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Background There has been limited progress in research on reasonable accommodations for persons with mild/moderate intellectual disabilities (ID) who are able to live independently but have struggles. This study aims to qualitatively investigate how pharmacists provide reasonable accommodations when communicating with people with ID. Methods Between October 2023 and March 2024, semi-structured interviews were conducted with 11 hospital or community pharmacists. They were mainly asked about how they have dealt with people with ID. Interviews were conducted either in person or online, each lasting 30–60 min. Data were analyzed using a thematic analysis approach. Results This study identified three main themes regarding the pharmacists’ reasonable accommodation practices: “comprehension aids,” “reminders,” and “structural accommodations.” Specifically, to help the individuals better understand, pharmacists tried to use simple expressions and visual information, including pictures and symbols, and to adjust their speaking speed and volume. As reminder strategies, they provided supplementary handwritten information, highlighted the main points, and use of post-its. Furthermore, they illustrated the medication sequence as a structural accommodation strategy. Conclusions The study suggests that pharmacists have employed several strategies to offer reasonable accommodations, aiming to build and maintain better relationships with people with ID and to promote these individuals’ understanding of medications, adherence, and treatment safety.

Dipeptidyl peptidase-4 inhibitors (DPP-4is) are widely used in Japan; however, their incretin activity raise concerns about gastrointestinal adverse events (GAEs). Therefore, we aimed to investigate GAEs symptoms commonly associated with DPP-4is and associated symptomatic treatment, to enable community pharmacists in charge of pharmaceutical management of outpatient prescriptions in Japan to strengthen patient intervention strategies. Therefore, we conducted a prescription sequence symmetry analysis (PSSA) using a prescription claims database (2018–2022) of a domestic chain pharmacy to evaluate the association between DPP-4is and GAEs. Adjusted sequence ratios (ASRs), a safety index, were calculated based on three treatment groups: prokinetic agents (dopamine D2 receptor blockers and serotonin 5-HT4 receptor agonists), gastric acid suppressants (histamine H2 receptor blockers and proton pump inhibitors), and laxatives, and the order in which DPP-4is were prescribed. The ASR was calculated for 90, 180, and 360 days, and subgroup analyses were performed for prokinetic agents and gastric acid suppressants groups based on their mechanism of action. ASR values > 1 indicated significant association with DPP-4is. PSSA results showed DPP-4is association across all observation periods for prokinetic agents and laxatives, but not for gastric acid suppressants. Subgroup analyses indicated a similar trend, suggesting that DPP-4is are associated with nausea and constipation owing to functional impairment rather than gastric acid secretion. Additionally, prescription data confirmed the possibility of adding gastrointestinal medications, which could cause a potential prescribing cascade, after prescribing DPP-4is. These findings highlight the importance of strengthening follow-up between patient visits to facilitate the early detection of GAEs caused by DPP-4is, and carefully considering the risks and benefits of symptomatic treatment.

In Japan, telepharmacy is becoming increasingly popular due to deregulation triggered by the outbreak of COVID-19. The purpose of this study was to gain an understanding of the actual state of telepharmacy in Japan by interviewing pharmacists who have experience with telepharmacy and describing its advantages and disadvantages, as well as their outlook for its use going forward. The interviews were conducted online using Zoom. Each interview lasted approximately 30 min. Eleven people were interviewed. The advantages mentioned by the pharmacists were classified into three main categories: “Better communication”, “Time savings”, and “Improved safety”. The disadvantages were classified into the following nine categories: “Drug delivery problems”, “Communication failures”, “Ease of use for patients”, “Emotional reactions”, “Pharmacy system”, “Communication issues”, “Healthcare system issues”, “App system issues”, and “Cost”. Many of these factors correspond to the Unified Theory of Acceptance and Use of Technology (UTAUT) constructs presented by Venkatesh, et al. Many of the pharmacists mentioned that the use of telepharmacy is likely to expand further in the future, but that this will require further development of communication technology and the widespread use of systems such as electronic prescriptions.

