Details of a Researcher - KAWAZOE Hitoshi

Papers - KAWAZOE Hitoshi

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Preventive Effects of Renin-angiotensin System Inhibitors on Oxaliplatin-induced Peripheral Neuropathy: A Retrospective Observational Study

Uchida M†, Kawazoe H†, Takatori S, Namba H, Uozumi R, Tanaka A, Kawasaki H, Araki H.

Clinical Therapeutics (ELSEVIER ) 40 ( 7 ) 1214 - 1222 2018.07

Research paper (scientific journal), Joint Work, Accepted, ISSN 01492918

© 2018 Elsevier Inc. Purpose: Oxaliplatin-induced peripheral neuropathy has remained an unresolved issue in clinical practice. Our previous study hypothesized that inhibition of the renin-angiotensin system (RAS) may produce a preventive effect on oxaliplatin-induced neuropathy. The aim of this study was to clarify whether RAS inhibitors prevent oxaliplatin-induced peripheral neuropathy. Methods: This study retrospectively analyzed data from cancer patients who had received chemotherapy including oxaliplatin and were treated with or without RAS inhibitors. This retrospective observational study was conducted at Ehime University Hospital using electronic medical records from May 2009 to December 2016. The primary end point was the incidence of severe peripheral neuropathy during or after oxaliplatin treatment, according to the Common Terminology Criteria for Adverse Events, version 4.0. A multivariate Cox proportional hazards model analysis was used to identify risk factors. Findings: A total of 150 patients were included in the study. The estimated incidence of peripheral neuropathy was 36.9% and 91.7% in the RAS inhibitor group and the non–RAS inhibitor group, respectively. The multivariate analysis using a Cox proportional hazards model showed that the RAS inhibitor group was slightly associated with a decreased risk of neurotoxicity (adjusted hazard ratio, 0.42 [95% CI, 0.18–0.99]; P = 0.048). Implications: The present findings suggest that RAS inhibitors have the ability to prevent oxaliplatin-induced peripheral neuropathy.

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Analysis of Clinical Factors and Mortality in Diffuse Large B-cell Lymphoma Patients Over or Under 80 Years of Age

Hasebe S, Tanaka K, Miyake Y, Asai H, Takeuchi K, Fujii T, Kawazoe H, Tanimoto K, Yamanouchi J, Azuma T, Yasukawa M, Yakushijin Y.

International Journal of Gerontology (TAIWAN SOC GERIATRIC EMERGENCY & CRITICAL CARE MEDICINE-TSGECM ) 12 ( 2 ) 100 - 104 2018.06

Research paper (scientific journal), Joint Work, Accepted, ISSN 18739598

© 2017 Background: The prognosis of diffuse large B-cell lymphoma (DLBCL) is remarkably improved after R-CHOP therapy. However, there are few detailed reports regarding very elderly DLBCL patients. We investigated relationships between prognostic factors and mortality risk in DLBCL patients, especially those aged 80 years or more. Methods: The study subjects consisted of 141 patients newly-diagnosed with de novo DLBCL. Information regarding age, sex, stage, performance status (PS), lactate dehydrogenase (LDH), extranodal (EN) involvement, and therapies was available. Results: For the 141 patients, the female sex was significantly inversely related to mortality, whereas age ≥80 years, PS ≥2, and non-standard therapy were significantly positively associated with death. No associations were observed between death and stage, LDH, or EN. When classifying patients by age (<80 [n = 108] and ≥80 [n = 33] years), a significant inverse association between female sex and mortality was found only in the latter (very elderly) group. Positive relationships of PS ≥2 with mortality was more pronounced in patients ≥80 years of age than in those <80 years of age. A significant positive relationship with non-standard therapy was found only in patients <80 years of age. Conclusion: PS ≥2 may be positively associated with mortality, regardless of age. Female sex may be inversely related to mortality only in DLBCL patients aged 80 years or more, possibly due to the difference in rituximab clearance between the two study groups.

