Journal of Pharmaceutical Health Care and Sciences最新文献

{"title":"Relationship of pre-diagnosis pharmacist continuity with patient-reported satisfaction at the first post-diagnosis community pharmacy visit among adolescents and young adults with cancer: a nationwide cross-sectional online survey.","authors":"Atsunobu Sagara, Tomofumi Watanabe, Tomoya Abe, Hiroyuki Terakado","doi":"10.1186/s40780-026-00589-9","DOIUrl":"10.1186/s40780-026-00589-9","url":null,"abstract":"<p><strong>Background: </strong>Adolescents and young adults (AYAs) with cancer often face developmental stage-specific challenges related to education and employment, interpersonal relationships, fertility, and family formation. Psychosocial support is important in cancer care, especially since psychological distress and anxiety tend to increase immediately after diagnosis. Some patients have an established relationship with a community pharmacist before diagnosis, but it remains unclear whether such continuity is associated with patient-reported satisfaction with pharmacist consultations during the early post-diagnosis period. Using nationwide survey data, this study investigated the association between patient-reported satisfaction at the first community pharmacy visit after an initial cancer diagnosis, assessed using the Medical Interview Satisfaction Scale Japanese version (MISS-21J), and pre-diagnosis pharmacist continuity.</p><p><strong>Methods: </strong>A nationwide cross-sectional online survey was conducted from March 25 to 27, 2025. Data were analyzed for 407 patients with an initial cancer diagnosis who were diagnosed at age 15-39 years and visited a community pharmacy after diagnosis. Participants were grouped according to the presence or absence of pre-diagnosis pharmacist continuity. The prespecified primary outcomes were the MISS-21J distress relief and rapport subscale scores, which reflect domains of patient-reported satisfaction with pharmacist consultations. Multivariable linear regression models (ordinary least squares) were fitted, adjusting for age at diagnosis, sex, cancer type, residential area, parents available, partner status, and minor children. Adjusted means (least-squares means; LSMeans) and adjusted mean differences with 95% confidence intervals (CIs) were reported.</p><p><strong>Results: </strong>For distress relief, the adjusted mean was 5.33 in patients with pre-diagnosis pharmacist continuity and 4.72 in those without such continuity (adjusted mean difference: 0.61; 95% CI, 0.42-0.81; p < 0.001). For rapport, the adjusted mean was 5.20 in patients with pre-diagnosis pharmacist continuity and 4.60 in those without such continuity (adjusted mean difference: 0.60; 95% CI, 0.41-0.80; p < 0.001).</p><p><strong>Conclusions: </strong>Among AYAs newly diagnosed with cancer, pre-diagnosis pharmacist continuity was associated with higher patient-reported satisfaction with pharmacist consultations, particularly in the MISS-21J domains of distress relief and rapport. These findings highlight the potential value of accessible, continuous relationships with pharmacists in improving patients' perceived pharmaceutical care experience during the early post-diagnosis period.</p>","PeriodicalId":16730,"journal":{"name":"Journal of Pharmaceutical Health Care and Sciences","volume":" ","pages":""},"PeriodicalIF":1.3,"publicationDate":"2026-06-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13479543/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148211660","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Therapeutic drug monitoring of intravenous amikacin during peritoneal dialysis for Mycobacterium abscessus exit-site infection: a case report.","authors":"Yuki Shimizu, Toshinori Hirai, Ei Kusahana, Kaori Hosonuma, Takeaki Watanabe, Keiko Kadota","doi":"10.1186/s40780-026-00593-z","DOIUrl":"10.1186/s40780-026-00593-z","url":null,"abstract":"<p><strong>Background: </strong>Patients with peritoneal dialysis (PD) often develop exit-site infections (ESI) caused by nontuberculous mycobacteria. Antimicrobial therapy, including intravenous amikacin (AMK), is combined with PD catheter removal to control the source of infection. However, the efficiency of AMK removal using PD remains unclear. In this report, we describe AMK pharmacokinetics before and after PD catheter removal in a patient diagnosed with Mycobacterium abscessus from ESI.