Journal of Pharmaceutical Health Care and Sciences最新文献

{"title":"Preliminary clinical evaluation of cefmetazole dosing regimens in Japanese patients with urinary tract infections.","authors":"Yuna Sadaka, Kokoro Nakajima, Yuki Sasaki, Mao Tsurugaya, Yasuhisa Oida, Midori Soda, Tomoyuki Hirashita, Kotoe Inoue, Yoshito Takahashi, Tsuyoshi Yokoi, Kiyoyuki Kitaichi","doi":"10.1186/s40780-025-00535-1","DOIUrl":"10.1186/s40780-025-00535-1","url":null,"abstract":"<p><p>BACKGROUND: Cefmetazole (CMZ) is widely used in Japan to treat infections such as urinary tract infections (UTIs), intra-abdominal infections, and bloodstream infections. However, pharmacokinetic and pharmacodynamic (PK/PD) data supporting the appropriate use of CMZ in Japanese patients with UTIs remain limited. Thus, as a preliminary study, we evaluated steady-state plasma concentrations of CMZ in Japanese patients with mild to moderate UTIs. METHODS: Twenty-three patients with mild to moderate UTIs admitted to the Department of Urology at Gifu Prefectural General Medical Center from October 2022 to January 2023 were enrolled. Two patients were excluded due to inappropriate sampling timing and lack of steady-state samples, resulting in 21 patients included in the final analysis. Repeated doses of cefmetazole (CMZ, 1 g-per dose) were administered at various intervals (6, 8, 12, or 24 h) based on renal function. Steady-state plasma samples 2–3.25 h after infusion (near peak) as well as just before the next dose (near trough) were collected. Plasma concentrations of CMZ were measured using a validated high-performance liquid chromatography (HPLC) method. The relationship between plasma concentrations of CMZ and creatinine clearance (Ccr) was analyzed. RESULTS: CMZ effectively treated ESBL-E-induced UTIs in all patients (n = 5). With CMZ dosing regimens based on renal function, the mean (± SD) steady-state plasma concentrations at near-peak and near-trough were 73.8 ± 27.1 µg/mL and 14.0 ± 11.0 µg/mL, respectively. Steady-state near-peak plasma concentrations of CMZ (n = 19) were found to be negatively correlated with Ccr (R = − 0.70, p < 0.001). However, there is no correlation between Ccr and near-trough plasma concentrations of CMZ (n = 11, R = − 0.53). CONCLUSIONS: Preliminary clinical data suggest the potential appropriateness of the CMZ dosing regimen in patients with mild to moderate UTIs based on renal function, although further detailed population PK/PD analysis would be necessary. </p>","PeriodicalId":16730,"journal":{"name":"Journal of Pharmaceutical Health Care and Sciences","volume":" ","pages":"12"},"PeriodicalIF":1.3,"publicationDate":"2025-12-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12853748/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145846840","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":"Impact of a tailored, department-specific antimicrobial stewardship team intervention based on AWaRe guidelines: a single-center, cohort, interrupted-time series study.","authors":"Yusuke Yagi, Yu Arakawa, Yukihiro Hamada, Yuka Yamagishi","doi":"10.1186/s40780-025-00525-3","DOIUrl":"10.1186/s40780-025-00525-3","url":null,"abstract":"<p><strong>Background: </strong>The global crisis of antimicrobial resistance (AMR) necessitates robust antimicrobial stewardship. The World Health Organization's (WHO) Access, Watch, Reserve (AWaRe) classification is a key tool for guiding antibiotic prescribing to combat AMR. The WHO's global target was to have at least 60% of antibiotic consumption fall into the Access category by 2023. This study evaluated the effectiveness of localized interventions toward this goal.</p><p><strong>Methods: </strong>This retrospective, longitudinal study analyzed oral outpatient antibiotic prescriptions at Kochi Medical School Hospital from April 2022 to June 2025. Data included defined daily doses (DDDs), days of therapy (DOTs), and AWaRe classifications. Based on a preceding analysis, the antimicrobial stewardship team (AST) implemented targeted, department-specific educational interventions starting in April 2024. The impact was evaluated using seasonally adjusted time-series analysis and regression models. The study also included a survey of Escherichia coli susceptibility to levofloxacin, ciprofloxacin, and sulfamethoxazole/trimethoprim from outpatient urinary isolates.