Kimura Natsuki, Miki Akiko, Satoh Hiroki, Yamazaki Hiroshi, Sawada Yasufumi
Faculty of Pharmaceutical Sciences, The University of Tokyo.
Graduate School of Pharmaceutical Sciences, The University of Tokyo.
Drug Discov Ther. 2018;12(5):283-290. doi: 10.5582/ddt.2018.01044.
The Japanese government actively urges pharmacists to support efforts to reduce surplus medicines. However, these activities currently serve only to dispose of surplus medicines; no measures are being taken to fundamentally prevent the accumulation of surplus medicines from the outset. A deep understanding of patients' views about storing medicines at home and how they might be accumulating surplus medicines would contribute to the prevention of surplus accumulation. This study aimed to characterize the process by which elderly chronic disease patients in Japan accumulate surplus medicines. Semi-structured interviews were conducted with 18 elderly patients, and the interview data were analyzed using a modified grounded theory approach (M-GTA) to present the process by which surplus medicines were accumulated at patients' homes. The results suggest that elderly patients with chronic diseases often wish to avoid unnecessary medications because of anxiety about medicines, and that these patients seek to maximize medicine suppression. In this context, patients use their own judgment to decide whether to use medicines as needed. Additionally, when patients accumulate surplus medicines, they hesitate to throw them away because they feel that to do so is mottainai (wasteful), or because they accumulate surplus medicines as emergency household medicines. These findings reveal when and how surplus medicine accumulation occurs and the points at which pharmacists can easily intervene to promote a close relationship with patients.
日本政府积极敦促药剂师支持减少过剩药品的工作。然而，目前这些活动仅用于处理过剩药品；尚未采取任何措施从根本上防止过剩药品的累积。深入了解患者对在家中储存药品的看法以及他们可能累积过剩药品的方式，将有助于预防过剩药品的累积。本研究旨在描述日本老年慢性病患者累积过剩药品的过程。对18名老年患者进行了半结构化访谈，并使用改良的扎根理论方法（M-GTA）对访谈数据进行分析，以呈现患者家中过剩药品的累积过程。结果表明，患有慢性病的老年患者常常因对药品的担忧而希望避免不必要的用药，并且这些患者试图最大程度地减少用药。在此背景下，患者会自行判断是否按需用药。此外，当患者累积了过剩药品时，他们会因觉得扔掉很浪费（“もったいない”），或者将过剩药品作为家庭应急药品而犹豫是否扔掉。这些发现揭示了过剩药品累积的时间和方式，以及药剂师可以轻松干预以促进与患者建立密切关系的关键点。