</p><p><strong>Case presentation: </strong>A 73-year-old female PD patient weighing 42.4 kg who received intravenous AMK + clarithromycin + imipenem/cilastatin for Mycobacterium abscessus ESI on day 1 under therapeutic drug monitoring. During hospitalization, the patient underwent a typical PD regimen including nocturnal continuous ambulatory PD with Reguneal HCa 1.5^® (1.5% glucose) 1.5 L (2-hour storage) + Reguneal HCa 1.5^® 1.5 L or Extraneal^® (7.5% icodextrin) 1.5 L (11.5-hour storage). Dosing schedule of AMK was 200 mg every 48 h to maintain an AMK trough concentration around 10 µg/mL. On day 14, the PD catheter was removed and reinserted on the contralateral side for source control of the infection site and PD was discontinued until day 20. The elimination rate constant (Ke) of AMK was 0.027 h^- 1 obtained from peak concentration (C_peak) of 16.3 µg/mL on day 1 and trough concentration (C_trough) of 4.5 µg/mL on day 3. In contrast, Ke was 0.020 h^- 1 calculated from both C_peak of 22.2 µg/mL on day 9 and C_trough of 8.4 µg/mL on day 11, as well as C_peak of 23.8 µg/mL on day 17 and C_trough was 9.3 µg/mL on day 19. Combination antibiotic therapy was completed due to clinical improvement on day 27. Post-treatment, clofazimine and clarithromycin were administered orally, and the patient was discharged on day 32.</p><p><strong>Conclusions: </strong>The effect of PD on AMK concentration was limited during therapeutic drug monitoring.</p>","PeriodicalId":16730,"journal":{"name":"Journal of Pharmaceutical Health Care and Sciences","volume":" ","pages":""},"PeriodicalIF":1.3,"publicationDate":"2026-06-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13474739/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148204873","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Antibiotic prescribing patterns for management of acute diarrheal diseases at a university teaching hospital in Central Ethiopia.","authors":"Mengistu Girma, Sisay Endale, Tamrat Assefa Tadesse","doi":"10.1186/s40780-026-00592-0","DOIUrl":"10.1186/s40780-026-00592-0","url":null,"abstract":"<p><strong>Background: </strong>Antibiotic resistance has emerged largely due to the improper use of antibiotics in clinical practice, although most acute diarrheal diseases resolve without antibiotic treatment and should be reserved for cases of invasive bacterial or dysenteric diarrhea. This study aimed to assess the patterns of antibiotic use for acute diarrheal diseases at Nigist Elleni Mohammed Memorial Teaching Hospital (NEMMTH) in Central Ethiopia.</p><p><strong>Methods: </strong>A retrospective cross-sectional study was conducted to assess patients treated for diarrhea between January 1 and June 30, 2023. The appropriateness of antibiotic prescriptions for diarrhea was evaluated according to the Ethiopian Standard Treatment Guidelines. Data were collected using a structured abstraction form, and patient charts were selected through systematic random sampling. The analysis was performed using the Statistical Package for Social Sciences version 25.</p><p><strong>Results: </strong>Among 302 patients evaluated, 53.3% were female and 46.4% were children under five years old. Of the 302 patients, 57.6% had watery diarrhea. A total of 74.5% of patients received at least one antibiotic, of whom 73.5% received a single antibiotic during the treatment of acute diarrheal cases. The most commonly prescribed antibiotics were metronidazole (18.2%), cotrimoxazole (17.5%), and ciprofloxacin (11.6%). The proportion of inappropriate antibiotic prescribing was 77.1%.</p><p><strong>Conclusions: </strong>This study found a high level of inappropriate antibiotic use for acute diarrheal disease at NEMMTH. Metronidazole and cotrimoxazole are the most commonly prescribed antibiotics. Ensuring proper management by adhering to the standard treatment guidelines is crucial.</p>","PeriodicalId":16730,"journal":{"name":"Journal of Pharmaceutical Health Care and Sciences","volume":" ","pages":""},"PeriodicalIF":1.3,"publicationDate":"2026-06-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13471187/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148194835","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Educational effects of a workshop on quantitative drug-drug interaction assessment for pharmacists: a pre-post study.","authors":"Yuki Kondo, Takeshi Kimura, Takashi Tomita, Junichi Masuda, Atsushi Yonezawa, Yuichiro Yamamoto, Tetsuya Sugawara, Atsushi Takahata, Hiromi Sato, Naomi Nagai, Kazuya Maeda, Yoshiyuki Ohno","doi":"10.1186/s40780-026-00591-1","DOIUrl":"10.1186/s40780-026-00591-1","url":null,"abstract":"<p><strong>Background: </strong>Drug-drug interactions (DDIs) are a major cause of adverse drug events and require appropriate evaluation and management in clinical practice. Quantitative evaluation methods based on pharmacokinetic parameters have been proposed to assess the clinical significance of DDIs. The Pharmacokinetic Drug Interaction Significance Classification System (PISCS) provides a framework for estimating changes in drug exposure using the contribution ratio and inhibition ratio; however, opportunities for pharmacists to learn its practical application remain limited. This study aimed to evaluate the educational effects of a workshop on DDI management using quantitative evaluation methods.