[Present Status of Displaying Pharmaceutical Products for Sale on Flea Market Applications for Smartphones and the Responses to Illicit Selling by Service Providers].

In Japan, a pharmacy or drug store license is required for selling pharmaceutical products. However, civilians without a pharmacy or drug store license are displaying pharmaceutical products for sale on a flea market application, which is illegal dealing. This study discussed the modality for implementing countermeasures for the illicit selling of pharmaceutical products. We extracted pharmaceutical products displayed for sale on three flea market applications (Mercari, Rakuma, Fril) on one day. One hundred and eighty-one pharmaceutical products were displayed (49 on Mercari, 86 on Rakuma, and 46 on Fril). There were 6.1% (11/181) domestically prescribed drugs, 69.1% (125/181) domestic OTC drugs, 23.8% (43/181) foreign-made prescribed drugs, and 1.1% (2/181) foreign-made OTC drugs. The seller could display the product for sale without confirming whether it is prohibited. We alerted the service providers of this illicit selling at flea markets at three different instances. The pharmaceutical product displays were deleted by the service providers at a rate of 55.1% (27/49) for Mercari and 51.2% (44/86) for Rakuma. The average number of drugs that were displayed for sale by each seller was 1.4 and the average number of total products that were displayed for sale by each seller was 100. The seller could have unintentionally displayed the pharmaceutical products for sale, without the knowledge that it is illegal. The service providers of flea market applications should create mechanisms to alert the sellers that displaying pharmaceutical products for sale is an illicit act and regulate these violations.

Whether Visual Information Loss of Expression by Community Pharmacist Masks to Effect a Change in Feeling of Trust among Help-seeker?

Pharmacy is required to shift toward human service such as hearing the complaints of health. But the study about help-seeking behavior to pharmacist is not really investigated. We hypothesized that a decrease in expression visibility, due to pharmacists' typical masks, may negatively impact help-seeker' trust in pharmacist. The sample included 100 drugstore customers aged ≥18 years. Participants were stratified by gender and randomly assigned to two groups: evaluation of clear-masked and normal-masked pharmacists. After viewing a video with either male or female pharmacists wearing either clear or normal masks, participants completed a questionnaire. The primary outcome was trust in pharmacist measured by the Trust Scale and the secondary outcome was impression of the pharmacist measured by nineteen pairs of adjectives. There were no differences by gender on trust scores. Results revealed that both male and female pharmacists who wore clear masks were rated as more trustworthy than normal-masked pharmacists (p<0.001, d=0.903, and p=0.001, d=0.716, respectively). Sixteen of nineteen adjectives reported for pharmacists wearing normal masks indicated greater negative intention than those with clear masks (d=0.431-1.469). In most cases, among pharmacists wearing clear masks, results showed positive correlations between trust and each impression adjective (r=0.279-0.710). Our findings indicate that pharmacists wearing normal masks, which partially hide facial expressions, may decrease customer's trust in pharmacist. Further, normal masks were associated with negative impression. To avoid the inhibition of help-seek behavior, we recommend that pharmacists wear a clear mask and increase non-verbal communication.

Social Pharmacy: Its Performance and Promise.

Among private Universities of Pharmacy in Japan, Kyoritsu University of Pharmacy was the first to introduce courses in social pharmacy in 1991. Social pharmacy is a discipline driven by social needs. By studying the relationship between pharmacy and society, particularly through case studies, the impact of drugs and changes in societal expectation of them, as well as through historical background studies and surveys of current trends, this discipline acts to determine the roles of pharmacists and pharmacies expected by society. Social pharmacy requires a basic knowledge of pharmaceutical science, but an understanding from economic viewpoints of the current systems and structures in which healthcare functions is important as well. Once these are understood, the goal is to identify social problems, and to create and apply models for their resolution which connect pharmacy and society. So far, social pharmacy has played an important role in training programs for community-based pharmacists essential for a hyper-aged society, for community pharmacies' health management programs aimed at promoting the health of residents, and educational programs for elementary and middle school children.

Activity and the Role of Keio University Pharmacy.

