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Medical Economic Benefit Derived from the Use of Tracing Reports by Pharmacy-Based Pharmacists for Pharmaceutical Intervention and Reduction of Leftover Medicines
Get PDF香川大学Kagawa University博士（医学）This study aimed to evaluate the effects on the medical economy of the use of tracing reports by pharmacy-based pharmacists for pharmaceutical interventions, including to reduce leftover medicines. These effects were estimated by analyzing 267 tracing reports issued by pharmacy pharmacists over a period of 1 year, 2020-2021. We estimate that these interventions created cost savings of USD108170.02/year (USD104800 via pharmaceutical interventions, USD3370.02 via interventions to reduce leftover medicines). The cost savings from pharmaceutical interventions prompted by patient follow-up was estimated to be USD47650. The medical economic effect per tracing report was estimated to be USD392.51 from pharmaceutical interventions, USD12.62 from reducing leftover medicines, and USD445.33 from pharmaceutical intervention prompted by patient follow-up. Overall, therefore, pharmaceutical interventions by pharmacy pharmacists using tracing reports, including those designed to reduce leftover medicines, may benefit the medical economy.doctoral thesi
Real-world clinical usage and efficacy of apalutamide in men with nonmetastatic castration-resistant prostate cancer: a multi-institutional study in the CsJUC
No full textObjective
To evaluate the real-world clinical usage and effectiveness of apalutamide in men with nonmetastatic castration-resistant prostate cancer (nmCRPC).Methods
We retrospectively reviewed the data of 186 men who received apalutamide across 17 institutions. The primary outcomes were the clinical usage of apalutamide for nmCRPC: prior usage of other androgen receptor signaling inhibitors (ARSIs), prior radical treatment, and the distribution of the prostate-specific antigen (PSA) doubling time (PSA-DT) at the initial administration of apalutamide. The secondary outcomes were the efficacy of apalutamide: PSA response (50% or 90% decline), progression-free survival, and skin-adverse events (AEs).Results
We identified 75 patients with nmCRPC. A total of 31 (41.3%) patients received prior treatment with other ARSIs. A total of 42 men (56%) did not receive any prior radical treatment. The PSA-DT was 10 months in 34.7%, 40%, 14.7%, and 10.6% of the patients, respectively. Patients receiving prior treatment with other ARSIs showed a significantly lower PSA response (PSA 50% decline, 88.4% vs. 18.8%; PSA 90% decline, 60.5% vs. 6.2%, P < .001, respectively) and significantly shorter progression-free survival (median: 37 months vs. 4 months; log-rank P < .001) than those without prior ARSI treatment, although cancer status did not differ between the groups. Skin-AEs were observed in 42.7%.Conclusions
This real-world study revealed that apalutamide was used for the treatment after other ARSIs in >40% of patients with nmCRPC and showed limited efficacy in this context, although the effectiveness of apalutamide without prior other ARSI treatment was comparable with that reported in clinical trial results.journal articl
The Current Status of Human Capital and Female Representation on Boards in Japan
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The Empirical Study on Regional Revitalization through Bidirectional Learning Workation in 2024
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Increased macular atrophy area with photodynamic therapy over intravitreal aflibercept at 2-year follow-up of pachychoroid neovasculopathy
No full text香川大学Kagawa University博士（医学）Purpose: To compare the therapeutic outcomes of intravitreal aflibercept injection (IVA) and reduced-fluence photodynamic therapy (rfPDT) for pachychoroid neovasculopathy (PNV) over 2 years.Study design: Observational, retrospective case series. Single-center study.Methods: This study involved 36 eyes of 36 patients with PNV. The IVA group comprised 18 eyes treated with IVA monotherapy (injection every 3 months followed by a pro re nata regimen), whereas the rfPDT group consisted of 18 eyes treated with rfPDT monotherapy. Post-treatment changes in best-corrected visual acuity (BCVA), macular atrophy (MA) area, central retinal thickness (CRT) and subfoveal choroidal thickness (SFCT) were compared between the 2 groups.Results: The IVA group received 8.94 ± 4.77 injections, whereas the rfPDT group received rfPDT 1.06 ± 0.24 times. The logMAR BCVA improved in both groups but did not differ between the 2 groups. The MA area increased from 0.163 ± 0.418 mm2 to 0.227 ± 0.480 mm2 (P = .024) and from 0.139 ± 0.402 mm2 to 0.597 ± 0.939 mm2 (P < .001) in the IVA and rfPDT groups, respectively, with the rfPDT group showing a greater increase than the IVA group (P = .013). The CRT was reduced in both groups but did not differ between the 2 groups. The SFCT was reduced in both groups, but the reduction was higher in the rfPDT group than in the IVA group (P = .027). The factors affecting change in the MA area were the treatment method and patient age.Conclusions: The increase in the MA area and the decrease in the SFCT were greater in the rfPDT group than in the IVA group for PNV, suggesting that IVA may be preferred over rfPDT for PNV treatment.doctoral thesi
Significant Correlation Between Retinal Blood Flow and Oxygen Saturation During Intravitreal Aflibercept Treatment for Central Retinal Vein Occlusion
No full text香川大学博士（医学）Purpose: The purpose of this study was to evaluate the relationship between retinal blood flow and oxygen saturation during intravitreal aflibercept treatment for central retinal vein occlusion (CRVO) using OxymapT1 and laser speckle flowgraphy (LSFG).Methods: Thirty-two untreated patients (32 eyes) with nonischemic CRVO received monthly intravitreal aflibercept injections for 3 months followed by a pro re nata regimen; they were followed up for approximately 1 year. Central retinal thickness, retinal oxygen saturation, and retinal blood flow were measured using optical coherence tomography, OxymapT1, and LSFG, respectively.Results: Visual acuity (VA) and central retinal thickness (CRT; µm) significantly improved from 1 month onward in both the all-patient and nonischemic groups (VA baseline = 0.51, 0.48, 1 month = 0.30, 0.29, P = 0.049, P = 0.032; and CRT baseline = 615.0, 615.0, 1 month = 278.4, 275.0, P = 0.049, P < 0.001). Using OxymapT1, retinal venous oxygen saturation was reduced at baseline but significantly increased from 1 month after aflibercept injection and remained elevated in both groups (baseline = 34.1%, and 1 month = 41.1%, P = 0.006). Mean blur rate (MBR) remained stable overall, with a significant increase at the final visit in the nonischemic group (baseline = 22.4, and final = 27.4, P = 0.001). A significant positive correlation was found between venous oxygen saturation and MBR from 1 month after treatment onward (1 month = R = 0.538, P = 0.002).Conclusions: In CRVO, venous oxygen saturation and MBR were significantly correlated.Translational relevance: Measuring and evaluating retinal blood flow and oxygen saturation during treatment of CRVO eyes is recommended.doctoral thesi
