc Sci Med 1995; 41: 1639-45. – reference: 35) 清水敦哉. 慢性疾患における薬剤アドヒアランスを向上させる工夫 3) 高血圧患者. Prog Med 2013; 33: 1293-8. – reference: 37) 庄司雅紀, 恩田光子, 岡田 浩ら. 保険薬局来局患者の経口血糖降下薬の服薬条件とアドヒアランスの関連について. 薬と糖尿病 2013; 2: 104-8. – reference: 6) 藤森真紀子. 在宅における残薬確認の重要性. 調剤と情報 2013; 19: 166-70. – reference: 27) Okuno J, Yanagi H, Tomura S. Is cognitive impairment a risk factor for compliance among Japanese elderly in the community ?. Eur J Clin Pharmacol 2001; 57: 589-94. – reference: 5) 吉松美津代, 赤間美恵子, 和田和子. 薬剤師に知ってほしい在宅服薬管理の現状. 月刊薬事 2013; 55: 1653-7. – reference: 16) Onda M, Imai H, Kataoka Y, et al. Preliminary study about the relationship between workload and the outcomes of community pharmacists’ home visiting service. Jpn J Soc Pharm 2013; 32: 2-7. – reference: 30) Martin RF, Rodriguez MM. Family support of treatment compliance in essential arterial hypertension. Salud Publica Mex 2001; 43: 336-9. – reference: 36) 鈴木一成, 中野博司. 慢性疾患における薬剤アドヒアランスを向上させる工夫 4) 糖尿病. Prog Med 2013; 33: 1301-4. – reference: 11) 松岡紗代, 三木晶子, 佐藤宏樹ら. NSAIDS貼付剤の処方に対する患者意識と自宅残薬の取扱い実態. 医療薬学 2012; 38: 592-8. – reference: 7) 原崎大作. 患者1人ひとりに寄り添う残薬解消へのアプローチ. 調剤と情報 2013; 19: 162-5. – reference: 1) 人口推計(平成24年10月1日現在)平成25年4月16日公表 結果の概要(全国年齢別人口). http://www.stat.go.jp/data/jinsui/2012np/pdf/gaiyou2.pdf(2014.2.20アクセス) – reference: 3) 畑中典子, 伊藤貴文, 石幡真澄ら. 在宅患者のアドヒアランスに及ぼす背景因子の解析—真の服薬率とヘルパーの推定する服薬率の比較—. YAKUGAKU ZASSHI 2009; 129: 727-34. – reference: 12) 五十嵐中. 残薬をめぐる諸問題 誰にとって「もったいない」？. 調剤と情報 2013; 19: 172-5. – reference: 33) Van Wijk BL, Klungel OH, Heerdink ER, et al. Generic substitution of antihypertensive drugs does it affect adherence ?. Ann Pharmacother 2006; 40: 15-20. |
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| Snippet | Objective: To examine the effect of pharmacists’ visits to homebound patients on the elimination of unused drugs.Method: We conducted a survey with pharmacies... |
| SourceID | nii jstage |
| SourceType | Publisher |
| StartPage | 21 |
| SubjectTerms | community pharmacy home visit pharmacist polypharmacy unused drugs |
| Title | 薬剤師の在宅医療サービスによる残薬解消効果 |
| URI | https://www.jstage.jst.go.jp/article/jjdi/17/1/17_21/_article/-char/ja https://cir.nii.ac.jp/crid/1390001205228866304 |
| Volume | 17 |
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| ispartofPNX | 医薬品情報学, 2015, Vol.17(1), pp.21-33 |
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