To prevent hepatitis B virus (HBV) reactivation in patients undergoing oral corticosteroid therapy, two precautionary measures were implemented: (1) a label with the words “Caution: HBV Reactivation” was added next to the drug names in the electronic medical record system, and (2) dedicated medication-safety pharmacists were involved to ensure appropriate HBV screening across all hospital departments. The introduction of the cautionary label resulted in a 5.4％ and 16.7％ increase in the screening rates for HBs antigen alone and for the three-panel test, which includes HBs antigen, HBs antibody, and HBc antibody, respectively, compared with the period before its introduction; the involvement of dedicated pharmacists further improved these rates to 96.0％ and 89.2％, respectively. Among patients receiving continuous corticosteroid therapy for ≥28 days, the screening rate was nearly 100％. Targeted interventions for patients eligible for nucleos(t)ide analog therapy ensured that all patients received appropriate antiviral treatment or were referred to a specialized department. In conclusion, we effectively facilitated adherence to HBV reactivation prevention guidelines by establishing a hospital-wide monitoring system led by the medical safety department and using the expertise of dedicated medication-safety pharmacists. These results indicate that a structured, proactive approach enhances HBV screening and antiviral management in clinical practice.

This study aimed to evaluate the effects of introducing an automated dispensing system and a picking support system on the accuracy of dispensing operations and subsequent workflow changes. Changes in dispensing errors and inquiries regarding prescription questions before and after system implementation were investigated. The introduction of these systems led to significant immediate reductions in the number of drug specification errors per 10,000 prescriptions per month in oral/topical and injectable drug dispensing (P < 0.01). While the monthly inquiry rate for oral/topical drug prescriptions showed no significant change (pre-implementation: 0.82 ± 0.06％; post-implementation: 0.91 ± 0.04％; P = 0.14), that for injectable drug prescriptions significantly increased (pre-implementation: 0.043 ± 0.019％; post-implementation: 0.13 ± 0.03％; P < 0.01). A common question that contributed to the increase in inquiries across oral/topical and injectable drug dispensing departments was related to renal function considerations. The automation and system support of dispensing operations improved the quality of picking and prescription verification, allowing pharmacists to allocate more effort toward ensuring safe and effective pharmacotherapy.

The Showa University School of Pharmacy mandates “Practical Psychiatric Pharmaceutical Training” as a compulsory subject to be undertaken by students requiring practical training at Showa Medical University Karasuyama Hospital, a psychiatric hospital that is one among eight hospitals affiliated with Showa Medical University. This practical training aims to enable students to work as part of a medical team and engage in dialogue with patients with psychiatric illnesses in closed wards, exchange information with colleagues from other occupations, and understand psychiatric medical care through hands-on learning using virtual devices. After this practical training, a survey was administered using a Likert scale evaluation and free responses, and the results were analyzed using text mining. The training increased students’ interest and concern regarding the psychiatry departments and deepened their understanding of psychiatric illnesses and psychiatric department patients; it also altered their impressions of the patients and the department. Furthermore, 91.6％ of the respondents agreed that pharmaceutical students at other universities would benefit from practical training in psychiatric departments, indicating that they truly understood the importance of learning about psychiatric medical care. University faculty members and instructing pharmacists themselves also need to deepen their knowledge and understanding of psychiatric medical care to enable pharmacists to uphold the provision of safe pharmacotherapy for all patients.

This study aimed to evaluate the effectiveness of a training program designed to enhance the comprehensive guidance skills of pharmacists and promote post-dispensing follow-up for patients with chronic heart failure. The web-based training, held on December 11, 2024, had 220 applicants, and pre- and post-training surveys were conducted (response rate: 80％). The survey results showed a significant improvement in the knowledge and awareness of pharmacists across all evaluated items, including identifying patients with chronic heart failure, understanding the stages of heart failure, recognizing follow-up items, knowing when to recommend urgent medical attention, and identifying information to provide to physicians (all P < 0.001). Furthermore, free-text responses from the post-training survey showed changes in awareness regarding “patient follow-up” and “self-awareness,” as well as an increased focus on specific attention points such as “body weight” and “medication adherence.”