Background This study aimed to elucidate the sense of burden and the factors that affect medication assistance among family caregivers who provide long-term care to elderly patients with dementia. Methods Survey method: A sample size of 96 was predetermined, and a web-based survey was conducted to caregivers who met the qualifying criteria. The survey encompassed following components: (1) assessment of burden, (2) determination of difficulty during medication assistance, (3) evaluation of comprehension of medication purposes, (4) evaluation of caregiver’s ability to recall administration method, (5) measurement of satisfaction with current medication, (6) examination of harmony between medication and lifestyle habits, (7) cohabitation status with the patient, (8) quantification of oral medications, (9) determination of medication doses (doses) per day, and (10) estimation of time spent on medication assistance. The respondents were categorized into “high burden” and “low burden” groups, and the distribution of responses for items (2) to (7) was compared between these groups using a chi-square test. Mean responses for items (8) to (10) were compared between the groups using a Student’s -t test. Furthermore, multivariate analysis was performed using burden as the target variable, and significant differences identified between the groups using chi-square and Student’s t-tests as explanatory variables. The significance level was established at 5%. Results The study comprised 100 respondents, 90% of whom offered medication assistance. Among the caregivers, 38.9% reported experiencing burden, 56.7% faced challenges with medication assistance, and 36.6% faced medication refusal. Additionally, 15.5% of participants experienced disharmony between their medication and lifestyle. The multivariate analysis results highlighted associations between burden and factors such as the presence/absence of difficulty in medication assistance, number of doses per day, medication refusal, and level of harmony between medication and lifestyle. Conclusion The burden was influenced by various factors indicating “difficulty.” The study highlighted the importance of simplifying medication usage by reducing the number of doses, addressing medication refusal through third-party intervention, and customizing assistance to individual needs based on the psychological conditions of patients and caregivers. These approaches aim to alleviate disharmony between medication and lifestyle.

Background Seamlessly providing appropriate drug therapy to patients recovering from stroke is essential for preventing recurrence, regardless of changes in their medical care environment. To address this, several initiatives have been undertaken to improve communication between hospital and community pharmacists, including the use of discharge medication summaries. However, we previously revealed discrepancies between the contents of prescriptions upon discharge and outpatient prescriptions from other institutions. Therefore, in the present study, we aimed to examine the effect of bidirectional information sharing between hospital pharmacists and community pharmacists, to assess the impact on prescription continuity in stroke patients. Methods The study included patients who received hospital treatment for stroke (cerebral infarction and transient ischemic attack) and were transferred to another hospital for outpatient treatment after discharge. The control group only received summaries, whereas in the intervention group, besides receiving summaries, patient information was shared bidirectionally between hospital pharmacists and community pharmacists through an online tool (secure messaging platform) for approximately 12 weeks post-discharge. The primary endpoint was the number of medication discrepancies resolved (the number of individual medications for which discrepancies were identified and successfully addressed, totaled across all patients), and the secondary endpoint was the percentage of prescription interventions by community pharmacists. These groups were compared using Fisher’s exact test. Results In the intervention group, medication discrepancies were reduced from 16 to 4 drugs, indicating the resolution of 12 discrepancies, whereas that in the control group remained the same at 13 drugs, showing no change (p  =  0.0051). The percentage of prescription interventions by community pharmacists ((number of drugs with at least one intervention/number of drugs)) was 16/16 (100%) in the IG vs. 3/13 (23.1%) in the CG. This difference was statistically significant ( p  = 0.0003). Conclusion This study demonstrated that bidirectional information sharing between hospital pharmacists and community pharmacists promotes prescription interventions and may contribute to improving medication continuity and safety in patients recovering from stroke compared with conventional care. These findings support the implementation of pharmacist collaboration systems to reduce medication discontinuation during care transitions in stroke patients. Trial registration This trial is registered on Japan Registry of Clinical Trials (jRCT) (identifier: jRCT1050250043), June 9, 2025 (retrospectively registered).