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全入院患者に対する抗がん剤の閉鎖式薬物移送システム導入とその評価

沖野真季, 河添　仁*, 泉　智基, 矢野安樹子, 白石沙弥, 芳野知栄, 渡邉真一, 田坂友紀, 飛鷹範明, 田中　守, 田中亮裕, 荒木博陽

医療薬学 ((一社)日本医療薬学会) 44 ( 1 ) 37 - 48 2018.01

Research paper (scientific journal), Joint Work, Corresponding author, Accepted, ISSN 1346-342X

A Japanese guideline for the safe handling of anticancer drugs recommends a closed system drug transfer device (CSTD). We gradually introduced the PhaSealTM system from preparation to administration of all anticancer drugs to inpatients on holidays as well as weekdays. We evaluated whether the CSTD handling of 36 pharmacists was appropriate or not and also retrospectively compared outcomes before and after the introduction of CSTD. In nine pharmacists who had more than 4 items of an inappropriate handling of CSTD, the median noncompliance ratio after re-training was significantly improved from 4 to 1 items (P = 0.008). We subsequently administered a questionnaire for 36 pharmacists. The customer satisfaction analysis indicated two issues for improvement: anxiety over appropriate preparation on the double audit system of pharmacists and anxiety over miss priming after liquid sensor. On the other hand, the median introduction ratio per day of CSTD between February and April 2016 and between September and October 2016 was significantly increased on weekdays and holidays (P < 0.001 and P < 0.001, respectively). In addition, the median preparation time per day between February and April 2016 and between September and October 2016 was not significantly increased on weekdays and holidays (P = 0.514 and P = 0.423, respectively). These results suggest that our training for pharmacists contributed to an appropriate handling of CSTD, resulting in the safe handling of all anticancer drugs to inpatients on weekdays as well as holidays and the risk management of pharmacists without increase of the preparation time.

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Preventive effect of pre-warming, hot compress, and pH adjustment in oxaliplatin-induced venous pain

Kawazoe H, Sumikawa S, Nakauchi K, Yakushijin Y, Yamamoto Y, Watanabe Y, Tanaka A, Araki H

International Journal of Clinical Pharmacy (SPRINGER) 39 ( 6 ) 1291 - 1297 2017.12

Research paper (scientific journal), Joint Work, Lead author, Corresponding author, Accepted

Background Venous pain induced by peripheral intravenous administration of oxaliplatin remains clinically unresolved. Objective The aim of this study was to determine the efficacy of comprehensive intervention care for venous pain in colorectal cancer patients receiving oxaliplatin. Setting A Japanese tertiary hospital. Method We treated all outpatients after April 2012 with comprehensive intervention care including pre-warming of the oxaliplatin solution, use of a hot compress, and pH adjustment by combination with dexamethasone. We retrospectively reviewed the electronic medical records from colorectal cancer patients who had received oxaliplatin via a peripheral vein between December 2009 and June 2014. Main outcome measures The primary endpoint of this study was the incidence of venous pain at the administration site during oxaliplatin infusion, according to injection site reaction grade ≥ 2. Results We evaluated 271 treatment courses in 59 patients. Venous pain occurred in 42 courses (15.5%) among 26 patients. Multivariate logistic regression analysis revealed that female gender and body mass index ≥ 25 kg/m2 were significantly associated with an increased risk of venous pain during all courses (adjusted odds ratio [OR]: 3.18, 95% confidence interval [CI] 1.35–7.92; P < 0.01; and adjusted OR: 3.37, 95% CI 1.26–9.40; P = 0.02, respectively), whereas comprehensive intervention care were significantly associated with reduced risk of venous pain during all courses (adjusted OR: 0.10, 95% CI 0.02–0.44; P < 0.01). Conclusion Comprehensive intervention care is a clinical treatment option for oxaliplatin-induced peripheral venous pain in patients with colorectal cancer, especially females with obesity.

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Psychiatric Patients with Antipsychotic Drug-Induced Hyperprolactinemia and Menstruation Disorders

Takechi K, Yoshioka Y, Kawazoe H, Tanaka M, Takatori S, Kobayashi M, Matsuoka I, Yanagawa H, Zamami Y, Imanishi M, Ishizawa K, Tanaka A, Araki H

Biological and Pharmaceutical Bulletin (The Pharmaceutical Society of Japan) 40 ( 10 ) 1775 - 1778 2017.10