</p><p><strong>Results: </strong>The AST intervention led to a statistically significant increase in the usage proportion and DDDs of Access antibiotics (+ 2.92%, p = 0.005 and + 376.5 DDDs, p = 0.001, respectively), with a corresponding decrease in Watch antibiotics (-3.00%, p = 0.003). However, DOTs did not significantly change, indicating the intervention primarily impacted drug choice, not treatment duration. Top prescribed agents were clarithromycin (24.2%), sulfamethoxazole/trimethoprim (20.7%), and rifaximin (10.7%). E. coli susceptibility to levofloxacin and ciprofloxacin was low (< 80% overall), particularly in extended-spectrum β-lactamase (ESBL)-producing strains (~ 10%). Sulfamethoxazole/trimethoprim susceptibility remained high overall (≥ 80%) but was low (< 80%) for ESBL-producing strains.</p><p><strong>Conclusions: </strong>AST interventions successfully shifted outpatient prescribing from Watch to Access antibiotics, demonstrating that targeted interventions can modify prescribing behavior. However, challenges remain, such as addressing treatment duration and achieving broader goals. The observed resistance patterns highlight the critical need for prescribers to consult local antibiograms. Future strategies require a more comprehensive approach, including real-time alerts and improved diagnostics, to further optimize antibiotic use and combat AMR.</p>","PeriodicalId":16730,"journal":{"name":"Journal of Pharmaceutical Health Care and Sciences","volume":" ","pages":"11"},"PeriodicalIF":1.2,"publicationDate":"2025-12-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12849487/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145834125","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":"Temporal trends in the prescription of traditional Japanese herbal (Kampo) medicines to pregnant women: analysis of an administrative hospital database in Japan.","authors":"Daisuke Kikuchi, Taku Obara, Shiro Hatakeyama, Risa Josaka, Misaki Tokunaga, Kouji Okada, Yuriko Murai","doi":"10.1186/s40780-025-00515-5","DOIUrl":"10.1186/s40780-025-00515-5","url":null,"abstract":"<p><strong>Background: </strong>Japanese traditional (Kampo) medicines are commonly prescribed in clinical practice, with increasing evidence supporting their use during pregnancy. The efficacy and safety of Kampo medicines during pregnancy have increasingly been studied; however, evidence in support of these medicines is inadequate. Thus, we conducted a temporal trend analysis of Kampo medicine prescriptions to determine the Kampo medicines for which further safety evidence is required.</p><p><strong>Methods: </strong>Administrative data from pregnant Japanese women who visited acute-care diagnosis procedure combination hospitals between January 1, 2014, and December 31, 2023, were used in this study. Therapeutic categories related to the Kyoto Encyclopedia of Genes and Genomes D numbers 5100 and 5200 were defined as target Kampo medicines. Annual prescription trends were calculated as proportions. Temporal trends in the proportion of prescriptions for each Kampo medicine were assessed using the Cochran-Armitage trend test. Statistical significance was set at p < 0.05.</p><p><strong>Results: </strong>Between 2014 and 2023, the proportion of Kampo medicine prescriptions increased significantly from 12.0% to 13.6% (p < 0.001). As of 2023, tokishakuyakusan (2.9%) was the most prescribed medication, followed by kakkonto (2.4%) and daikenchuto (2.0%). From 2014 to 2023, the proportions of tokishakuyakusan (3.3% to 2.9%) and kakkonto (2.4% to 2.4%) prescriptions showed no significant temporal changes (p = 0.07 and 0.36, respectively). In contrast, the proportion of daikenchuto prescriptions increased significantly from 0.8% to 2.0% (p < 0.001).</p><p><strong>Conclusion: </strong>The primary prescribed Kampo medicines were those with established safety evidence for use in pregnant women. The proportion of Kampo medicine prescriptions for pregnant women in Japan has increased over time, with tokishakuyakusan being the most prescribed during the study period.