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When I graduated from university, my aim was to become a pharmacist capable of recommending prescription medicines to doctors and teaching others to do the same. To achieve this goal, I developed comprehensive curricula incorporating progressive educational tools such as problem-based learning and small group discussions. Subsequently, the effectiveness of these tools and curricula was evaluated, and the findings of these assessments were published in various peer-reviewed journal articles. Consequently, a body of evidence on the most effective ways to recommend prescription medicines to doctors was gradually established. This paper aims to summarize this comprehensive body of research spanning over 43 years, with the objective of highlighting the valuable insights gained thus far, identifying the best practice techniques, and exploring potential avenues for future research.

Several good manufacturing practice (GMP) compliance issues and their associated quality problems that have been revealed since 2020 have led to large-scale recalls and supply suspensions of drug products in Japan. This paper provides an overview of the causes and countermeasures for supply disruptions of low-molecular-weight chemical pharmaceutical agents, focusing on quality-related issues. A recent increase in the use of generic drugs emphasized the importance of strengthening active pharmaceutical ingredient (API) supply chains and ensuring GMP compliance among drug manufacturers. In addition, increasing recalls in the drug products of certain marketing authorization holders due to storage stability problems strongly suggests the need to improve their development process considerably. Other measures to stabilize the supply of pharmaceuticals, including increasing stockpiles of APIs, were also discussed.

Non-medical use of prescription medications is a serious public health crisis. The black market for prescription medications should be routinely surveyed to encourage their appropriate use. Herein, we focused on Twitter to investigate the possibility of illicit drug trading in Japan. From March 1 to 8, 2021, we examined the characteristics of Twitter posts, identified using the search term "Okusuri Mogu Mogu", a Japanese argot used for trading of medications. The captured data included the date of the posts, whether with a hashtag was used, an indication of the trades type (buy, sell, self-administration, and unknown), and the name of the mentioned pharmaceutical products. The number of named medications in the posts was counted and further categorized according to the Anatomical Therapeutic Chemical (ATC) classification. Two hundred and thirty-eight posts were identified with the searching term "Okusuri Mogu Mogu", of which 154 (64.7%) named specific medications. Of note, 73 posts (30.7%) were associated with buying or selling medications. We examined the 73 posts. These posts included 118 medications (26 types), of which 107 (88.4%) were classified as nervous system drugs. Hypnotics and sedatives were the most frequently mentioned medications. The present study sheds light on pharmaceutical medication trading via Twitter. Reinforcing the surveillance practices or cracking down on traders by authorities may be insufficient. We consider the possible effectiveness of socially supportive approaches to help those who lack support to access the appropriate psychiatric care.

The present multicenter study performed by the MIYAZAKI UROLOGICAL-NETWORK GROUP involving patients from 32 hospitals in Miyazaki Prefecture demonstrates that an association exists between the use of prescription drugs for male lower urinary tract symptoms (MLUTS) and patient characteristics. Men aged ≥40 years who were prescribed at least one drug for MLUTS between April 1, 2014 and March 31, 2015 were prospectively recruited. In total, 2,295 patients with a median age of 72 years were enrolled. The median prostate volume was 33 ml, the median International Prostate Symptom Score (IPSS) was 15, and the median quality-of-life score was 5. Prescribed drugs were α1-blockers alone in 1,661 patients, tamsulosin hydrochloride in 702, silodosin in 481, and naftopidil in 477. Multivariate analysis of the associations between use of α1-blockers and patient characteristics revealed use of tamsulosin hydrochloride to be more significantly associated with higher age (P=0.02), higher prostate volume (P=0.048), and higher IPSS score (P=0. 01) than silodosin. No significant associations between patient characteristics and naftopidil or tamsulosin hydrochloride ware revealed. We found that 369 patients received drug therapy for MLUTS plus overactive bladder (OAB). Multivariate analysis of the associations between patient characteristics and use of drugs for MLUTS or MLUTS plus OAB revealed higher age (P=0.001) and lower PSA value (P=0.04), lower prostate volume (P=0.01), and higher storage symptom score of IPSS (P< 0.001) to be more strongly associated with use of drugs for MLUTS plus OAB than drugs for MLUTS alone.