Background Supporting smoking cessation at pharmacies can be challenging owing to difficulties in recruiting smokers to participate in cessation programs, insufficient communication skills among pharmacists, and lack of knowledge and self-efficacy in successfully quitting smoking in Japan. Objective This study evaluates the effectiveness of a smoking cessation training program on community pharmacists’ knowledge, attitude, and self-efficacy in supporting smoking cessation. Methods The study, conducted in Japanese pharmacies with 100 community pharmacists, employed a quasi-experimental design. Two online training programs were implemented. Participants completed a web-based survey assessing their knowledge, attitude, and self-efficacy in supporting smoking cessation before, immediately after, and 1 year after the training program. A two-way analysis of variance with a mixed model was used to examine score changes at each time point. Results Total knowledge scores significantly increased between baseline and immediately after training and baseline and 1 year after training. The total attitude scores between baseline and immediately after training differed significantly. However, no differences were noted between baseline and 1 year after training. Total self-efficacy scores significantly increased at baseline, immediately after training, and between baseline and 1 year after training. Despite no significant interactions between the programs, there was a partial interaction effect on knowledge, with only the customized program having items whose knowledge levels improved after 1 year. Conclusion and Relevance The training program improved community pharmacists’ knowledge, attitude, and self-efficacy regarding smoking cessation support. The customized program must be reinforced to improve support performance and maintain attitude.

In this multicenter, nonrandomised comparative study, we evaluated the potential effectiveness of a program to promote the safe use of dipeptidyl peptidase-4 (DPP-4) inhibitors led by community pharmacists. The program facilitated early detection of gastrointestinal adverse events (GIAEs) in patients newly prescribed DPP-4 inhibitors and facilitated timely communication with physicians. Community pharmacists reviewed patient conditions and provided relevant information to physicians as needed. GIAE monitoring based on the program was conducted in 35 patients at 10 pharmacies in Japan (intervention group) between March and August 2024. The proportion of pharmacist interventions was compared with that in 451 patients from March to August 2023, before program implementation (baseline cohort). The primary outcome, pharmacist intervention rate, was significantly higher in the intervention group (5 out of 35 patients, 14.3%) than in the baseline cohort (0 out of 451 patients, 0.0%) (p < 0.001). GIAEs were identified in 13 out of 35 patients (37.1%) in the intervention group; information for five patients (14.3%) was shared with physicians, resulting in discontinuation of the DPP-4 inhibitor in one patient and addition of supportive therapy in others. Most GIAEs occurred within the first 1–2 weeks of therapy, highlighting the need for early intervention. Thus, proactive involvement of community pharmacists may improve the care process in these cases and contribute to healthcare coordination and diabetes care quality.

Background Prejudice and stigma against patients with depression may lead to adverse clinical consequences, such as delayed initiation and premature termination of therapy. However, available survey results on pharmacists’ awareness showed a lack of confidence in dealing with patients with depression. Until recently, few studies addressed the relationship between pharmacists’ perceptions of their social distance from and confidence in interacting with patients with depression. Objectives To determine pharmacists’ social distance from patients with depression, and investigate the factors that influence and are influenced by it. Methods The target population of this survey study included 161 pharmacists employed at a drug chain who had participated in the Effects of Community Pharmacists’ Medication Assistance for the Patients Taking Antidepressant study. The questionnaire included six questions on social distance, which were adopted from a previous nation-wide survey of mental illness stigma in Japan. Other questions related to the respondents’ attributes, personal experience (living with depression, abusive behaviors inflicted by patients with depression), and confidence in interacting with patients with depression. Results Valid responses were obtained from 77 study participants. The mean total social distance score was 12.49. Greater total social distance scores were associated with greater difficulty in relationship building, information provision, and comprehension of condition. Pharmacists’ personal experience of living with depression decreased their social distance from patients with depression, whereas their experience of being verbally or physically abused by patients with depression increased their social distance. Conclusion This study showed that community pharmacists in Japan had less social distance from patients with depression than the general population. A significant negative correlation was observed between community pharmacists’ social distance from and their confidence in interacting with patients with depression.

