Nanaumi Yoko, Onda Mitsuko, Tsubota Kenichi, Tanaka Rie, Mukai Yusuke, Matoba Syunya, Tanaka Yuka, Arakawa Yukio
Advance Pharma Research Office.
Yakugaku Zasshi. 2015;135(9):1057-67. doi: 10.1248/yakushi.15-00109.
In Japan the prevalence of dementia has increased considerably, and pharmacists are involved in addressing these patients' medication-related problems. Here, we determined whether pharmacists' comprehensive assessment of medication profiles could reduce the burden of dementia patients' medication-related problems. In this historical cohort study 120 community pharmacies were randomly selected, and participating pharmacists completed questionnaires concerning comprehensive assessment of patient medication profiles, using a "start" questionnaire for patients prescribed medication prior to or during the study period and a "follow-up" questionnaire for patients who subsequently visited pharmacies for prescriptions. Numbers and details of problems and solutions implemented by pharmacists and identified in the start and follow-up questionnaires were compared. Changes in start and follow-up scores were also compared between patients whose problems were identified by pharmacists (identified group) and those whose problems were not (non-identified group). Data were collected for 349 patients issued medication by 60 pharmacies. The most common medication-related problems identified in the start survey were key person's understanding of donepezil (60 cases) and other dementia treatments (60 cases), and adherence to treatment (53 cases). Solutions implemented by pharmacists included gathering information regarding drug administration and dementia awareness from the key person and providing pharmaceutical counseling and instruction. Subsequently, problems related to understanding of dementia treatment, understanding donepezil, and adherence were resolved by 70.0%, 65.0%, and 58.5%, respectively. Pharmacists' comprehensive assessment of medication profiles could effectively solve dementia patients' medication-related problems.
在日本，痴呆症的患病率大幅上升，药剂师参与解决这些患者与用药相关的问题。在此，我们确定药剂师对用药情况的综合评估是否可以减轻痴呆症患者与用药相关问题的负担。在这项历史性队列研究中，随机选择了120家社区药房，参与的药剂师使用“起始”问卷对在研究期间之前或期间开具药物的患者进行用药情况综合评估，并使用“随访”问卷对随后到药房开处方的患者进行评估。比较了起始问卷和随访问卷中由药剂师发现并实施的问题及解决方案的数量和细节。还比较了问题被药剂师发现的患者（发现组）和问题未被发现的患者（未发现组）在起始和随访评分上的变化。收集了60家药房为349名患者开具药物的数据。起始调查中发现的最常见的与用药相关的问题是关键人物对多奈哌齐（60例）和其他痴呆症治疗方法（60例）的了解，以及治疗依从性（53例）。药剂师实施的解决方案包括从关键人物那里收集有关药物服用和痴呆症认知的信息，并提供药学咨询和指导。随后，与痴呆症治疗理解、多奈哌齐理解和依从性相关的问题分别有70.0%、65.0%和58.5%得到解决。药剂师对用药情况的综合评估可以有效解决痴呆症患者与用药相关的问题。