These findings indicate that this training program served as a crucial catalyst, shifting pharmacists’ approach to heart failure patient care from traditional dispensing-dependent tasks to a more comprehensive and proactive support system that considers the patient’s entire lifestyle. Pharmacists are expected to foster interprofessional collaboration, enhance the quality of team-based care in the community, and contribute to the efficient use of medical resources by actively engaging in heart failure patient follow-up.

Opioids are thought to relieve dyspnea in end-stage heart failure; however, morphine must be used with caution in patients with renal dysfunction owing to the risk of metabolite accumulation. We report two cases of patients with end-stage heart failure with renal impairment who were administered transdermal fentanyl because injectable and oral formulations were difficult to administer. Subjective dyspnea was alleviated in both patients without serious adverse events. Fentanyl patches offer the advantages of non-invasiveness and stable plasma concentrations, which may contribute to symptom control and quality of life. Although the use of fentanyl patches for dyspnea is off-label in Japan, the drug was introduced after a thorough explanation was provided and written informed consent was obtained from the patients. To ensure safety, both patients were managed through close interdisciplinary collaboration. Although these patches do not provide immediate relief, their sustained effects may be beneficial in palliative care settings, particularly when other opioids are contraindicated. These findings indicate that transdermal fentanyl is a practical option for managing dyspnea in patients with end-stage heart failure and renal dysfunction. Further case reports and prospective studies are required to validate the efficacy of this approach and establish clinical guidelines.

In the 2024 revision of the medical reimbursement system in Japan, the enhancement fee for cancer pharmacotherapy framework included requiring pharmacist consultations before physician examinations. At Kyoto Katsura Hospital, pharmacists are stationed in the outpatient chemotherapy center and conduct post-examination consultations with all patients to provide pharmaceutical care. This study retrospectively analyzed the interventions of pharmacists over the past 10 years using daily work records to evaluate the impact of post-examination consultations. A total of 13,534 pharmaceutical care cases were recorded, with a physician acceptance rate of 97.3％. Among the interventions conducted during post-consultation interviews, those related to immune checkpoint inhibitor safety management have increased over the years. The involvement of pharmacists in immune-related adverse event management is crucial. Establishing a structured workflow for pre-examination consultations and incorporating laboratory results may help reduce the workload of physicians and improve patient outcomes. Post-examination consultations allow pharmacists to confirm prescription accuracy and address adverse effects based on real-time clinical data. This study indicates that optimizing pre- and post-examination consultations enhances the effectiveness of pharmacist interventions in outpatient cancer chemotherapy. A complementary approach could improve safety, streamline the workload of physicians, and improve patient care. Further studies are required to refine workflow protocols and assess the long-term benefits of pharmacist interventions in cancer treatment settings.

Therapeutic drug monitoring (TDM) is recommended during vancomycin (VCM) therapy to ensure efficacy and safety. TDM analysis software is commonly used in clinical practice to optimize dosing. For pediatric patients receiving VCM, the two primary software programs used are “SHIONOGI-VCM-TDM (SVT)” and “practical antimicrobial TDM for vancomycin (PAT).” However, no studies have directly compared their predictive accuracy.

This study aimed to evaluate the predictive performance of SVT and PAT in initial dosing design and Bayesian estimation for pediatric patients aged 0.25 – 15 years who received VCM between April 2011 and March 2022. A total of 48 patients (30 males and 18 females) were included in the analysis. In the prediction of trough concentrations during initial dosing design, PAT demonstrated significantly superior accuracy across all metrics, including mean prediction error, mean absolute prediction error, and root mean squared error. SVT tended to overestimate trough concentrations, possibly owing to its reliance on population pharmacokinetic parameters that do not account for renal function, resulting in inadequate consideration of growth-associated renal function changes. Conversely, Bayesian estimation showed no significant differences between SVT and PAT, with both methods converging well with measured values. These findings indicate that PAT is a more reliable tool for initial dose design in pediatric patients, whereas Bayesian estimation remains effective regardless of the software used.