</p>","PeriodicalId":16730,"journal":{"name":"Journal of Pharmaceutical Health Care and Sciences","volume":"11 1","pages":"112"},"PeriodicalIF":1.2,"publicationDate":"2025-12-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12729618/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145827894","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":"Efficacy of protocol-based pharmacotherapy management in switching of antibiotic administration routes and dose adjustment based on renal function: a before-after study.","authors":"Yuki Sato, Yudai Takatani, Shunsaku Nakagawa, Yoshiki Katada, Yasuhiro Tsuchido, Mitsuhiro Sugimoto, Masanori Kimata, Mamiko Saigo, Masahiro Tsuda, Shigeru Ohtsuru, Tomohiro Terada","doi":"10.1186/s40780-025-00512-8","DOIUrl":"10.1186/s40780-025-00512-8","url":null,"abstract":"<p><p>BACKGROUND: Antibiotics are crucial for treating infectious diseases, but their appropriate use is essential to minimize adverse reactions and resistance. This study evaluated the effectiveness of protocol-based pharmacotherapy management (PBPM) based on renal function in adjusting antibiotic dosage and implementing an intravenous-to-oral switch in older patients at high risk of drug-related adverse events. The study compared antibiotic treatment outcomes before and after PBPM implementation at Kyoto University Hospital. METHODS: This before-and-after study included patients aged ≥ 65 years diagnosed with community-acquired pneumonia or uncomplicated pyelonephritis at Kyoto University Hospital. The control group (January to December 2021) received conventional antibiotic treatment, whereas the PBPM group (June 2022 to May 2023) received treatment based on a protocol developed by pharmacists, emergency physicians, and infectious disease specialists. Primary and secondary outcomes included antibiotic administration duration, clinical response, adverse reactions, and costs. RESULTS: The study included 78 patients (40 control, 38 PBPM). The PBPM group showed a significantly shorter total antibiotic treatment duration (9.6 ± 4.4 vs. 7.5 ± 2.4 days, P < 0.05) and intravenous administration duration (7.1 ± 2.8 vs. 5.6 ± 2.2 days, P < 0.01) compared with the control group. The PBPM group also demonstrated lower clinical treatment failure rates and reduced incidences of acute kidney injury and alanine aminotransferase elevation. Antibiotic costs per patient were 13% lower in the PBPM group. There were no significant differences in early clinical response, readmission rates, or mortality between groups. CONCLUSIONS: PBPM, conducted collaboratively by pharmacists and physicians, effectively optimized antibiotic use, reduced adverse event risks, shortened treatment duration, and lowered healthcare costs without compromising clinical outcomes. These findings support PBPM implementation to improve antibiotic stewardship in older patients with common infections. CLINICAL TRIAL NUMBER: Not applicable. </p>","PeriodicalId":16730,"journal":{"name":"Journal of Pharmaceutical Health Care and Sciences","volume":"11 1","pages":"113"},"PeriodicalIF":1.3,"publicationDate":"2025-12-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12729801/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145827960","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":"Successful re-administration after nano-liposomal irinotecan-induced severe hypersensitivity reaction: a case report.","authors":"Ryota Kanno, Yoshitaka Saito, Yoh Takekuma, Kazuaki Harada, Yoshito Komatsu, Mitsuru Sugawara","doi":"10.1186/s40780-025-00514-6","DOIUrl":"10.1186/s40780-025-00514-6","url":null,"abstract":"<p><strong>Background: </strong>Nano-liposomal irinotecan (nal-IRI) combined with 5-fluorouracil (5-FU) and levofolinate has been reported to extend the survival of patients with pancreatic cancer and represents an effective second-line treatment. Nal-IRI encapsulates IRI in liposomes modified with polyethylene glycol (PEGylation), which can lead to infusion reactions. Hypersensitivity reactions (HSR) to chemotherapeutic agents include both allergic and infusion reactions, which are difficult to distinguish. Severe HSR can be fatal; however, discontinuation of the suspected drug directly affects the treatment strategy. We report a case of severe HSR during the first nal-IRI administration, in which treatment was successfully continued with supportive management.