![]() | KOTAKE TakeshiDepartment of Pharmacy Professor |
Given the rapid spread of COVID-19, the case analysis debriefing session during pharmacy practice was changed from a group format to an online format. This report provides an overview of the online format of case analysis debriefing. In addition, we discuss the benefits and problems of the debriefing session that were revealed by the questionnaire survey. The online debriefing sessions were conducted by connecting trainees and evaluators from Osaka General Hospital of West Japan Railway Company via Zoom during the 6th and 11th weeks of practice. Most participants (83%) approved of the online debriefing sessions because of the ease of participation and time advantage. However, some participants disapproved due to the lack of realism and communication between participants in the group training. The online format is considered a very effective educational tool in a collaborative hospital-pharmacy-university setting. However, it was suggested that challenges remain with the online format, such as whether participants can create as much of an atmosphere as in the group format.
Since the passing of the (guidelines aimed to augment the role of the pharmacists in 2010) pharmacists are required to conduct patient vital checks. As a result, the Pharmaceutical Education Model Core Curriculum require physical assessment (PA) competencies of students. In order to carry out physical assessment task, volunteer subjects need to be recruited and trained to perform the role of simulated patients (SPs). However, to date, there are few investigations into SP attitudes toward PA. The purpose of this study is to conduct a questionnaire to investigate SP attitudes towards PA, and their understanding of the current state of the home medical care system. Responses from the questionnaire show volunteer SPs had little knowledge about PA and the home medical care system. During vital check examinations, SPs were open to having their blood measured but were averse to auscultation. This bias was stronger in woman than men. In terms of future considerations, the questionnaire results suggest volunteer SPs need to be instructed on the benefits of having comprehensive vital check assessments as well as understand the meaning of the role they are asked to play in order to better authenticate the patient/pharmacist relationship. This is particularly important as the performance of vital checks have expanded to become a part of home medical care practices.
In Sakai City Medical Center, creatinine clearance (Ccr) is described on prescriptions. When drugs to be regulated in accordance with the kidney function are prescribed, the term "kidney" follows the drug name. Furthermore, the submission of PreAVOID reports is promoted in our hospital, and the number of reports has slightly increased. Many reports associated with the kidney function have also been submitted. In this study, we examined the influence of patient/drug information described on prescriptions on the accuracy of dispensing/surveillance and optimization of prescription surveillance, as well as the timing of PreAVOID -report submission and changes in the contents. A prescription surveillance involving pharmacists in our hospital and university pharmacy students was conducted by preparing sham prescriptions. On all sham prescriptions, Ccr was described, and prescriptions with "kidney" and without such a description were prepared. The accuracy of surveillance and time required were established as endpoints. Concerning PreAVOID reports, we compared reports on drugs for which kidney-function-based regulation is necessary between PreAVOID report groups in 2015 ("kidney"-describing group (2015)) and 2014 (non-"kidney"-describing group (2014)). The accuracy of auditing prescriptions with the "kidney" description was significantly higher than that of auditing prescriptions without such a description, and the time required for surveillance was significantly shortened. When comparing the number of kidney-function-associated PreAVOID reports between the above two groups, it was significantly greater in the "kidney"-describing group (2015). These results suggest that information on prescriptions contributes to an improvement in the accuracy of dispensing/surveillance and reduction of the time required, facilitating accurate, efficient surveillance. Thus, the description of "drugs to be regulated in accordance with the kidney function" on prescriptions may be useful for achieving prompt drug therapy.
Studies in rabbits have been performed to evaluate the intraocular pressure (IOP)-reducing effect of various anti-glaucoma eye drops and eye drops of latanoprost (LP), which is a selective agonist of prostaglandin F receptor (FP). However, the sensitivity and localization of FP receptors in the rabbit eye are different from those in humans, and studying the relationship between IOP regulation and FP receptors in rabbits is important for the evaluation of antiglaucoma eye drops. In this study, we investigated whether stimulation of FP receptors in rabbits affects the regulation of aqueous humour production via β receptors by using the LP and the β-blocker timolol (TM). Ocular hypertension was induced in the rabbits by the infusion of a 5% glucose solution (15 mL/kg). Although no reduction in IOP was observed after the instillation of saline and 0.005% LP, 0.5% TM eye drops significantly reduced IOP. The IOP-reducing effect, as measured by area under the curve (AUC∆IOP) in rabbits treated with TM eye drops, was 81.3% that of LP 0.005%/TM 0.5% fixed combination (LTFC) eye drops, and the TM concentration in the aqueous humour following the instillation of LTFC eye drops was similar to that of TM eye drops. These results show that the stimulation of FP receptors affects the production of aqueous humour via β receptors in rabbits, meaning the rabbit model is not suitable for the evaluation of anti-glaucoma eye drops with FP receptor activity, since this drug effect was not observed in humans.