</p><p><strong>Methods: </strong>Workshops were conducted at two national pharmaceutical conferences in Japan. A total of 45 participants were included in the analysis. Participants completed questionnaires before and after the workshop. Self-efficacy in DDI management was assessed using a five-point Likert scale.</p><p><strong>Results: </strong>Although 60.0% of participants reported being aware of the PISCS, 55.6% had never used it in clinical practice. Self-efficacy significantly improved in all evaluated domains after the workshop, including confidence in obtaining DDI information, quantitatively predicting drug exposure changes, and making prescription proposals based on DDI evaluation (all p < 0.001). Furthermore, 95.6% of participants considered the workshop useful for clinical practice, and 91.1% reported that they felt able to apply the PISCS in prescription review and consultation.</p><p><strong>Conclusions: </strong>These findings suggest that a case-based workshop on quantitative DDI assessment may improve pharmacists' confidence in DDI management and facilitate the practical application of the PISCS in clinical settings.</p>","PeriodicalId":16730,"journal":{"name":"Journal of Pharmaceutical Health Care and Sciences","volume":" ","pages":""},"PeriodicalIF":1.3,"publicationDate":"2026-06-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13455426/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148163558","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effects of phenytoin on ethanol-induced gastric ulceration in rats: involvement of oxidative stress, inflammation, and apoptosis.","authors":"Kaveh Rahimi, Masoud Najafi, Shahrzad Fayazfard, Mehdi Esmaeili","doi":"10.1186/s40780-026-00582-2","DOIUrl":"10.1186/s40780-026-00582-2","url":null,"abstract":"<p><strong>Background: </strong>Peptic ulcer disease is a common gastrointestinal disorder caused by an imbalance between damaging factors and mucosal protection. Alcohol induces gastric injury through oxidative stress, inflammation, and apoptosis, while phenytoin may have potential preventive effects in ulcer. This study aimed to evaluate the gastroprotective effects of phenytoin against ethanol-induced gastric ulcers in rats, focusing on oxidative stress, inflammatory, and apoptotic biomarkers, and to elucidate the underlying molecular mechanisms.</p><p><strong>Methods: </strong>Thirty-two male Wistar rats were randomly divided into four groups: control, ethanol-induced gastric ulcer (ETH), phenytoin-treated (ETH + Phen), and omeprazole-treated (ETH + Ome). Gastric ulcers were induced by oral administration of absolute ethanol. Ulcer area, gastric content volume, oxidative stress markers (TAC, MDA, GSH, SOD, CAT), inflammatory mediators (NF-κB, TNF-α, IL-1β, iNOS, COX-2), and apoptotic markers (Bax, Bcl-2, Caspase-3) were measured using biochemical assays, real time PCR, and ELISA.</p><p><strong>Results: </strong>Ethanol administration significantly increased ulcer area, gastric content volume, MDA levels, NF-κB activation, pro-inflammatory cytokines, and pro-apoptotic markers, while reducing TAC, GSH, and antioxidant enzyme activities. Preventive phenytoin treatment significantly attenuated these effects, reducing ulcer area, restoring antioxidant balance, suppressing NF-κB-mediated inflammation, and modulating apoptotic signaling. Both phenytoin and omeprazole improved these parameters compared with the ethanol group; however, no direct statistical comparison between the two treatments was performed.</p><p><strong>Conclusion: </strong>Phenytoin exhibits significant gastroprotective effects against ethanol-induced gastric injury, which may be associated with modulation of oxidative stress, inflammatory pathways, and apoptosis.