Kampo medicine is an original traditional medicine in Japan. Currently, 148 ethical Kampo formulations (Kampo prescription drugs) are registered in the National Health Insurance Price List. Kampo medicines can be prescribed under the national insurance system, which shows that they are part of conventional medicine in Japan. Japan has a unified drug approval system that does not distinguish between Western and Kampo medicines, and both are subject to the same regulations. The application for the market approval of ethical Kampo medicines is based on the general notification for drugs, i.e., "Handling of Ethical Combination Drugs" in "Precautions Necessary When Applying for Drug Marketing Approval" (Yakushokushinsa Notification No. 1121-12 of November 21, 2014). Furthermore, applications for the market approval of ethical Kampo medicines should follow the Kampo-specific notification of "Handling of Ethical Kampo Medicines" (Yakushin Notification No. 804 of June 25, 1980). Data from comparative studies with standard decoctions must be submitted with approval applications according to Yakushin 2 Notification No. 120 of May 31, 1985. The safety, efficacy, and quality of Kampo medicines are comprehensively assured by the Japanese Pharmacopoeia, Good Manufacturing Practice, Good Agricultural and Collection Practices, marketing approval certificate, approval standard, and pharmacovigilance. I believe that the basic framework for the market approval of ethical Kampo medicines has been established as described above. The key factors for the practical application of superior manufacturing technology and research achievements and the promotion of drug development are the specific guidelines for the approval of drugs of herbal origin.

We herein analyzed the issues that pharmacists in a community pharmacy in peacetime need to prepare for regarding headache medical care in emergencies (the state that supply of medical supplies is difficult) using a questionnaire intended for doctors and pharmacists in a community pharmacy. Recovery rates were 48.0% (96/200) for doctors and 37.3% (112/300) for pharmacists. In order to distinguish between patients for whom pharmacists need to "recommend OTC drugs" and those who need to be encouraged "to consult a hospital or clinic", doctors indicated that pharmacists need to use an "assistance tool to diagnosis headaches, such as a migraine screener" and "guidelines for chronic headaches". However, few pharmacists used these tools. Approximately 66.7% of doctors indicated that it is "meaningful" for pharmacists to distinguish patients with headaches. Moreover, doctors indicated the need for guidance by pharmacists in peacetime regarding headache medical care in emergencies. Although 73.2% of pharmacists instructed the patients with headaches of the importance of medication notebooks in emergencies, guidance ("understanding the triggers of headaches", "understanding the importance of removing the cause of the headache", "standing OTC drugs" and "standing prescription drugs") by pharmacists to prepare for an emergency was insufficient. These results provide useful information to improve the efforts by pharmacists in community pharmacies in peacetime for headache medical care in emergencies.

Home-based medical care has been promoted in recent times because of a decline in the birthrate and increased elderly population, and there is wide individual variation in the elderly patients' recuperating environment and/or symptoms. In our experience, when solitude and dementia overlap, patient-management becomes challenging. In the management of such patients, we have identified the importance of a pharmacist as part of the home-based medical care team. The pharmacist plays an important role in providing optimal solutions in terms of environmental adjustment for medication/medication support plan, according to the physical ability and cognitive ability of the patient, under a limited care plan. The statistical data from the national database indicates that there will be an increase in the number of elderly people who are "solitary" and have "declined cognitive ability", and this could be a challenge which could be tackled with home-based medical care system.

