The proclamation of April 2002 of a Ministry of Health, Labor and Welfare ordinance has enabled doctors to prescribe drugs for an outpatient without a limit on the length of prescription terms except for a few drugs. There is a concern that the prescription-term deregulation could cause careless drug therapy management in order to extend the interval between patient hospital visits. The purpose of this study is to make pre- and post-deregulation comparisons of two items, prescription terms and implementation of clinical examination that complied with package-insert precautions, and to discuss the approaches to increase safety. Prescription terms have lengthened progressively. In the pre-regulation period of January to March 2002, the mean prescription term was 19.9 days; in the post-regulation period of July to September 2002, it was 24.9 days; and in July to September 2003, 28.6 days. Even for anti-tumor agents, there were prescriptions over 90 days after deregulation. There was no significant difference between the pre- and post-deregulation compliance ratios for the package-insert precautions in eight drugs of investigated nine. However, one case had a delay in detection of liver dysfunction, which was caused by deviation from the once-a-month testing indicated in the package-insert precautions for prolonged prescription terms. The evidence suggested that the deregulation led to negligent drug therapy management. To assure safe therapy, the following should be addressed: first, sufficient function of a computerized prescriber order entry system and second, creation of a new framework with pharmacists' active involvement such as collaborative therapy management with physicians.

译文

:2002年4月颁布的厚生劳动省法令使医生能够为门诊病人开药,除少数药物外,对处方期限没有限制。人们担心处方期限的放松可能会导致药物治疗管理不慎,从而延长了患者就诊的间隔时间。这项研究的目的是对两种项目的处方前和处方后进行比较,包括处方条款和符合插入包装预防措施的临床检查的实施,并讨论提高安全性的方法。处方条款已逐渐延长。在2002年1月至2002年3月的预先监管期间,平均处方期为19.9天;在2002年7月至2002年9月的后监管期内,该时间为24.9天;从2003年7月到2003年9月为28.6天。即使是抗肿瘤药,放松管制后90天内也有处方。在调查的9种药物中,有8种药物的插装前预防措施的解除前和解除后合规率之间没有显着差异。但是,有1例患者的肝功能障碍检测延迟,这是由于长期处方药的包装插入注意事项中指出的每月一次检测结果的偏离所致。有证据表明,放松管制导致过失的药物治疗管理。为了确保安全的治疗,应解决以下问题:首先,要有足够的计算机处方程序输入系统功能,其次,要在药剂师的积极参与下(例如与医生合作进行治疗)创建新的框架。

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