Keio University Faculty of Pharmacy opened an insurance pharmacy on its campus in 2001. This pharmacy was opened with the objectives of 1) educating pharmacists to serve the regional community; 2) heightening students' motivation; and 3) providing practical education geared to the needs of actual healthcare settings. Since my appointment as director in 2003, I have led various initiatives to determine an ideal business model for a university pharmacy. This paper reports these initiatives and discusses the mission and future prospects of university pharmacies. In terms of education, all 4th-year students provide medication guidance to simulated patients at our university pharmacy counters, and are briefed by pharmacists about pharmacy administration and dispensing activities. Over three periods each academic year, trainees from other universities have been accepted for long-term on-site training. Students also work at local facilities for elderly persons to learn how to effectively communicate with this demographic and to better understand their unique pharmacokinetic profiles, impaired QOL, etc. Students can also participate in health promotion and drug education courses for regional residents, and support their self-medication. Pharmacies are important points of contact with local communities where residents' lives can be medically monitored. It is important for pharmaceutical universities to operate their own pharmacies in order to determine and stay abreast of the evolving challenges society expects pharmaceutical science to address. University pharmacies need to become models for general community pharmacies.

[A study on comparison of learning effects between a board game and a lecture about infection control].

  In order to provide an opportunity for community pharmacists to actively learn about infection control, this study created learning materials through a board game format and verified characteristics of learning by determining and comparing evaluation according to viewpoint and motivational effects between a lecture and the game. To create the board game, we collected cases of infection from 30 community pharmacists. The game was created using collected and created case studies, and we held a workshop on infection control. Participants were assigned to a lecture (n=32) or game group (n=27) and completed a questionnaire before and after the workshop. The questionnaire included the evaluation according to viewpoint based on the ministry's curriculum guidelines and the motivational effect of Keller's ARCS motivation model. In the evaluation according to viewpoint, the lecture group scores were significantly higher on "knowledge and understanding" than the game group scores. In the comparison of the motivational effects, the game group was significantly higher in three out of the four items of the ARCS motivation model, "Attention", "Relevance", and "Satisfaction". These results indicate that learning through the game aroused the curiosity of the learners, increased the learning outcome, and maintained certain levels of motivation. In addition, the evaluation according to viewpoint showed that the lecture group understood the key concepts and knowledge regarding infection control, whereas there was a possibility that the game group required additional motivational factors for learning and maintaining motivation level.

[Patients' reaction to pharmacists wearing a mask during their consultations].

  This study sought to determine the effect of pharmacists wearing a mask on the consultation intention of patients who do not have a trusting relationship with the pharmacists. We conducted a questionnaire survey of customers at a Tokyo drugstore in August 2012. Subjects answered a questionnaire after watching two medical teaching videos, one in which the pharmacist was wearing a mask and the other in which the pharmacist was not wearing a mask. Data analysis was performed using a paired t-test and multiple logistic regression. The paired t-test revealed a significant difference in 'Maintenance Problem' between the two pharmacist situations. After excluding factors not associated with wearing a mask, multiple logistic regression analysis identified three independent variables with a significant effect on participants not wanting to consult with a pharmacist wearing a mask. Positive factors were 'active-inactive' and 'frequency mask use', a negative factor was 'age'. Our study has shown that pharmacists wearing a mask may be a factor that prevents patients from consulting with pharmacist. Those patients whose intention to consult might be affected by the pharmacists wearing a mask tended to be younger, to have no habit of wearing masks preventively themselves, and to form a negative opinion of such pharmacists. Therefore, it was estimated that pharmacists who wear masks need to provide medical education by asking questions more positively than when they do not wear a mask in order to prevent the patient worrying about oneself.

Survey on the attitudes of pharmacy students in Japan toward doping and supplement intake.

Doping is one of the most serious problems for athletes, and it is important that pharmacists have more interaction with athletes to ensure safer drug usage. Education is one of the most important roles of sports pharmacists, who are specialists regarding drug usage for athletes. We investigated pharmacy students' interests and comprehension regarding drug usage, doping and supplement intake by using the form of a questionnaire, since it is important to know how they understand these subjects as part of their greater educational program. The subjects were sophomore and junior pharmacy students at three universities. It was revealed that most of the students have negative images regarding doping violation, and they answered that they are familiar with doping. However, only sixteen percent of the students had attended lectures by specialists on doping. In addition, one third of pharmacy students did not know that some over-the-counter (OTC) drugs might contain doping substances. With regard to supplement intake, approximately two thirds of the respondents had an interest in and positive image of supplement intake. However, it was revealed that only one third of them recognized supplements as food, and their information regarding supplements was obtained from uncertain media. It was suggested that it is important for pharmacy students to have more opportunities to learn about what doping is. More education and enlightenment by sports pharmacists would be effective for pharmacy students as well as athletes, and it would help us to broaden the scope of what we can do for athletes and society.