</p><p><strong>Case presentation: </strong>A woman in her early 80s with metastatic pancreatic cancer received nal-IRI + 5-FU + levofolinate as second-line treatment. Five minutes after the initiation of the first nal-IRI infusion, the patient developed a tightening sensation in the head, respiratory distress, convulsions, and loss of consciousness, with percutaneous oxygen saturation dropping to the 80% range. The nal-IRI infusion was immediately discontinued, and emergency management was initiated with intravenous infusion of hydrocortisone, famotidine, d-chlorpheniramine maleate, and oxygen administration, resulting in symptom improvement. Given the limited treatment options for metastatic pancreatic cancer and the patient's strong desire to continue therapy, we decided to re-administer the regimen with intensified management, increasing dexamethasone to 19.8 mg and adding famotidine 20 mg and d-chlorpheniramine maleate 5 mg. Furthermore, we adopted a three-step dose-escalation method. The infusion was started at one-third of the standard rate, increased to two-thirds after 30 min, and finally adjusted to the full rate after another 30 min, after confirming the absence of HSR symptoms. Consequently, the patient did not exhibit any signs of HSR, and the same administration method was continued for 11 cycles until disease progression.</p><p><strong>Conclusions: </strong>The novelty of this report lies in presenting, for the first time, the detailed course and process by which treatment was successfully continued in a patient experiencing severe HSR upon initial nal-IRI administration, through enhanced supportive care tailored to the characteristics of the drug and stepwise dose adjustment.</p>","PeriodicalId":16730,"journal":{"name":"Journal of Pharmaceutical Health Care and Sciences","volume":"11 1","pages":"110"},"PeriodicalIF":1.2,"publicationDate":"2025-12-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12723823/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145809582","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":"Association between dispensing regulations for extended-release methylphenidate and prescription trends in Japan: an exploratory descriptive study.","authors":"Kazumasa Kotake, Toshiki Nakamura, Yuki Nakano, Naoya Kitamura","doi":"10.1186/s40780-025-00531-5","DOIUrl":"10.1186/s40780-025-00531-5","url":null,"abstract":"<p><p>BACKGROUND: In December 2019, a nationwide registration system with strict distribution controls for extended-release methylphenidate (ER-MPH) was introduced to prevent inappropriate use while maintaining treatment access for patients with attention deficit hyperactivity disorder (ADHD). However, its impact on prescription patterns remains unclear. METHODS: We conducted an observational study using Japan’s National Database of Health Insurance Claims from 2016 to 2022. ER-MPH prescription volumes were calculated as defined daily doses per 1,000 individuals. Interrupted time series (ITS) analysis was performed to assess the impact of the 2019 distribution-control policy across age and sex groups. We additionally examined whether regional differences in prescription trends could be explained by access to care by assessing the correlation between ER-MPH prescription volumes and the distribution of board-certified pediatricians using Pearson’s correlation coefficients. RESULTS: ER-MPH prescriptions continued to increase after the 2019 policy implementation, but ITS analysis revealed a substantial slowdown in the growth rate. Prescriptions declined immediately by 7% at policy implementation (level change incidence rate ratio [IRR] = 0.93, 95% confidence interval [CI]: 0.89–0.96), and the annual growth rate slowed from 27% pre-policy (IRR = 1.27, 95% CI: 1.25–1.28) to 9% post-policy (IRR = 1.09, 95% CI: 1.08–1.10) (slope change IRR = 0.86, 95% CI: 0.85–0.87). Age-stratified