Ishibashi Masaaki, Ishii Masakazu, Nagano Miku, Kiuchi Yuji, Iwamoto Sanju
Division of Physiology and Pathology, School of Pharmacy, Showa University.
Department of Pharmacology, School of Medicine, Showa University.
Yakugaku Zasshi. 2018;138(3):425-435. doi: 10.1248/yakushi.17-00182.
Previous reports suggested that sharing outpatient information during chemotherapy is very important for managing pharmaceutical usage between community pharmacies and hospitals. We herein examined using a questionnaire survey whether pharmaceutical management for outpatient chemotherapy is desired by community and hospital pharmacists. The response rates were 44.3% (133/300) for pharmacists in community pharmacies and 53.7% (161/300) for pharmacists in hospitals. Prescriptions for outpatients during chemotherapy were issued at 88.2% of the hospitals. Currently, 28.9% of hospital pharmacists rarely provide pharmaceutical care, such as patient guidance and adverse effect monitoring, for outpatients receiving oral chemotherapy. Furthermore, whereas 93.7% of hospital pharmacists conducted prescription audits based on the chemotherapy regimen, audits were only performed by 14.8% of community pharmacists. Thus, outpatients, particularly those on oral regimens, were unable to receive safe pharmaceutical care during chemotherapy. Community pharmacists suggested that hospital pharmacists should use "medication notebooks" and disclose prescription information when providing clinical information to community pharmacists. They also suggested sending clinical information to hospital pharmacists by fax. On the other hand, hospital pharmacists suggested the use of "medication notebooks" and electronic medical records when providing clinical information to community pharmacists. In addition, they suggested for community pharmacists to use electronic medical records when providing clinical information to hospital pharmacists. As there may be differences in opinion between community and hospital pharmacists, mutual preliminary communication is important for successful outpatient chemotherapy.
先前的报告表明,在化疗期间共享门诊信息对于社区药房和医院之间的药物使用管理非常重要。我们在此通过问卷调查研究社区和医院药剂师是否希望对门诊化疗进行药物管理。社区药房药剂师的回复率为44.3%(133/300),医院药剂师的回复率为53.7%(161/300)。88.2%的医院会开具化疗期间的门诊处方。目前,28.9%的医院药剂师很少为接受口服化疗的门诊患者提供药学服务,如患者指导和不良反应监测。此外,93.7%的医院药剂师会根据化疗方案进行处方审核,而社区药剂师中只有14.8%会进行审核。因此,门诊患者,尤其是口服化疗方案的患者,在化疗期间无法获得安全的药学服务。社区药剂师建议医院药剂师在向社区药剂师提供临床信息时应使用“用药记录册”并披露处方信息。他们还建议通过传真向医院药剂师发送临床信息。另一方面,医院药剂师建议在向社区药剂师提供临床信息时使用“用药记录册”和电子病历。此外,他们建议社区药剂师在向医院药剂师提供临床信息时使用电子病历。由于社区和医院药剂师之间可能存在意见分歧,相互的初步沟通对于成功开展门诊化疗很重要。