Depression, but not sleep disorder, is an independent factor affecting exacerbations and hospitalization in patients with chronic obstructive pulmonary disease.

BACKGROUND AND OBJECTIVE: Patients with chronic obstructive pulmonary disease (COPD) may experience depression and sleep disorders, which can adversely affect their health-related quality of life (HRQOL). The aim of this study was to investigate depression and sleep disorders among 85 COPD patients and 46 control subjects, aged 40 years and over. METHODS: Patients underwent spirometry and arterial blood gas analysis, self-completed St. George's respiratory questionnaire and were assessed on the center for epidemiologic studies depression (CES-D) and the Pittsburgh sleep quality index (PSQI). The frequency of exacerbations among COPD patients was prospectively monitored for 12 months. RESULTS: The prevalence of depression and sleep disorders was significantly higher among COPD patients than control subjects. The relative risks (95% confidence interval) of depression and sleep disorders were 7.58 (1.03 to 55.8) and 1.82 (1.03 to 3.22), respectively, in COPD patients compared with control subjects. Among COPD patients, there was a correlation between CES-D and PSQI. Lower body mass index, more severe dyspnoea, poorer HRQOL, lower partial pressure of arterial oxygen and higher partial pressure of arterial carbon dioxide were significantly associated with the incidence of depression and sleep disorders. Exacerbations and hospitalizations were more frequent among COPD patients with depression than those with sleep disorders alone or those without depression or sleep disorders. CONCLUSIONS: Depression and sleep disorders are very common co-morbidities among COPD patients and significantly reduce activities and HRQOL among these patients. Depression, but not sleep disorder, is an independent risk factor for exacerbations and hospitalization among COPD patients.

[Historical consideration of the widespread infection of the hepatitis C virus in Japan and use of a fishbone diagram to investigate the cause].

About 75% of Japanese liver cancer is caused by hepatitis C. Widespread infection of the virus resulted from inadequate medical knowledge, as well as the political, economic and administrative conditions of the time. We investigated the association between the widespread infection of the hepatitis C virus and the historical events. We used a fishbone diagram to investigate the cause of widespread infection of the hepatitis C virus and considered the issue from a historical standpoint. We found causes including treatment (medical care), transfusion (medicine), economy (expense) and people (infection route). These causes are explained in further detail below. 1) Treatment (medical care). The initial large-scale infection occurred following attempts to eradicate Schistosoma japonicum involving mass vaccination in schools and public health centers. 2) Transfusion (medicine). The use of non-heated fibrinogen for massive postpartum hemorrhage spread the virus further. In 1987, it resulted in a mass outbreak of hepatitis in Aomori Prefecture. 3) Economy (expense). Recognition of the benefit of disposable syringes was delayed. As a result, disposable syringes were too expensive to be widely available, and did not become low-priced. 4) People (infection route). The second wave of dissemination of the hepatitis C virus was stimulant abuse after World War II. Prior to the discovery of the hepatitis C virus, transmission resulted from repeated use of contaminated syringes. Although we initially thought that these four causes occurred independently on a historical chronology, associations between the causes were found when we investigated the problem with a fishbone diagram.

Use of anonymous Web communities and websites by medical consumers in Japan to research drug information.

In this study, we investigated the status of researching drug information online, and the type of Internet user who uses anonymous Web communities and websites. A Web-based cross-sectional survey of 10875 male and female Internet users aged 16 and over was conducted in March 2010. Of 10282 analyzed respondents, excluding medical professionals, about 47% reported that they had previously searched the Internet for drug information and had used online resources ranging from drug information search engines and pharmaceutical industry websites to social networking sites and Twitter. Respondents who had researched drug information online (n=4861) were analyzed by two multivariable logistic regressions. In Model 1, the use of anonymous websites associated with age (OR, 0.778; 95% CI, 0.742-0.816), referring to the reputation and the narrative of other Internet users on shopping (OR, 1.640; 95% CI, 1.450-1.855), taking a prescription drug (OR, 0.806; 95% CI, 0.705-0.922), and frequent consulting with non-professionals about medical care and health (OR, 1.613; 95% CI, 1.396-1.865). In Model 2, use of only anonymous websites was associated with age (OR, 0.753; 95% CI, 0.705-0.805), using the Internet daily (OR, 0.611; 95% CI, 0.462-0.808), taking a prescription drug (OR, 0.614; 95% CI, 0.505-0.747), and experience a side effect (OR, 0.526; 95% CI, 0.421-0.658). The analysis revealed the profiles of Internet users who researched drug information on social media sites where the information providers are anonymous and do not necessarily have adequate knowledge of medicine and online information literacy.