analyses revealed differential impacts: individuals aged < 20 years showed a 47% immediate decline (IRR = 0.53, 95% CI: 0.42–0.68) with nearly flat subsequent growth, while adults aged ≥ 20 years had only a 19% reduction (IRR = 0.81, 95% CI: 0.79–0.84) and continued slower growth. Sex-specific analyses also showed attenuated growth. The correlation between prescription volumes and pediatrician distribution was weak, indicating no substantial relationship. CONCLUSIONS: The 2019 distribution-control measures markedly attenuated the existing upward trend, especially among individuals aged < 20 years. Although prescription patterns differed by age and sex, these differences alone did not fully explain the overall attenuation, and regional variation showed only weak correlations with pediatrician distribution. These findings suggest that additional factors such as psychiatrist availability and broader healthcare system characteristics may also have influenced prescribing trends, underscoring the need for further investigation. </p>","PeriodicalId":16730,"journal":{"name":"Journal of Pharmaceutical Health Care and Sciences","volume":" ","pages":"111"},"PeriodicalIF":1.3,"publicationDate":"2025-12-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12729221/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145809847","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":"Postoperative opioid-free analgesia with acetaminophen and its impact on pain and postoperative nausea and vomiting following arthroscopic rotator cuff repair: a single-center retrospective study.","authors":"Misa Okizuka, Ryo Inose, Shiho Maruoka, Mikiko Takeuchi, Subaru Hirotsu, Miki Nakamura, Yuichi Muraki","doi":"10.1186/s40780-025-00530-6","DOIUrl":"10.1186/s40780-025-00530-6","url":null,"abstract":"<p><p>BACKGROUND: Opioids are commonly used for postoperative analgesia after arthroscopic rotator cuff repair; however, they pose an increased risk of postoperative nausea and vomiting. Therefore, multimodal analgesia using non-opioid analgesics is recommended. However, the efficacy of postoperative opioid-free analgesia, including acetaminophen, has not been fully elucidated. Therefore, this study aimed to assess the effect of postoperative opioid-free, acetaminophen-containing analgesia on postoperative outcomes in patients undergoing arthroscopic rotator cuff repair. METHODS: Patients who underwent arthroscopic rotator cuff repair at Rakuwakai Marutamachi Hospital between June 2022 and May 2025 were included. The patients were divided into postoperative opioid and opioid-free groups. Propensity score matching was used to balance baseline characteristics. The postoperative outcomes, including pain scores, incidence of nausea and vomiting, use of additional analgesics, and length of postoperative hospital stay, were compared between the groups. RESULTS: After propensity score matching, 78 patients were assigned to each group. Postoperative pain scores did not significantly differ between the groups. However, the postoperative opioid-free group had a significantly lower incidence of nausea and vomiting (5.1% vs. 20.5%, p < 0.05) and use of additional analgesics (5.1% vs. 20.5%, p < 0.05). The length of postoperative hospital stay did not differ significantly between the groups (13 days vs. 11.5 days, p = 0.268). CONCLUSIONS: Postoperative opioid-free analgesia, including acetaminophen, may provide pain control comparable to conventional opioid-based strategies, reduce the incidence of postoperative nausea and vomiting, and represent a safe and effective approach for postoperative analgesia after arthroscopic rotator cuff repair. </p>","PeriodicalId":16730,"journal":{"name":"Journal of Pharmaceutical Health Care and Sciences","volume":" ","pages":"115"},"PeriodicalIF":1.3,"publicationDate":"2025-12-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12751185/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145809869","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":"Impact of a local formulary on prescribing patterns and pharmaceutical expenditure: an observational study in Japan.","authors":"Hirofumi Koike, Maho Taguchi, Akihiro