This study aimed to determine how much time can be saved with the use of unit-of-use packaging for prescription drugs as compared with bulk packaging in community pharmacies as well as to determine the number of errors. In a simulation, mock prescriptions were dispensed either in unit-of-use packages or by transferring medication from a bulk container, and a time study was conducted to measure the time spent on dispensing and prescription auditing by pharmacists. Pharmacists' and patients' degree of satisfaction was also surveyed. The time saved with unit-of-use packaging was 66.25 s per prescription. The sole dispensing error that was found in the study occurred with bulk dispensing. Among both pharmacists and patients, many were of the opinion that dispensing with unit-of-use packaging was preferable to bulk dispensing. Unit-of-use packaging shortens the time that pharmacists spend on dispensing activities and increases the efficiency of their work. Unit-of-use packaging is also thought to reduce the number of counting errors.

The percentage of the population over age 65 in Japan was greater than 23% in 2010. Therefore, Japan is the world's first "super-aged society", and our country needs a new regional health care system. Our medical systems face many challenges, such as this increase in elderly population with chronic diseases, maintenance of universal health insurance and free access to hospitals, and expensive health care costs. It is not easy to change the current health care system without a sufficient number of doctors. On the other hand, Japan's curriculum in pharmaceutical education has been expanded to six years to establish a new profession of pharmacist. Rapid progress in the market of pharmacies in accepting prescriptions since 1974 has caused pharmacists to primarily act as "technicians". But this is not the best way to solve the serious problems of Japanese medical systems. I want to present the image of a next-generation pharmacist (Pharmacist 3.0), to be involved in the idea of collaborative drug therapy management (CDTM) in this article. The total optimization of our medical supply system with all medical and pharmaceutical specialists is necessary in Japan.

Marketing authorization holders do not disclose any information on the pharmaceutical properties of over-the-counter drugs (OTC). When a drug is switched from a prescription drug to OTC, pharmacists can acquire that information from the corresponding ethical drug (ED) through the package insert, interview form, and so on. However, the pharmaceutical equivalence between ED and OTC is unclear. In this study, we examined the drug dissolution behavior of both ED and OTCs containing scopolamine butylbromide. Dissolution tests were performed by the paddle method using Japanese Pharmacopeia (JP) XV test fluids at pH 1.2, 4.0 and 6.8 and water based on the guidelines for bioequivalence studies of generic products. The dissolution profiles of OTCs differed significantly from ED showing a similarity factor (f2) value ranging from 8.9 to 42.9. Time until 85% dissolution ranged from 23 to 95 min and from 17 to 174 min at pH 1.2 and pH 6.8, respectively. Then JP XV disintegration tests were conducted to investigate differences in the disintegration process. The disintegration time of preparations showing delayed dissolution was prolonged compared to that of others, suggesting that the disintegration of the tablet or capsule is one of the important factors affecting the drug dissolution. These differences in the disintegration and drug dissolution might cause differences in the bioavailability of the drug. For patient safety, more detailed product information of OTCs should be supplied by the manufacturer, and not be assumed from that of corresponding ED.

As the separation of dispensary from medical practices has developed over the last 20 years, pharmacies have changed their function accordingly. Pharmacies are now actively participating in medical care, covered by insurance, by preparing medicines for out patients. Also, pharmacists play a integral role in the collaborative approach to health care of home care patients by promoting the proper use of medicines. As pharmacies became the personal pharmacy for local residents, pharmacies which dispense drugs were authorized as medical facilities from 2006. Thus, pharmacies are now facing a new era, in which their role to offer medical products is clear, and that since the collaborative approach by a multidiscipline medical group is now being promoted in local healthcare, the ability to dispense clinical judgment and the capability to cooperate with other professionals from different health care fields is required.

Confronted with an aging society, saving costs by efficiently utilizing medical resources has become urgent in Japan. Therefore, due to medical treatment fee constraints, hospitals now have to focus on reducing the length of one's hospital stays resulting in patients who are heavily dependent on medical care being discharged and shifted to home care. Especially for cancer, which is the most common cause of death in Japan, the system of healthcare delivery from inpatient treatment to home palliative treatment has been dramatically improved. Against such a backdrop, this medical supply delivery role of pharmacies was clearly and newly codified into medical law in 2006, thus enabling pharmacies to fulfill their newfound responsibilities as healthcare delivering facilities 24 hours, a day, 365 days a year.