Paper Details
- Mitsuhiro Nakamura (Laboratory of Drug Informatics, Gifu Pharmaceutical University / mnakamura@gifu-pu.ac.jp)
1) Laboratory of Drug Informatics, Gifu Pharmaceutical University , 2) Yanaizu Pharmacy , 3) Department of Pharmacy, Kyushu University Hospital , 4) Laboratory of Community Pharmacy, Gifu Pharmaceutical University
Background: In Japan, measures are being taken to strengthen the cooperation between local hospitals and pharmacies to improve the quality of cancer treatment. Objective: To evaluate the progress of the medical care provision system in terms of the collaboration between hospital pharmacists and community pharmacists in outpatient chemotherapy. Methods: We focused on the Additional Fee for Outpatient Chemotherapy 1 (when anticancer drugs are injected) (A1OC) as an indicator of high-quality medical care, Additional Fee for Enhanced Collaboration (AEC) as an indicator of hospital pharmacist involvement, and Additional Fee for Specific Drug Management Guidance 2 (ASD2) as an indicator of community pharmacist involvement. Using prefecture-specific receipt claims data from NDB Open Data Japan (NODJ) and from e-Stat, we investigated the number of insurance claims made by hospitals and pharmacies for outpatient chemotherapy involving pharmacists and the factors associated with them. Results: The coefficients of determination (R2) for A1OC, AEC, and ASD2 claims with respect to the number of anticancer drugs injected were 0.9960, 0.8298, and 0.7244, respectively. A higher number of claims for ASD2 was observed in prefectures in which the average age of community pharmacists was lower. Conclusion: The number of A1OC claims, which represents the number of times high-quality medical care was provided, suggests that the quality of the facilities for outpatient chemotherapy delivery systems varies little between prefectures. The involvement of hospital pharmacists varied by region more than A1OC did, and the involvement of community pharmacists varied even more. Reducing these regional differences is necessary to standardize the quality of outpatient cancer chemotherapy in Japan. Our study findings indicate the need for promoting the further involvement of community pharmacists with patients and their collaboration with hospital pharmacists to prevent adverse effects and enhance the quality of life of patients undergoing outpatient chemotherapy. Through such activities, the local collaborative efforts and reimbursement requirements may be improved.