Koide, Hiroaki Yamada","doi":"10.1186/s40780-025-00526-2","DOIUrl":"10.1186/s40780-025-00526-2","url":null,"abstract":"<p><strong>Background: </strong>The implementation of local formularies in Japan began in November 2018 in the Sakata area of Yamagata Prefecture. A local formulary is a regional list of recommended pharmaceuticals selected based on comprehensive criteria, including efficacy, safety, and economic considerations. However, the economic impact of these formulations has not yet been clearly demonstrated. This retrospective observational study aimed to verify their effectiveness by analyzing real-world data.</p><p><strong>Methods: </strong>Prescription and outpatient data from the National Database were extracted for October 2018, 2019, and 2020, covering both the Sakata area and the rest of Yamagata Prefecture. The number of prescriptions and cost per prescription were calculated for four therapeutic classes: proton pump inhibitors/potassium-competitive acid blockers, angiotensin receptor blockers, α-glucosidase inhibitors, and statins.</p><p><strong>Results: </strong>In 2020, the formulary adherence rate in Sakata exceeded that in the rest of Yamagata Prefecture across all therapeutic classes. Although the cost per prescription annually decreased in Sakata, some therapeutic classes showed increased costs in the remainder of the prefecture from 2019 to 2020. In contrast, formulary adherence to outpatient medical prescriptions was lower in Sakata, and no clear impact of the local formulary was observed. Applying the rate of cost reduction observed in Sakata to the rest of the prefecture, the estimated monthly savings reached approximately 35 million JPY after 1 year and 15 million JPY after 2 years. Furthermore, although no prior measures existed to control the use of originator drugs without generics, Sakata showed a trend of reduced usage compared with the rest of the prefecture, suggesting the influence of the local formulary.</p><p><strong>Conclusions: </strong>Local formularies can contribute to the sustainability of Japan's healthcare financing systems.</p>","PeriodicalId":16730,"journal":{"name":"Journal of Pharmaceutical Health Care and Sciences","volume":" ","pages":"114"},"PeriodicalIF":1.2,"publicationDate":"2025-12-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12751966/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145809805","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 the pSMILE (Palliative care-Situational Motivating Interactive Learning and Education) educational program based on web-based and face-to-face workshops for palliative care pharmacists.","authors":"Megumi Kabeya, Mayako Uchida, Masahiko Amagawa, Makio Imamura, Yoko Kasahara, Yasunori Miyamoto, Takuya Yano, Takayuki Nakagawa","doi":"10.1186/s40780-025-00491-w","DOIUrl":"10.1186/s40780-025-00491-w","url":null,"abstract":"<p><strong>Background: </strong>In 2021, the Education and Training Committee of the Japanese Society for Pharmaceutical Palliative Care and Sciences established an educational training program for pharmacists in palliative care, named Palliative care-Situational Motivating Interactive Learning and Education (pSMILE), based on web-based and face-to-face workshops. The program aims to enhance pharmacists' knowledge of palliative care and develop communication and cooperation skills.</p><p><strong>Methods: </strong>We constructed a web-based pSMILE training program, which was later adapted for face-to-face workshops. This program consisted of two sessions, with the first half at a hospital and the second half at a clinic or community pharmacy. The participants could choose from three learning scenarios. A post-survey (within 1 week of the workshop) assessed usefulness, difficulty, length, and satisfaction. Participants also completed a web-based survey on behavioral changes related to daily palliative care following the workshop. Nine items on behavioral changes were assessed before and 1 month after the workshop, which was held from April 2021 to March 2024.