Miwako Kamei

Evaluation of estimated number of influenza patients from national sentinel surveillance using the national database of electronic medical claims.

Officially, the national official sentinel surveillance of infectious diseases (NOSSID) has been used to estimate the number of influenza patients nationwide; NOSSID is based on the Law Concerning the Prevention of Infectious Diseases and Medical Care for Patients of Infections (the Infectious Diseases Control Law). Prescription Surveillance (PS) has also provided a numerical estimate of influenza patients. This study compared these 2 estimations using NOSSID and PS with the numbers of influenza patients from all electronic medical claims (NDBEMC), which had the nearly-comprehensive data from surveys. Results showed that the estimate from NOSSID was about twice the estimate from the NDBEMC. However, the estimated number from the PS was almost equivalent to that from the NDBEMC. The estimated number of patients from NOSSID might not be precise, but NOSSID itself may be useful to monitor influenza trends.

The effect of one-dose package on medication adherence for the elderly care in Japan

Deterioration of the medication adherence for elderly could result in wasteful medical expenditure in a long-term span as well as aggravating the patient’s medical condition. Objective This study surveyed the effect of one-dose package medication made up by a pharmacist on the patient’s behavior towards medication, what is expected to be one of the measures to improve the medication adherence for elderly. Methods With support activity of the Pharmacist Association in Ueda-city in Nagano Prefecture, Japan, the survey form of one-dose package was sent to 86 pharmacy directors located in Ueda-city. Results The most frequent reasons of one dose packaging was “Patient’s request” though, “Large number of doses”, “Prevent the improper drug use” and “Improved medication adherence” which is considered that the pharmacists are willing to utilize one dose package for patient’s care in order to improve the medication adherence were chosen as well. The influences of one dose package for patient’s medication adherence were very positive, and most answers indicated that medication adherence was improved. Conclusion It is noticed that the pharmacists were willing to dispense one dose packaging by own decision, not physician’s order, in order to improve the medication adherence, prevent improper drug use and optimize the medication therapy. It is also noticed that there are great improvement of patient’s compliance by one dose package, and patients felt advantage to reduce the improper drug use as well.

Pharmaceutical Cost Comparison Analysis of Antimicrobial Use for Surgical Prophylaxis on Gastrectomy Patients in a Tertiary Care Hospital

The present study investigated the clinical effects and therapeutic cost of cefazolin (CEZ) and ampicillin/sulbactam (SBT/ABPC) compared to analyze cost-effectiveness for surgical prophylaxis in gastric cancer patients. 157 inpatients who underwent surgery for gastric cancer were investigated. There was no difference between the two groups with regard to sex, age, incidence of complication, stage of cancer, operative time and blood loss, length of hospitalization, the appearance of systematic inflammatory responses syndrome and the prophylactic effect of infection. Meanwhile, decision analysis indicated that the anticipated therapeutic cost per patient in CEZ group was less than that of SBT/ABPC group (USD 142.72 and USD 187.17, respectively). In this case, CEZ use was more cost-effective, insofar as only drug cost was considered.

Evaluation of the global action plan on antimicrobial resistance in Japan during its first eighteen months

Antimicrobial resistance (AMR) has garnered the most attention among public health concerns worldwide. Japan formulated a national action plan for AMR in April 2016. The plan seeks to reduce the amount of antimicrobials used in 2020 to two-thirds of the use recorded in 2013. Prescription surveillance (PS) is being used to monitor trends in the amount of antimicrobials used. PS estimates the number of patients prescribed an antimicrobial each day. The number of patients who were prescribed an antimicrobial under the action plan was analyzed by including dummy variables with other control variables. Data from April 1, 2011 to 30 September 30, 2017 were analyzed. When the number of patients with an infectious disease (1 of 13 specified diseases) served as a dummy variable, estimates indicated that the coefficient of that dummy variable was not significant. If the number of patients with an infectious disease (1 of 13 specified diseases) was excluded as an explanatory variable, then the estimated coefficient was significant. The global action plan in Japan might not reduce the amount of antimicrobials used. The current results indicated that the number of patients who were prescribed an antimicrobial did not decrease significantly after initiation of the action plan. This finding does not exclude the possibility that the average amount of antimicrobials used per patient has decreased.

Community pharmacists provided telephone treatment support for patients who received long-term prescribed medication

Purpose This study was conducted to evaluate whether a community pharmacist’s assistance during the treatment of a patient with a chronic illness would help to discover and improve issues regarding the treatment. Method We employed a prospective intervention study with a control group. The patients ranging in age from 60 to 74, were using one of the six selected community pharmacies in the Tokyo metropolitan area. They had been prescribed six or fewer kinds of medications, one of which was amlodipine. The medication dosages covered 1 month or longer. Patients who agreed to participate in the study were randomly assigned to the groups at each pharmacy. For the patients in the intervention group, the pharmacists provided telephone counseling between physician visits, in addition to the time they visited the pharmacies to collect their medications. For the patients in the control group, the pharmacists provided counseling only at their pharmacies. Results and discussion The average days of medication administration were 49.2 days for the 58 patients in the intervention group, and 49.8 days for the 53 patients in the control group, with the average number of medications being 3.4 items per person for both groups. Through the telephone counseling, we were able to collect more information, eg, changes in physical condition and occurrences of side effects, from the intervention group than from the control group. The rate of incident detection in the information from the intervention group was five times that of the control group, making subsequent incident resolutions faster. Conclusion This study suggested that phone counseling between physician visits could enable the identification of more issues regarding patients’ conditions.

Welfare analysis of a zero-smoking policy – A case study in Japan

Smoking cessation efforts in Japan reduce smoking rates. A future zero-smoking policy would completely prohibit smoking (0% rate). We therefore analyzed the social welfare of smokers and non-smokers under a hypothetical zero-smoking policy. The demand curve for smoking from 1990 to 2014 was estimated by defining quantity as the number of cigarettes smoked and price as total tobacco sales/total cigarettes smoked by the two-stage least squares method using the tax on tobacco as the instrumental variable. In the estimation equation (calculated using the ordinary least squares method), the price of tobacco was the dependent variable and tobacco quantity the explanatory variable. The estimated constant was 31.90, the estimated coefficient of quantity was - 0.0061 (both, p < 0.0004), and the determinant coefficient was 0.9187. Thus, the 2015 consumer surplus was 1.08 trillion yen (US

Proposition of real-time precise prediction model of infectious disease patients from Prescription Surveillance using the National Database of Electronic Medical Claims

9.82 billion) (95% confidence interval (CI), 889 billion yen (US

Antibody production to secretory component (SC) using recombinant SC fragment.

8.08 billion) - 1.27 trillion yen (US

Investigation of patients' demand for community pharmacies: relationship between pharmacy services and patient satisfaction.

11.6 billion)). Because tax revenue from tobacco in 2011 was 2.38 trillion yen (US

Comparative analysis of pharmacy services based on newly developed evaluation index.

21.6 billion), the estimated deadweight loss if smoking were prohibited in 2014 was 3.31 trillion yen (US