[Study of the health food information for cancer patients on Japanese websites].

The aim of this paper is to evaluate the reliability of websites providing health food information for cancer patients and, to assess the status to get this information online. We used four common Japanese search engines (Yahoo!, Google, goo, and MSN) to look up websites on Dec. 2, 2008. The search keywords were "health food" and "cancer". The websites for the first 100 hits generated by each search engine were screened and extracted by three conditions. We extracted 64 unique websites by the result of retrieval, of which 54 websites had information about health food factors. The two scales were used to evaluate the quality of the content on 54 websites. On the scale of reliability of information on the Web, the average score was 2.69+/-1.70 (maximum 6) and the median was 2.5. The other scale was matter need to check whether listed to use safely this information. On this scale, the average score was 0.72+/-1.22 (maximum 5) and the median was 0. Three engines showed poor correlation between the ranking and the latter score. But several websites on the top indicated 0 score. Fifty-four websites were extracted with one to four engines and the average number of search engines was 1.9. The two scales were positively correlated with the number of search engines, but these correlations were very poor. Ranking high and extraction by multiple search engines were of minor benefit to pick out more reliable information.

[Factors related to purchasing over-the-counter medications online].

We conducted a Web-based survey of approximately 40,000 Internet users on the purchase of over-the-counter (OTC) medications online in March 2009. The valid response rate was 97.8% and the number of responses was 39,208. The number of people who had purchased OTC medications online was 4,653 (11.9%), prescription medicines 792 (2.0%), and medical contact lenses 1,993 (5.1%). As a result of the multiple logistic regression analysis, independent variables with odds ratios (ORs) >1.5 were experience of purchasing prescription-only medicine online (OR=4.997, 95%CI=4.288-5.824), regular supplement use (OR=2.384, 95%CI=2.233-2.548), experience of purchasing colored contact lenses online (OR=2.206, 95%CI=1.632-2.983), no time to visit drugstores (OR=2.092, 95%CI=1.928-2.270), usage of Web sites of uncertain reliability (OR=1.992, 95%CI=1.857-2.137), and experience of purchasing therapeutic contact lenses online (OR=1.796, 95%CI=1.597-2.020). As some people have purchased prescription-only medicine or medical devices and had problems with drug information sources, the development of awareness of medical and pharmaceutical supplies and health and medical information literacy are key priorities to ensure safe OTC medication sales systems.

Induction of (6-4) photolyase gene transcription by blue light in Xenopus A6 cells.

(6-4) photolyase repairs pyrimidine-pyrimidone (6-4) photoproducts generated in DNA upon UV light exposure. We studied the effects of blue light on the expression of this gene in Xenopus A6 cells. Exposure of the cells to blue light, but not red light, for 12h resulted in more than 20-fold increase of the (6-4) photolyase mRNA. By contrast, levels of the other two photolyase mRNAs, i.e., those for CPD photolyase and cryptochrome DASH, did not change significantly. Oxygen radicals presumably generated within the cells upon exposure to blue light were not the cause of the induction, since addition of neither hydrogen peroxide nor a photosensitizer, phenol red, in the culture medium increased the (6-4) photolyase mRNA level. These results support the possibility that the expression of (6-4) photolyase may be regulated by a mechanism involving an as yet ill-defined blue light photoreceptor in the peripheral tissues of Xenopus.

[Fifty years after the enactment of the law to separate drug dispensing from doctors].

This report summarizes the action of Mr. Usho Mizoroki, who was not a pharmacist but was an activist for enacting the law to separate drug dispensing from doctors (Division of Labour Law). We collected the information Mrs. Shigeko Mizoroki revealed about her husband's activities towards enacting the Division of Labour Law, and added the historical background of that era. Nobody knows of his activities related to the enactment of the Division of Labour Law. It may be possible that the law itself was not successful, or that Mr. Usho Mizoroki was not a pharmacist. However it is important to know his efforts because the present division of labour practice is the result of the efforts of many people like him.

High-dose vitamins E and C supplementation prevents ribavirin-induced hemolytic anemia in patients with chronic hepatitis C.