</p>","PeriodicalId":16730,"journal":{"name":"Journal of Pharmaceutical Health Care and Sciences","volume":" ","pages":""},"PeriodicalIF":1.3,"publicationDate":"2026-06-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13449315/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148156858","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Contribution of pharmacist intervention to postoperative nausea and vomiting prophylaxis in routine multidisciplinary practice: a retrospective observational study.","authors":"Kotaro Sato, Shinya Suzuki, Takuma Koinuma, Akinori Omata, Emiko Iguchi","doi":"10.1186/s40780-026-00590-2","DOIUrl":"10.1186/s40780-026-00590-2","url":null,"abstract":"<p><strong>Background: </strong>Postoperative nausea and vomiting (PONV) is a common surgical complication that delays recovery and increases healthcare costs. Although U.S. guidelines recommend multimodal, risk-stratified prophylaxis, Japan lacks unified national guidelines, resulting in practice variation. Despite expanded insurance coverage for 5-HT₃ receptor antagonists, sustained adherence to best practices requires a multidisciplinary framework. We implemented a pharmacist-led, multidisciplinary PONV prevention protocol and evaluated its impact on PONV incidence among adults undergoing elective surgery across multiple specialties.</p><p><strong>Methods: </strong>We developed a pharmacist-led multidisciplinary PONV prevention protocol based on U.S. guideline algorithms, recommending ≥ 2 and ≥3 prophylactic agents for medium- and high-risk patients, respectively. Pharmacists in the admission support center collected preoperative risk factors, while operating room pharmacists relayed assessments to anesthesiologists and nurses. We conducted a retrospective observational study of patients aged ≥ 18 years undergoing elective gastrointestinal or gynecological surgery under general anesthesia. We compared 110 and 255 patients in the pre- and post-intervention groups, respectively, focusing on patients at medium to high risk. For primary analysis, we performed 1:1 propensity score matching (PSM) using five covariates to control for confounding. Conditional logistic regression evaluated intervention effects while accounting for the matched design.</p><p><strong>Results: </strong>The final analysis included 106 controls and 243 intervention patients. PSM produced 103 well-balanced matched pairs (standardized differences < 0.1). Conditional logistic regression showed that the pharmacist-led intervention significantly reduced PONV occurrence (odds ratio [OR] 0.308, 95% confidence interval [CI], 0.139-0.680). Prophylactic agent use increased significantly after the intervention (OR 3.95, 95% CI 2.43-6.54), with dexamethasone (OR 5.92, 95% CI 3.03-11.60) and 5-HT₃ receptor antagonists (OR 4.98, 95% CI 2.69-9.22) showing the largest increases. Dopamine antagonists and total intravenous anesthesia administration also showed upward trends, though without statistical significance.</p><p><strong>Conclusions: </strong>The implementation of a pharmacist-led multidisciplinary PONV prevention protocol was associated with a lower incidence of PONV in medium- to high-risk patients. Pharmacist-conducted preoperative risk assessment improved the implementation of risk-based prophylaxis within a multidisciplinary framework. These findings suggest that pharmacist-driven collaborative approaches may facilitate more consistent PONV prophylaxis in clinical settings lacking unified guidelines.</p>","PeriodicalId":16730,"journal":{"name":"Journal of Pharmaceutical Health Care and Sciences","volume":" ","pages":""},"PeriodicalIF":1.3,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13435793/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148138441","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A survey of community pharmacists' perceptions, attitudes, and practices regarding support for physical activity, exercise, and frailty.","authors":"Takuya Azechi, Miho Yamamura, Eiji Kose, Toshimi Kimura","doi":"10.1186/s40780-026-00588-w","DOIUrl":"10.1186/s40780-026-00588-w","url":null,"abstract":"<p><strong>Background: </strong>Community pharmacists are expected to contribute to frailty prevention through physical activity and exercise support. However, their definitive involvement and the factors influencing their engagement remain unclear.</p><p><strong>Methods: </strong>An anonymous online questionnaire-based survey targeting pharmacists working in community pharmacies or the pharmacy sections of drugstores was conducted from November 2024 to March 2025. The survey assessed their recognition, attitudes, and practices regarding frailty and support for physical activity and exercise. Frailty assessment was defined as responses of \"occasionally\" or more. Descriptive statistics and multivariate logistic regression were used for the analysis.