Research paper (scientific journal), Joint Work, Accepted

Treatment with antipsychotic drugs has been associated with hyperprolactinemia. The same antipsychotic drugs have also been associated with side effects such as menstruation disorders. The aim of this study was to evaluate the prevalence of hyperprolactinemia and menstruation disorders in women undergoing antipsychotic treatment. We performed a retrospective chart review study of psychiatric patients who underwent laboratory testing for serum prolactin (PRL) level between March 2011 and March 2015 in Ehime University Hospital. Patients presenting with and without menstruation disorders were evaluated to determine if they presented concomitant hyperprolactinemia. Patients with menstrual disorders had a significant increase in serum PRL level with a mean of approximately 90 ng/mL. Those with menstrual disorders presented increased PRL levels by 2-fold that of patients without menstrual disorder. However, there was no significant difference in the equivalent dose of chlorpromazine between these two groups. Additionally, about 70% of patients with menstrual disorders received risperidone treatment. The receiver operating characteristic curve showed that the optimal cutoff point of serum PRL level associated with the development of menstrual disorders was 60 ng/mL. Based on these results, we concluded that patients with menstrual disorders presented increased serum PRL, and that most of them underwent treatment with risperidone.

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Antiemetic Effectiveness and Cost-Saving of Aprepitant plus Granisetron Is Superior to Palonosetron in Gastrointestinal Cancer Patients Who Received Moderately Emetogenic Chemotherapy

Toda H†, Kawazoe H†*, Yano A, Yamamoto Y, Watanabe Y, Yamamoto Y, Hiasa Y, Yakushijin Y, Tanaka H, Araki H

Journal of Cancer (IVYSPRING INTERNATIONAL PUBLISHER) 8 ( 8 ) 1371 - 1377 2017.05

Research paper (scientific journal), Joint Work, Corresponding author, Accepted

Purpose: The therapeutic benefit of a three-drug combination of antiemetics has not been established in moderately emetogenic chemotherapy (MEC). The aim of this study was to compare the antiemetic effectiveness and cost-saving of palonosetron plus dexamethasone (control group) with aprepitant, granisetron, and dexamethasone (study group) in cancer patients who received MEC.
Methods: We switched the standard antiemetic treatment from the control group to the study group in gastrointestinal cancer patients who received MEC after October 2015. The antiemetics in both groups were modified using salvage antiemetic therapy at the clinicians' discretion, according to the severity of chemotherapy-induced nausea and vomiting. We retrospectively reviewed the electronic medical records from patients, before and after switching groups, from between April 2014 and March 2016.
Results: We evaluated 443 treatment courses in 83 patients. The proportion of courses that included salvage antiemetic therapy in the control group and the study group was 34.8 % (116/333) and 8.2 % (9/110), respectively, and was statistically significant (p < 0.001). The mean integrated costs of antiemetics per course in the control group and the study group were 193 ± 55 USD and 143 ± 38 USD, respectively. Multivariate logistic regression analysis revealed that the study group was significantly associated with a reduced risk of requiring salvage antiemetic therapy (p = 0.038).
Conclusions: These results suggest that the antiemetic effectiveness and cost-saving of a three-drug combination of aprepitant, generic granisetron, and dexamethasone was superior to a two-drug combination of palonosetron plus dexamethasone in gastrointestinal cancer patients who received MEC.

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再発・難治性悪性軟部腫瘍に対するpazopanib治療の検討

長谷部晋士, 木谷彰岐, 河添　仁, 竹内一人, 薬師神芳洋

愛媛医学 36 ( 1 ) 41 - 46 2017.03

Research paper (scientific journal), Joint Work, Accepted

Non-steroidal anti-inflammatory drugs induce severe hematologic toxicities in lung cancer patients receiving pemetrexed plus carboplatin: A retrospective cohort study

Kawazoe H, Yano A, Ishida Y, Takechi K, Katayama H, Ito R, Yakushijin Y, Moriguchi T, Tanaka M, Tanaka A, Araki H