AIM: In combination therapy using interferon (IFN) and ribavirin for chronic hepatitis C, reduced doses should be used due to ribavirin-induced hemolytic anemia. The present study aimed to elucidate whether high-dose vitamins E and C supplementation attenuated ribavirin-induced hemolytic anemia. METHODS: Twenty-one consecutive patients with chronic hepatitis C were enrolled in this study between July 2003 and December 2004, and received high-dose vitamins E (2000 mg) and C (2000 mg) supplementation, daily, in addition to IFN alfa-2b and ribavirin combination therapy (vitamins E/C group). Twenty-one sex- and age-matched patients who received a standard regimen of IFN alfa-2b and ribavirin for chronic hepatitis C between January 2001 and June 2003 were evaluated as the control group. RESULTS: Decrease in hemoglobin level was significantly prevented in the vitamins E and C group compared to that in the control group (P = 0.029). Three (14.3%) patients in the control group discontinued treatment because of anemia, while no treated patient dropped out of the study due to anemia. Sustained virological response was not significantly different between the two groups. CONCLUSION: High-dose vitamins E and C supplementation prevented ribavirin-induced hemolytic anemia during combination therapy with ribavirin and IFN alfa-2b in patients with chronic hepatitis C.

Ethnic differences in the VKORC1 gene polymorphism and an association with warfarin dosage requirements in cardiovascular surgery patients.

OBJECTIVES: Vitamin K epoxide reductase (VKORC1) is the drug target for inhibition by coumarin-based anticoagulant drugs such as warfarin. Warfarin therapy has been reported as a leading cause of drug-related hospitalization and there is therefore an urgent need to develop tests for better warfarin prescription. We report here the distribution of the intron 1 -136 T>C (1173 T>C intron) polymorphism of VKORC1, previously reported to be associated with warfarin maintenance dose in Caucasians and Japanese, in several ethnic populations from Japan and Israel, and describe its significance for warfarin dosage in Japanese cardiovascular surgery patients. METHODS: Subjects consisted of 132 Japanese individuals and 341 Israeli individuals from four Jewish ethnic groups (86 Ashkenazi Jews, 95 Yemenite Jews, 73 Moroccan Jews and 87 Libyan Jews). In addition, 31 Japanese patients receiving warfarin therapy after cardiovascular surgery, maintained with a target International Normalized Ratio, were studied. The genotyping for the 1173 T>C intron polymorphism of VKORC1 was determined using rapid real-time PCR. RESULTS: The allele frequency of the combined VKORC1 1173 CT and CC genotypes varied among the four Israeli ethnic groups and was, on average, much higher in the Israeli (0.728) than in the Japanese population (0.152). For the Japanese cardiovascular surgery patients, the maintenance dose of warfarin was significantly larger in the combined VKORC1 1173 TC and CC genotype group than in the 1173 TT genotype group (3.6 +/- 0.5 mg vs 2.8 +/- 0.7 mg, respectively; p = 0.02). CONCLUSION: The frequencies of the intron 1 VKORC1 1173 T>C SNP show significant differences between ethnic groups and are associated with warfarin dose requirements for achieving a recommended International Normalized Ratio range in Japanese cardiovascular surgery patients. This study supports the example of warfarin as an appropriate model for applying personalized medicine for anticoagulant drugs, and highlights the importance of ethnicity in pharmacogenetics.

Ethnic differences in CYP2C9*2 (Arg144Cys) and CYP2C9*3 (Ile359Leu) genotypes in Japanese and Israeli populations.