</p><p><strong>Results: </strong>Among the 1,054 responses, 89.8% expressed positive attitudes toward supporting physical activity and exercise, but insufficient knowledge and lack of confidence were major barriers. Furthermore, although 88.3% of respondents considered awareness of the patient frailty status to be important and 60.1% recognized the importance of pharmacist-led frailty assessments, only 29.6% performed such assessments. The independent factors associated with frailty assessment were implementation of pharmacist-led support for physical activity and exercise (adjusted odds ratio [aOR]: 2.46; 95% confidence interval [CI]: 1.73-3.50), recognition of the importance of frailty assessment (aOR: 2.83; 95% CI: 1.97-4.07), and availability of educational opportunities related to physical activity and exercise support (aOR: 1.62; 95% CI: 1.12-2.34).</p><p><strong>Conclusion: </strong>While many pharmacists recognize the importance of frailty care, their involvement remains limited due to insufficient knowledge. Practical and educational experiences regarding physical activity and exercise support were significantly associated with frailty assessment practices, suggesting their importance in promoting future pharmacists' engagement in frailty prevention.</p>","PeriodicalId":16730,"journal":{"name":"Journal of Pharmaceutical Health Care and Sciences","volume":" ","pages":""},"PeriodicalIF":1.3,"publicationDate":"2026-05-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13397794/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148042526","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Safety and effects of continuous argatroban administration in acute cerebral infarction: a retrospective analysis.","authors":"Machiko Hirai, Yuki Shigetsura, Daiki Hira, Takakuni Maki, Masayoshi Kawata, Shunsaku Nakagawa, Riki Matsumoto, Tomohiro Terada","doi":"10.1186/s40780-026-00585-z","DOIUrl":"10.1186/s40780-026-00585-z","url":null,"abstract":"<p><strong>Background: </strong>Argatroban is an antithrombotic agent commonly used in the acute phase of cerebral infarction. Although the standard administration method is continuous infusion within the first 2 days only, many patients receive continuous intravenous infusion beyond day 3 owing to concerns of symptoms worsening during intermittent dosing, which may be insufficient given the short half-life of argatroban. However, evidence supporting the continuous intravenous infusion beyond day 3 remains limited. This study aimed to compare the safety and efficacy between continuous and intermittent argatroban administration.</p><p><strong>Methods: </strong>Patients who received argatroban for acute cerebral infarction at Kyoto University Hospital between January 2019 and August 2021 were retrospectively evaluated. The patients were categorized based on actual treatment regimens into either the intermittent or continuous infusion group. Clinical characteristics, safety outcomes, and neurological status were then compared between the groups. The primary outcome was the incidence of bleeding events, and the secondary outcome was neurological status, as assessed using the manual muscle test.</p><p><strong>Results: </strong>No clear difference in safety was observed between the two groups. The proportion of patients with a manual muscle test score of 10 significantly increased over time in the intermittent infusion group, whereas no such trend was observed in the continuous infusion group. Subgroup analysis by stroke type showed a similar increasing trend in all groups except the continuous infusion group with branch atheromatous disease, which is known to be associated with a high risk of early neurological deterioration.</p><p><strong>Conclusion: </strong>Continuous argatroban administration was not associated with an increased risk of bleeding events within the limitations of the current study, despite more intensive concomitant antithrombotic therapy. Although no clear neurological improvement was observed, continuous administration may represent a feasible treatment option in carefully selected patients; however, these findings should be interpreted with caution due to baseline imbalances and potential selection bias, warranting further prospective investigation.