[Reduction in Patient Waiting Times in Pharmacies by a Protocol to Minimize Inquiries to Doctors under an Agreement between a Hospital and Community Pharmacies].

Cooperative care between hospitals and community pharmacies is important to safe and effective pharmacotherapy for outpatients. We developed a protocol comprising three agreements about alternative drugs and dosing schedules with the aim of minimizing inquiries about prescriptions to doctors. The protocol was implemented under an agreement between core hospitals in Gifu City and community pharmacy members of the Gifu City Pharmaceutical Association from October 2019. Here, we examined the impact of this protocol on patient waiting time in pharmacies. Before introduction of the protocol, median patient waiting time for questionable prescriptions requiring an inquiry to a doctor was significantly longer than that for prescriptions not requiring an inquiry (23.0 min vs. 10.0 min, p<0.001). After introduction of the protocol, median time for prescriptions which were questionable but nevertheless under the protocol did not require an inquiry to a doctor was significantly reduced compared with those which were questionable and still did require an inquiry (15.0 min vs. 24.0 min, p=0.038). In conclusion, introduction of a protocol aimed at minimizing inquiries about prescriptions to doctors from a community pharmacy was useful in reducing the waiting time of patients, and also likely in decreasing the working times of medical doctors and pharmacists.

Antacid attenuates the laxative action of magnesia in cancer patients receiving opioid analgesic.

OBJECTIVE: This study was designed to investigate pharmacological interaction between magnesium laxative and antacid in patients receiving opioid analgesic. METHODS: Data obtained from a total of 441 eligible patients receiving opioid analgesic for the first time were retrospectively analysed. The incidence of constipation, defined as stool-free interval of 3 days and more within the first week of opioid intake, was compared between patients who took laxative alone and those who received laxative in combination with antacid. KEY FINDINGS: Laxatives were prescribed in 74% of patients, among them 61% received antacids such as proton pump inhibitor and H2 receptor blocker. Magnesia was the most commonly used laxative (89%). Constipation occurred in 21% and 55% of patients with and without laxatives, respectively. Antacids reversed the laxative action of lower doses (<2000 mg/day) but not higher doses (>2000 mg/day) of magnesia without affecting the effects of other laxatives. Therefore, it is suggested that both acid-dependent and acid-independent mechanisms may operate in the laxative action of magnesia, in which the former may be involved in the action of lower doses of magnesia. CONCLUSION: Care should be taken to avoid the unfavourable pharmacological interaction between low doses of magnesia and antacid.