Patient Organization Collaboration Promotion Committee The 30th and 31st Patient Group Seminars
Lecture: "'Family Pharmacist' for Patients" and "Response to Patients with Intractable Diseases in the Kumamoto Earthquake
Lecture: "Family Pharmacist" for Patients
Pharmacist's work and division of labor
The Pharmacists Act (*1) defines the duties of pharmacists as "pharmacists shall contribute to the improvement and promotion of public health and thereby ensure the healthy lives of citizens by dispensing medicines, supplying pharmaceutical products, and taking charge of other pharmaceutical hygiene. Specifically, pharmacists perform a wide range of tasks, including quality control and hygiene management at companies and factories that manufacture pharmaceuticals, foods, cosmetics, etc., pharmaceutical inspections and guidance at local government pharmacy departments and public health centers, and inspections of the environment and sanitary conditions at schools.
Akaando Pharmacy
Mr. Daisuke Nishizaki
In the division of labor, physicians issue prescriptions to patients, and pharmacists at pharmacies dispense drugs based on those prescriptions, with physicians and pharmacists sharing the work in their respective fields of expertise to improve the quality of national healthcare (*2). The benefits to patients of the division of pharmaceuticals include shorter waiting times for dispensing and adequate explanations about drugs, while for hospitals, it means lower costs for purchasing drugs and an expanded range of drugs prescribed by doctors. Due to these advantages, the percentage of patients who receive separate dispensing of drugs has been increasing year by year, reaching 68.7% (*3) in FY2014. The increase in the division of labor has been accompanied by an increase in the number of pharmacies (*4), medical expenses (*5), and dispensing medical expenses (*6). However, the "family pharmacist" system was born from the viewpoint that more patient-oriented division of labor should be realized. (Mr. Nishizaki)
Towa Pharmacy
Mr. Fumihiko Takemasa
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1Pharmaceutical Act (Act No. 146 of August 10, 1960, last revised: Act No. 69 of June 13, 2006)
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2.2014 White Paper on Health, Labour and Welfare, etc.
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3Japan Pharmaceutical Manufacturers Association . Estimated prescription receipt rate "All insurances (company health insurance + national health insurance + latter term elderly)" for dispensing in 2014
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4Ministry of Health, Labour and Welfare. Example of Health Administration Report: Summary of Results. Fiscal year report
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5Ministry of Health, Labour and Welfare. Survey on Trends in Medical Expenditure: Summary of Results. Annual Report
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6Ministry of Health, Labour and Welfare. Survey of trends in dispensing medical expenses: summary results. Annual Report
Family Pharmacist
The "kakaritsuke pharmacist," a new system started in April 2016, is a pharmacist who meets certain conditions, such as having at least three years of experience working at a pharmacy as an insurance pharmacist and participating in community activities related to medical care (*7). The three functions that a family pharmacist should have are:
(1) Centralized and continuous identification of all medical institutions where patients receive care and the medications they take
(2) 24-hour response and home support (telephone consultation after office hours, dispensing medications at night and on holidays, managing residual medication, etc.)
(3) Cooperation with medical institutions (questionable inquiries and prescription suggestions to doctors (4) Cooperation with medical institutions (e.g., making inquiries to physicians and prescribing prescriptions, recommending consultations with medical institutions, etc.) (*8)
In addition to the above three basic functions of a family pharmacist/pharmacy, the functions that should be strengthened in response to the needs of the community and residents are listed as the health support functions (such as proactive drug management by local residents), which came into effect in April 2016 based on the "Vision of Pharmacies for Patients" formulated by the Ministry of Health, Labour and Welfare in October 2015. support function (support for community residents to proactively maintain and promote their health), and the advanced pharmacy management function (a system that can provide specialized pharmacotherapy for patients with cancer, HIV, and intractable diseases), which is currently being studied by a research group of the MHLW (*9).
In order for patients to have a pharmacist, they must first confirm whether or not their usual pharmacy has a pharmacist who meets the requirements for a "family pharmacist," and if so, they must agree to receive medication guidance by the pharmacist (by signing a consent form). When the family pharmacist gives the patient a drug, the patient must pay an additional 60-100 yen (when 30% of the cost is borne by the patient) as a "family pharmacist guidance fee" (*10). (Mr. Nishizaki, Mr. Takemasa)
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7Medical Care Division, Health Insurance Bureau, Ministry of Health, Labour and Welfare. Summary of the revision of dispensing fees and drug-related medical fees in fiscal year 2008.
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*8Ministry of Health, Labour and Welfare. Vision of Pharmacies for Patients - From "at the gate" to "kakitsuke" and "community" - October 23, 2015. Japan Pharmaceutical Association. Role of "kakitsuke pharmacists" and "kakitsuke pharmacies" trusted by local residents and patients Jpn.
