The level of understanding of taking medicine was examined at the start and the end of medicine-taking guidance, based on the estimation by pharmacists and inpatients. Six items for the estimation, such as``the way of taking medicines'' were evaluated using aˆve-grade system. The signiˆcant improvement was observed in all items, suggesting that inpatients' understanding is improved by the guidance. A markedly positive correlation was found between the estimation by inpatients and that by pharmacists ( p<0.001). This conˆrms the appropriateness of estimation by pharmacists. Inpatients whose estimation was signiˆcantly diŠerent from that by pharmacists (diŠerence of two grades or more) were examined to identify clear and potential problems with taking medicine. The problems were classiˆed into such seven categories as``types of medicine''. For each item with diŠerences in estimation (two grades or more), problems were biased in some speciˆc categories. On the basis of such a bias, a ‰ow chart was prepared to clarify problems. In addition, a standard pharmaceutical management and guidance services program was drafted, in which measures in observation, treatment and education against problems by pharmacists were described according to the frequency of occurrence. Information about the program available on the Internet enables its use by other hospitals.
These results indicate that EM appears to cause adverse effects more frequently than reported in the package insert in Japan. The prophylactic use of EM for pertussis infection is recognized in the guideline of the Centers for Disease Control and Prevention. However, this study suggests that attention should be paid to EM non-compliance during a pertussis outbreak, which could extend the duration of the outbreak and increase the number of affected patients.
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