title: Clinical behavior of Japanese community pharmacists for preventing prescription drug overdose.
abstract: OBJECTIVE
  Prescription drug abuse, including benzodiazepines, is a growing health problem in Japan. This study examined the community pharmacist's clinical behavior regarding patients who overdose on prescribed drugs, and explored the possibility of overdose prevention by community pharmacists.
  
  
  METHODS
  We surveyed all registered community pharmacies with dispensing functions (n = 1867) in the Saitama Pharmaceutical Association. An anonymous self-administered questionnaire was mailed to each pharmacy. Respondents were asked about clinical behavior such as medication counseling and referral to the prescriber if prescription drug overdose was identified.
  
  
  RESULTS
  Among respondents, 26% of community pharmacists reported clinical experience of working with patients who overdosed on prescribed drugs in the previous year. Half of respondents evaluated their practice such as medication counseling and referral to the prescriber as 'good'. On multivariate analysis, a 'poor' self-evaluation of referral to the prescriber was significantly associated with the following perceptions: 'insufficient confidence in communication with prescribers' (odds ratio [OR], 2.7; 95% confidence interval [95%CI]: 1.4-5.3), and 'to avoid trouble with prescribers' (OR, 1.7; 95%CI: 1.0-2.7).
  
  
  CONCLUSIONS
  Japanese community pharmacists could prevent prescription drug abuse in their practice, but the pharmacists who have insufficient confidence in communication with prescribers and who are afraid of trouble with a prescriber, reported poor self-evaluation for referral to the prescribers. All prescribers should understand the importance of referral by community pharmacists, to assist community pharmacists in playing a critical role in prevention of prescription drug abuse.
authors.affiliation: Department of Drug Dependence Research, National Center of Neurology and Psychiatry, Tokyo, Japan.
authors.forename: Takuya
authors.initials: T
authors.lastname: Shimane
authors.forename: Toshihiko
authors.initials: T
authors.lastname: Matsumoto
authors.forename: Kiyoshi
authors.initials: K
authors.lastname: Wada
mesh_terms: D001291:Attitude of Health Personnel; D062787:Drug Overdose / Q000517:prevention & control*; D019538:Health Care Surveys; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D007564:Japan; D010595:Pharmacists; D055553:Prescription Drugs / Q000506:poisoning*
chemical_list: D055553:Prescription Drugs
keywords: addiction psychiatry; drug overdose; pharmacist; prescription drug misuse; suicidology