title: Economic and safety benefits of pharmaceutical interventions by community and hospital pharmacists in Japan.
abstract: BACKGROUND
  Pharmaceutical interventions by community and hospital pharmacists can improve medication safety and result in financial savings. Their effect has not been fully explored in Japan.
  
  
  OBJECTIVE
  To evaluate the economic and safety contributions of various pharmaceutical interventions by community and hospital pharmacists in Japan.
  
  
  METHODS
  Two hospitals and eight community pharmacies in Ehime Prefecture, Japan, in 2014-2015.
  
  
  METHODS
  Pharmacists entered data about pharmaceutical interventions via the internet, and the data were divided into 11 types of interventions. The economic impact was estimated based on the rate of avoidance of serious adverse drug reactions and the monetary cost of these reactions in the Japanese compensation system. The cost saving from adjusting prescriptions to take account of unused prescription drugs was calculated using drug prices from the national health insurance scheme. Main
  
  
  METHODS
  The number of pharmaceutical interventions and their economic impact. RESULTS The total cost savings from 500 to 509 pharmaceutical interventions by community and hospital pharmacists were US$207,126.6 and US$592,840, respectively. Community pharmacists mainly intervened to correct prescription errors. They also adjusted 135 prescriptions to take account of unused prescription drugs. This potentially improved patients' adherence and contributed to effective use of medication. Pharmaceutical interventions by hospital pharmacists facilitated avoidance of 10 serious adverse drug reactions, and included 42 transvenous antimicrobial therapy interventions, 88 interventions in cancer chemotherapy, and 47 monitoring recommendations. Hospital pharmacists helped improve patients' quality of life using more aggressive interventions besides correcting prescription errors. Over half of pharmaceutical interventions by community and hospital pharmacists contributed to avoidance of adverse drug reactions.
  
  
  CONCLUSIONS
  These results suggest the importance of pharmaceutical interventions by both community and hospital pharmacists in reducing increasing medical expenses and contributing to safety and effectiveness of medication. They also suggest that community and hospital pharmacists have different roles.
authors.affiliation: Ehime University Hospital, 454 Shistukawa, Toon, Ehime, Japan.|Ehime Society of Hospital Pharmacists, 454 Shistukawa, Toon, Ehime, Japan.
authors.forename: Yuichi
authors.initials: Y
authors.lastname: Tasaka
authors.affiliation: Ehime University Hospital, 454 Shistukawa, Toon, Ehime, Japan.|Ehime Society of Hospital Pharmacists, 454 Shistukawa, Toon, Ehime, Japan.
authors.forename: Daiki
authors.initials: D
authors.lastname: Yasunaga
authors.affiliation: Ehime University Hospital, 454 Shistukawa, Toon, Ehime, Japan.|Ehime Society of Hospital Pharmacists, 454 Shistukawa, Toon, Ehime, Japan.|Ehime Pharmaceutical Association, 7-6-9 Sanbancho, Matsuyama, Ehime, Japan.
authors.forename: Mamoru
authors.initials: M
authors.lastname: Tanaka
authors.affiliation: Ehime University Hospital, 454 Shistukawa, Toon, Ehime, Japan. akiki@m.ehime-u.ac.jp.|Ehime Society of Hospital Pharmacists, 454 Shistukawa, Toon, Ehime, Japan. akiki@m.ehime-u.ac.jp.|Ehime Pharmaceutical Association, 7-6-9 Sanbancho, Matsuyama, Ehime, Japan. akiki@m.ehime-u.ac.jp.
authors.forename: Akihiro
authors.initials: A
authors.lastname: Tanaka
authors.affiliation: Ehime Society of Hospital Pharmacists, 454 Shistukawa, Toon, Ehime, Japan.|Ehime Pharmaceutical Association, 7-6-9 Sanbancho, Matsuyama, Ehime, Japan.
authors.forename: Takashige
authors.initials: T
authors.lastname: Asakawa
authors.affiliation: Ehime Pharmaceutical Association, 7-6-9 Sanbancho, Matsuyama, Ehime, Japan.
authors.forename: Ikuo
authors.initials: I
authors.lastname: Horio
authors.affiliation: Ehime Pharmaceutical Association, 7-6-9 Sanbancho, Matsuyama, Ehime, Japan.
authors.forename: Yoshiro
authors.initials: Y
authors.lastname: Miyauchi
authors.affiliation: Ehime University Hospital, 454 Shistukawa, Toon, Ehime, Japan.|Ehime Society of Hospital Pharmacists, 454 Shistukawa, Toon, Ehime, Japan.
authors.forename: Hiroaki
authors.initials: H
authors.lastname: Araki
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002648:Child; D002675:Child, Preschool; D003157:Community Pharmacy Services / Q000191:economics* / Q000592:standards; D064420:Drug-Related Side Effects and Adverse Reactions / Q000191:economics* / Q000453:epidemiology / Q000517:prevention & control*; D005260:Female; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D007564:Japan / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D010595:Pharmacists / Q000191:economics* / Q000592:standards; D010607:Pharmacy Service, Hospital / Q000191:economics* / Q000592:standards; D024382:Professional Role; D055815:Young Adult
keywords: Adverse drug reaction; Community pharmacist; Economic impact; Hospital pharmacist; Japan; Pharmaceutical intervention