</p><p><strong>Results: </strong>Twelve pSMILE workshops were held during this period (10 web-based and two face-to-face). A total of 296 pharmacists participated, 152 (51.4%) of whom were Board Certified Pharmacist in Palliative Pharmacy, and 292 (98.6%) responded to the before/after workshop survey. Usefulness ratings were 4.39 for Session I and 4.20 for Session II. Satisfaction ratings were high (≥ 4.5), with no significant differences based on affiliation, training format, or certification. All confidence scores of nine daily palliative care behaviors (symptom assessment; multidisciplinary information sharing; proposing pharmacotherapy; polypharmacy intervention; palliative pharmacotherapy with awareness of pharmacokinetics; explanation of delirium; response in the discharge conference; information sharing between hospitals, clinics, and community pharmacies; and pharmacotherapy suggestions in view of the post-discharge) improved significantly post-workshop (p < 0.01), across both web-based and face-to-face workshops. Certified participants had higher confidence scores both before and after the workshop, and each group showed a significant improvement.</p><p><strong>Conclusions: </strong>These results suggest that either web-based or face-to-face pSMILE workshops improve the quality of pharmacists' contribution in daily palliative care. This is the first report on the effectiveness of an academically approved web-based educational program for palliative care pharmacists, comparable to face-to-face workshops.</p>","PeriodicalId":16730,"journal":{"name":"Journal of Pharmaceutical Health Care and Sciences","volume":" ","pages":"109"},"PeriodicalIF":1.2,"publicationDate":"2025-12-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12720441/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145800548","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":"Preservation of eGFRcre for 1 year with HIF-PHI in non-dialysis patients: a retrospective observational cohort study.","authors":"Tomohiro Aigami, Tomoyuki Ishigo, Mai Miyao, Masatoshi Nonoyama, Tomohisa Yamashita, Masayuki Koyama, Satoshi Fujii, Toshiyuki Yano, Masato Furuhashi, Masahide Fukudo, Takaki Toda","doi":"10.1186/s40780-025-00527-1","DOIUrl":"10.1186/s40780-025-00527-1","url":null,"abstract":"<p><p>BACKGROUND: Hypoxia-inducible factor prolyl hydroxylase inhibitors (HIF-PHIs) effectively increase hemoglobin levels to treat anemia in patients with chronic kidney disease (CKD). However, there is a paucity of studies on the effect of HIF-PHIs on renal outcomes, such as estimated glomerular filtration rate based on serum creatinine (eGFRcre). Therefore, this study aimed to examine the trajectory of eGFRcre decline following initiation of treatment with HIF-PHI and erythropoiesis-stimulating agents (ESAs) in non-dialysis patients. METHODS: This single-center, retrospective study enrolled non-dialysis patients who were prescribed HIF-PHIs between January 1, 2020 and December 31, 2022. We used five HIF-PHIs approved in Japan. The eGFRcre slope for a year after HIF-PHIs therapy was initiated was compared with that of ESAs. The eGFRcre slope was calculated using a linear mixed-effects model for repeated measures over a year from the time of enrollment. RESULTS: This study included 134 patients: 79 and 55 patients treated with HIF-PHIs and ESAs, respectively. The model adjusting for time, drug (HIF-PHI or ESA), their interaction, age, sex, BMI, and CKD stage showed that the effect on eGFRcre differed between HIF-PHIs and ESAs (−2.11 ± 0.57 mL/min/1.73 m2 per year vs. −3.27 ± 0.17 mL/min/1.73 m2 per year, p = 0.046). Subgroup analysis by CKD stage revealed a difference in the eGFRcre slope between HIF-PHI and ESA only in the stage 4 group (−1.89 ± 0.44 mL/min/1.73 m2 per year vs. −3.69 ± 0.44 mL/min/1.73 m2 per year, p < 0.001). CONCLUSIONS: HIF-PHI preserved eGFRcre for a year, suggesting that its effect was superior to that of ESA. </p>","PeriodicalId":16730,"journal":{"name":"Journal of Pharmaceutical Health Care and Sciences","volume":" ","pages":"10"},"PeriodicalIF":1.3,"publicationDate":"2025-12-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12838504/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145800559","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}