CYP2C9 is a major P450 2C enzyme, which hydroxylates about 16% of drugs that are in current clinical use and contributes to the metabolism of a number of clinically important substrate drugs such as warfarin. Ethnic differences in the genetic variation of CYP2C9 have been reported, and might be related to the frequencies of adverse reactions to drugs metabolized by CYP2C9 in different ethnic groups. In the present study, ethnic differences in the CYP2C9*2 and CYP2C9*3 allele distribution in Japanese and Israeli populations were evaluated using a newly developed oligonucleotide based DNA array (OligoArray(R)). The population studied consisted of 147 Japanese and 388 Israeli donors (100 Ashkenazi Jews, 99 Yemenite Jews, 100 Moroccan Jews and 89 Libyan Jews). The CYP2C9*2 [Arg144Cys (416 C>T), exon 3] and CYP2C9*3 [Ile359Leu (1061 A>C), exon 7] genotypes were determined using an OligoArray(R). The accuracy of genotyping by the OligoArray(R) was verified by the fluorescent dye-terminator cycle sequencing method. A Hardy-Weinberg test indicated equilibrium (chi(2)<3.84 is Hardy-Weinberg) in all populations. The CYP2C9*2 genotype (CC/CT+TT) was absent in Japanese (1/0) (OR 0.02), and its frequency was significant in Libyan Jews (0.697/0.303) (OR 2.13; 95% CI 1.07-4.24) compared with Ashkenazi Jews (0.83/0.17), Yemenite Jews (0.899/0.101), and Moroccan Jews (0.81/0.19). The frequencies of CYP2C9*3 genotype (AA/AC+CC) was significantly lower in Japanese (0.986/0.014) (OR 0.08), and was higher in Libyan Jews (0.652/0.348) (OR 3.03; 95% CI 1.5-6.1) and Moroccan Jews (0.77/0.23) (OR 1.69; 95% CI 0.62-3.48) compared with those in Ashkenazi Jews (0.85/0.15) and Yemenite Jews (0.849/0.151). Thus, the CYP2C9*2 (Arg144Cys) and CYP2C9*3 (Ile359Leu) variants were rare in the Japanese population, and showed different frequencies in the four Jewish ethnic groups examined.

Ethnic differences of coronary artery disease-associated SNPs in two Israeli healthy populations using MALDI-TOF mass spectrometry.

Differences in prevalence and mortality from coronary artery disease (CAD) were observed among the different Israeli ethnic groups. The incidence of CAD in Israel is highest among Ashkenazi Jews and is much lower among Yemenite Jews. In this present study, we selected 15 single nucleotide polymorphisms (SNPs) from 14 candidate genes involved in (1) the renin-angiotensin system, (2) lipid metabolism, (3) cytokines and adhesion molecules, and (4) growth factors, and (5) the coagulation-fibrinolysis system. We analyzed the 15 SNPs in 94 Israeli healthy populations (47 Ashkenazi Jews and 47 Yemenite Jews) obtained from the National Laboratory for the Genetics of Israeli Populations. We applied chip-based MALDI-TOF mass spectrometry as a method for screening multiplexed genotyping of SNPs for ethnic difference in these healthy populations. Among the 15 candidate SNPs, significant differences in allelic frequency were observed in the 1166A>C of the AGTR1 gene, R158C of the Apo E gene, W64R of the ADRB3 gene, S101S of the TIMP 2 gene, and A222V of the MTHFR gene with respect to allele frequency. The incidence of A/C allele of the AGTR1 gene were 0.638/0.362 vs 0.765/0.235, C/T allele in the apo E gene was 0.915/0.085 vs 0.989/0.011, T/C allele of the ADRB3 gene was 0.989/0.0011 vs 0.926/0.074, G/A allele of the TIMP2 gene was 0.974/0.054 vs 0.830/0.170, and C/T allele in the MTHFR gene was 0.521/0.479 vs 0.819/0.181 for Ashkenazi Jews and Yemenite Jews, respectively. We demonstrated an ethnic difference of CAD-associated SNPs in two Israeli healthy populations using MALDI-TOF mass spectrometry. Further study is necessary to prove causal relation with CAD-associated SNPs and the prevalence of CAD.

A survey on low-dose oral contraceptive transactions at pharmacies.

Low-dose oral contraceptives (OCs) were approved by the Japanese Ministry of Health, Labor and Welfare in 1999. However, few women use low-dose OCs (married 1.9%, unmarried 0.7%). A survey of pharmacies was conducted to determine the current status of OC transactions. Of the 449 pharmacies randomly selected from each prefecture in Japan, 408 agreed to be interviewed. The survey results indicated that few pharmacies (15.1% of the total) stocked low-dose OCs. Even among pharmacies where they were available, only a few (13.5%) offered a wide variety of low-dose OCs for immediate dispensing. The price of low-dose OCs varied widely (yen 1,167-yen 7,000). In many pharmacies, the amount of space and interior structure were not adequate for users to seek advice on and receive low-dose OCs. The survey revealed that the current environment of many pharmacies is not adequate for users to visit, consult on OC use, and receive their prescriptions. To promote wider use of low-dose OCs, the facilities of pharmacies as well as the behavior of pharmacists need to be improved to safeguard the privacy of users.