title: Role of the community pharmacy in palliative care: a nationwide survey in Japan.
abstract: OBJECTIVE
  The role of the community pharmacy in palliative care may become increasingly important in Japan. There has been however no investigation to date of community pharmacies in Japan that takes into account their role in enabling palliative care in the home. The aims of the present study were thus to evaluate (1) the availability of narcotics through community pharmacies and the experience of pharmacists in prescribing narcotics; (2) availability of patient counseling provided by pharmacists; (3) pharmacist-perceived difficulties in treating cancer patients with narcotics; and (4) useful strategies to make narcotics more easily available to patients.
  
  
  METHODS
  We sent 3000 questionnaires to community pharmacies as a representative national sample, and 1036 responses were analyzed (response rate: 34.5%).
  
  
  RESULTS
  We found that 77% of community pharmacies had a narcotics retailer license, and that approximately 50% received prescriptions for and prepared narcotics each month. Approximately 70% of community pharmacies received however only 3 narcotics prescriptions each month. Half of the pharmacists reported that they did not counsel patients, primarily because they lacked information about the patient. The most common area reported by pharmacists as being extremely difficult was communicating with terminally ill cancer patients. To make narcotics more easily available to patients, 76% of community pharmacists felt it was important to be able to return narcotics to wholesalers.
  
  
  CONCLUSIONS
  The present study suggests that there are many problems in community pharmacy that need to be addressed to improve access to palliative care in the home, including (1) increased sharing of patient information; (2) increasing community pharmacists' communication skills; and (3) changing current regulations regarding the distribution of narcotics. If these issues are addressed, palliative care in the home could become more widely accepted.
authors.affiliation: Department of Pharmaceutical Services, Nippon Medical School Hospital, Sendagi Bunkyo-ku, Tokyo, Japan. yuyaise@nms.ac.jp
authors.forename: Yuya
authors.initials: Y
authors.lastname: Ise
authors.forename: Tatsuya
authors.initials: T
authors.lastname: Morita
authors.forename: Naomi
authors.initials: N
authors.lastname: Maehori
authors.forename: Motoharu
authors.initials: M
authors.lastname: Kutsuwa
authors.forename: Mitsuru
authors.initials: M
authors.lastname: Shiokawa
authors.forename: Yoshiyuki
authors.initials: Y
authors.lastname: Kizawa
mesh_terms: D003157:Community Pharmacy Services; D005260:Female; D019538:Health Care Surveys; D006801:Humans; D007564:Japan; D008297:Male; D009292:Narcotic Antagonists / Q000627:therapeutic use; D009369:Neoplasms / Q000188:drug therapy; D010166:Palliative Care; D024382:Professional Role
chemical_list: D009292:Narcotic Antagonists