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*9Ministry of Health, Labour and Welfare, Vision of Pharmacies for Patients - From "Kakitate" to "Kakitsuke" and "Community" - October 23, 2015.
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*10Japan Pharmaceutical Association. (Attachment) To patients who have agreed to the calculation of the kakaritsu kakaritsu pharmacist guidance fee (comprehensive management fee for kakaritsu kakaritsu pharmacists)
To have a reliable pharmacist
The Japan Council of Patients' Associations for Intractable Diseases and Disorders clearly describes three roles of patients' associations (*11), which, if taken from the perspective of drugs, can be thought of as follows.
(1) To understand diseases scientifically → Know and use drugs well
(2) To have the spirit to fight diseases → Have a reliable pharmacist
(3) To create conditions to overcome diseases → Create a pharmaceutical system and structure for patients together
In particular, regarding the second "reliable pharmacist," it is a good idea to have one near your home or workplace. In particular, it would be helpful to have a "trusted pharmacist" as close to your home or office as possible. A reliable pharmacist has been working in the community pharmacy for many years, listens carefully to the patient, responds appropriately to the patient's questions (always confirms any unclear points without immediately answering them, and does not hide any mistakes), and is trusted by the patient's doctor. Please use this as a reference when choosing your family pharmacist.
Lecture: "Response to Patients with Intractable Diseases in the Kumamoto Earthquake
Issues in cooperation between medical care and government and the importance of "mutual aid
After the night of April 14, 2016, Kumamoto and other prefectures in Japan were hit by a series of earthquakes measuring 7 or 6 on the Japanese seismic scale, and seismic activity continued to be active. On the night of April 14 (21:26), just as I was about to start my evening drink at home, I felt a large vertical tremor that caused picture frames on the wall to fall, dishes to break, and TV sets to topple over. Then, at around 1:25 a.m. on April 16, I experienced the main quake, which shook so violently that I was thrown out of the futon on the tatami mat and into the air.
The damage in many areas was severe, and many hospitals were unable to provide normal treatment for some time due to water and power outages. At a symposium (*12) held in September, there were comments such as "I was troubled because it was difficult to find information on vacant beds at neighboring hospitals," and "I was confused because I did not know where to go for advice because the administrative districts, the jurisdiction of the public health center, and the area of the county and city medical associations were all different. This highlighted the issue of cooperation between medical care and government. In addition to self-help, mutual aid, and public assistance, we were reminded of the importance of "mutual aid," the face-to-face help of fellow members of the patients' association, in times of disaster when everyone is in turmoil and experiencing difficulties.
Kumamoto Association of Intractable Diseases and Disease Groups
Mr. Yasuo Nakayama, Representative Secretary
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*12National Hospital Organization Kumamoto Medical Center. Symposium "Response and Recovery from the Kumamoto Earthquake" - What we could do, what we couldn't do, and toward recovery. Held on September 30, 2008
What I want to tell you from my experience in the disaster
I have Inflammatory Bowel Disease (IBD) (*13), an incurable disease, so I need to dissolve one packet of powdered enteral high-calorie nutrition in 300 cc of water and take about 5 packets in total to get enough nutrition. In addition, after using the toilet, the buttocks must be washed clean with water to prevent inflammation. However, since the water ration at the shelter was only 1 liter per day, we had a very hard time finding enough water at all, including for washing and cleansing our bodies. That is why I would like to convey the following to everyone who is suffering from some disease, especially an incurable disease.
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September 30, 2008
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September 30, 2008
Self-help (what you can do by yourself)
- Prepare an emergency evacuation bag (3 days worth of food, dry batteries, warming sheets, etc.)
- Prepare a week's supply of regular medicine that can be taken without water (including gel supplements, etc.)
- Gather information on medical institutions and dispensing pharmacies beyond your daily living area (consider evacuation sites)
Mutual aid (to get help from the community)
- Minimum disclosure of information about one's illness to community welfare committee members and community association presidents
- Confirm evacuation centers in advance and understand what you lack in your stockpile
- Become a member of social contribution activities
Public assistance (to receive social support)
- Register as a person in need of assistance in times of disaster (*14) at the local government
- Connect with local government officials (public health nurses, welfare workers, etc.)
Mutual aid (to check in case of emergency)
- (In patients' associations) Establish a system to respond to requests for support from members
- Request local governments for guidelines that cover issues specific to patients with intractable diseases.
Even if at first glance it may seem futile, I think it is important to be prepared for "just in case" and to protect your own life.
In addition to these lectures, Mr. Tokuo Tanaka, Executive Director of the Pharmaceutical Manufacturers Association of Japan (PMAJ), gave a presentation titled "Provision of Pharmaceuticals in Times of Disaster" and the moderator introduced the preliminary report of the "Second Survey on Awareness and Activities of Patient Groups" and "PMAJ Industry Vision 2025".
Patient Groups Coordination Promotion Committee Yuka Saito