</p>","PeriodicalId":16730,"journal":{"name":"Journal of Pharmaceutical Health Care and Sciences","volume":" ","pages":""},"PeriodicalIF":1.3,"publicationDate":"2026-05-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13403830/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148055091","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Evaluation of adverse drug reactions in cancer-related settings using diverse real-world data.","authors":"Ryo Inose","doi":"10.1186/s40780-026-00587-x","DOIUrl":"10.1186/s40780-026-00587-x","url":null,"abstract":"<p><p>The evaluation of adverse drug reactions in cancer-related settings represents a complex clinical challenge that extends beyond the toxicities associated with anticancer therapies, including drug-induced malignancies and treatment-related complications, in heterogeneous patient populations. Since randomized controlled trials are conducted in highly selected populations, their findings are not always directly generalizable to routine clinical practice. In this context, real-world data (RWD) have become an important resource for evaluating drug safety and clinical outcomes in real-world clinical practice. This review provides an overview of RWD-based approaches for evaluating adverse drug reactions in cancer-related settings, with a particular focus on how different data sources can be used to address clinically relevant safety questions. Electronic medical records enable the detailed evaluation of patient-level clinical information and have been used to identify clinical and pharmacokinetic factors associated with adverse drug reactions. Spontaneous adverse event reporting databases are particularly useful for detecting rare and unexpected adverse events, including drug-induced malignancies. Medical claims databases enable large-scale longitudinal analyses and evaluation of the incidence and time-to-onset of adverse drug reactions. Additionally, the Diagnosis Procedure Combination database provides detailed inpatient information and has been used to evaluate treatment-related complications in routine clinical practice. As each type of RWD has distinct strengths and limitations, the choice of an appropriate data source should be guided by a specific research objective. Selecting the most suitable RWD source according to the research question is essential for appropriately evaluating adverse drug reactions. This approach enables the assessment of diverse clinically relevant safety issues in cancer-related settings and supports the generation of evidence that reflects routine clinical practice.</p>","PeriodicalId":16730,"journal":{"name":"Journal of Pharmaceutical Health Care and Sciences","volume":" ","pages":""},"PeriodicalIF":1.3,"publicationDate":"2026-05-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13378064/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148005611","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Delayed decrease in voriconazole concentration after resolution of inflammation in a patient with invasive pulmonary aspergillosis: a case report.","authors":"Haruka Igarashi, Hayato Yokota, Ayano Saito, Yumiko Akamine, Naoto Takahashi, Masafumi Kikuchi","doi":"10.1186/s40780-026-00583-1","DOIUrl":"10.1186/s40780-026-00583-1","url":null,"abstract":"<p><strong>Background: </strong>Voriconazole (VRCZ) is an effective treatment for pulmonary aspergillosis. Active infectious disease leads to a reduction in cytochrome P450 activity, resulting in increased VRCZ concentrations. However, the impact of VRCZ dose reduction during the severe inflammatory state on VRCZ concentrations after the resolution of inflammation is not yet fully understood. Here, we report the time-course changes in VRCZ blood concentrations after inflammation in a patient with invasive pulmonary aspergillosis.</p><p><strong>Case presentation: </strong>A man in his 60s receiving oral VRCZ tablets at 400 mg/day for invasive pulmonary aspergillosis developed marked inflammation due to bacterial pneumonia and influenza virus infection. C-reactive protein (CRP) levels increased to a peak of 35.54 mg/dL, with a concomitant elevation in the VRCZ trough concentration to 4.7 µg/mL. Following dose reduction to VRCZ 300 mg/day, the trough concentration decreased to 1.1 µg/mL on day 11 after dose reduction, while CRP declined to 4.78 mg/dL after antibiotic therapy. VRCZ was continued at the same dose. However, four weeks after CRP levels had stabilized, the VRCZ concentration decreased to 0.6 µg/mL. After re-escalation of VRCZ to 400 mg/day, the trough concentration returned to the effective therapeutic range of 1.1 µg/mL.</p><p><strong>Conclusions: </strong>After infection is controlled, VRCZ concentrations may decrease to levels below the therapeutic range. Following VRCZ dose reduction during a high inflammatory state, reassessment of trough concentrations after improvement of inflammation may be useful to prevent excessive decreases in VRCZ concentrations.</p>","PeriodicalId":16730,"journal":{"name":"Journal of Pharmaceutical Health Care and Sciences","volume":" ","pages":""},"PeriodicalIF":1.3,"publicationDate":"2026-05-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13352798/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147973251","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}