Background The prevalence of depression is increasing in Japan. Pharmacists play an important role in helping patients use medicines effectively. Several studies had investigated the impact of community pharmacists on patient adherence to antidepressant therapy, and their results indicated that further study was warranted. Methods This study was conducted from June 2019 to May 2020 using a cluster non-randomized, open-label, parallel-group design. Four community pharmacy stores in Osaka and Hyogo Prefectures, Japan, participated in the study, and enrolled patients with unipolar depression. In the intervention group (IG), patients received cognitive behavioral therapy (CBT)-based medication support, and their medication adherence and adverse drug reactions were monitored by telephone. In the control group (CG), the pharmacists engaged in routine interactions with the study participants. Before participating in this study, the intervention-group pharmacists attended a 5-hour training session on CBT-based medication support. The primary outcome of this study was medication adherence, assessed using the Drug Attitude Inventory (DAI)-10. Secondary outcomes included the changes from baseline at 6 months in the following variables: the Patient Health Questionnaire (PHQ)-9 total score, the EQ-5D-5 L (Euro-QOL 5 dimensions 5 levels) score, patient satisfaction, and the Pharmacists’ Confidence Scale about Medication Consultation for Depressive Patients (PCMCD) score. Results Four pharmacies (two in IG and two in CG) completed the intervention period. Results were obtained from 19 patients in the IG and 12 patients in the CG. In the IG, the mean DAI-10 score increased from 4.941 at baseline to 6.105, the mean PHQ-9 score decreased from 9.263 to 8.625, and the mean patient satisfaction score increased from 39.947 to 42.211. In the CG, the mean DAI-10 score decreased from 6.333 to 4.167, the mean PHQ-9 score increased from 9.333 to 12.923, and the mean patient satisfaction score decreased from 38.929 to 38.167. Conclusion CBT-based medication support provided by community pharmacists may improve patient medication adherence to antidepressant therapy and symptoms. Such support can be expected to facilitate better treatment of depressed patients and may also allow the duration of treatment to be shortened. Trial registration UMIN000037954, Date of first registration: 17/06/2019.

Background Stroke is a leading cause of death, reducing disability-free life expectancy. After acute treatment, patients require rehabilitation to prevent recurrence. Continued use of medication is crucial for recurrence prevention and risk management, even after the transition from acute-care institutions to other medical institutions. Although “discharge summaries on medications” are shared between hospitals and community pharmacists, no reports have addressed medication continuity for patients with stroke transferred to other institutions after discharge. This study aimed to clarify medication continuity, particularly for medications adjusted during hospitalization that should be continued even after discharge, by investigating the medication use histories of patients with stroke transferred from acute care hospitals to outpatient hospitals. Methods We enrolled patients who were discharged from an acute ward between June 11, 2022, and March 31, 2023, after receiving inpatient care at the Japan Community Healthcare Organization, Hoshigaoka Medical Center for acute stroke, and transferred to other outpatient hospitals. This study was conducted between June 2022 and April 2023. We extracted and assessed prescription continuity and carefully examined clinically relevant discrepancies after comparing the discharge prescription with that at the first outpatient visit. Results Of the 42 patients enrolled, seven (16.7%) had one or more discrepancies involving 13 medications. Based on the medicinal efficacy classification, four patients treated with other blood and body fluids-related agents (antiplatelet drugs), three patients treated with agents for hyperlipidemia (statins), two patients with agents for peptic ulcers, two patients with vasodilators, one patient treated with antihypertensives, and one patient with other agents affecting digestive organs (antiemetic agents that acts on the central nervous system) had discrepancies. Furthermore, discrepancies in medication discontinuation or reduction recommended by a stroke specialist, which may increase the risk of stroke recurrence, were identified in five patients (seven drugs: four antiplatelet drugs and three statins). Of 13 discrepancies, community pharmacists inquired about 3 cases with physicians, none were approved. Conclusion The medication to prevent stroke recurrence might not be continued after transit to another outpatient after discharge. Reconsidering patient information sharing between hospital and community pharmacists and establishing a more strengthened sharing system is necessary to achieve seamless pharmacotherapy.