PloS One (PUBLIC LIBRARY SCIENCE ) 12 ( 2 ) e0171066 2017.02

Research paper (scientific journal), Joint Work, Lead author, Accepted

Purpose: As the major toxicity induced by pemetrexed plus carboplatin is severe hematologic toxicities, the aim of this study was to determine the risk factors for severe hematologic toxicities in lung cancer patients.
Methods: We retrospectively investigated data from lung cancer patients who had received pemetrexed plus carboplatin, with or without bevacizumab. This observational study was carried out at Ehime University Hospital using electronic medical records dating from July 2009 to March 2015. Severe hematologic toxicities were defined as grade 3 or 4, according to the Common Terminology Criteria for Adverse Events, version 4.0.
Results: Forty-two patients were included in the study. The incidence of grade 3 or 4 hematologic toxicities during the first cycle of chemotherapy and during all cycles was 19.0% and 16.1%, respectively. Multivariate time-depend generalized estimating equations logistic regression analysis revealed that regular use of non-steroidal anti-inflammatory drugs (NSAIDs) was significantly associated with an increased risk of severe hematologic toxicities during all cycles (adjusted odds ratio (OR): 8.32, 95% confidence interval (CI): 1.27–54.38; p = 0.03), whereas creatinine clearance of <45 mL/min was not significantly associated with an increased risk of severe hematologic toxicities during all cycles (adjusted OR: 0.91, 95% CI: 0.25–3.34; p = 0.88).
Conclusions: The results suggest that severe hematologic toxicities in patients receiving carboplatin-based pemetrexed may be significantly induced by the inhibition of renal tubular pemetrexed secretion through drug–drug interactions between NSAIDs and pemetrexed rather than through glomerular filtration of pemetrexed, even with moderate to sufficient renal function.

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S-1における副作用モニタリングシートを利用した病院と保険薬局の患者情報共有システム導入の副作用発見率への貢献

河添　仁, 岡田由季, 矢野安樹子, 白石沙弥, 酒井　瞳, 亀田慶太, 橋岡多津, 木下清司, 古川　清, 田中　守, 田中亮裕, 荒木博陽

医療薬学 ((一社)日本医療薬学会) 43 ( 2 ) 94 - 103 2017.02

Research paper (scientific journal), Joint Work, Lead author, Accepted

Limited sharing of information occurs between hospitals and community pharmacies regarding outpatients receiving oral chemotherapy. We therefore developed the sharing system of patient information between hospital and community pharmacies using the monitoring sheet of tegafur/gimeracil/oteracil potassium (S-1). After October 2013, community pharmacies monitored adverse events in patients receiving S-1 using the monitoring sheet, and subsequently provided this information to our hospital by fax. A medical clerk entered the information into the electronic medical records, thus providing feedback to hospital physicians. In this study, we retrospectively investigated adverse events in outpatients who had received S-1 between September 2012 and October 2014. In total, sixty-seven patients were included in the study. The proportion of patients who experienced adverse events in the control group and the monitoring sheet group was 69.0％ and 76.0％, respectively. The proportion of patients who developed lacrimation in the control group and the monitoring sheet group was 11.9％ and 36.0％, respectively, which was statistically significant (P = 0.03). On the other hand, the proportion of patients who managed any adverse events in the control group and the monitoring sheet group was 45.2％ and 68.0％, respectively. The proportion of patients who managed lacrimation in the control group and the monitoring sheet group was 11.9％ and 32.0％, respectively, which was not statistically significant (P = 0.06). These results suggest that this sharing system contributed to the identification of adverse events induced by S-1, resulting in appropriate management for patients who developed these adverse events by hospital physicians and community pharmacists.

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アプレピタント併用によりデキサメタゾンの前投与を減量時にパクリタキセルの過敏症反応が生じた1例

佐々木優, 河添　仁, 村上　聡, 守口淑秀, 田中亮裕, 荒木博陽

日本臨床腫瘍薬学会雑誌 ((一社)日本臨床腫瘍薬学会) 5 19 - 22 2016.12

Research paper (scientific journal), Joint Work, Accepted

外来患者におけるハザーダス・ドラッグ調製から投与管理までの閉鎖式薬物移送システム導入の臨床的アウトカムと医療経済効果の推算

河添　仁, 中内香菜, 矢野安樹子, 白石沙弥, 薬師神芳洋, 竹内　茜, 井門静香, 恒岡菊江, 松尾真由美, 中井昌紀, 田中　守, 田中亮裕, 荒木博陽

医療薬学 ((一社)日本医療薬学会) 42 ( 7 ) 518 - 528 2016.07

Research paper (scientific journal), Joint Work, Lead author, Accepted, ISSN 1346-342X

Following the publication of a guideline on the safe handling of hazardous drugs (HDs) in Japan, the issue of cost-effectiveness has been become a problem. We introduced the PhaSeal™ system in June 2015, a closed system drug transfer devices (CSTD) used for all outpatients, from preparation to administration. We retrospectively compared clinical outcomes before and after the introduction of CSTD of HDs included chemotherapy. Furthermore, we evaluated the medical fee income and the cost of providing CSTD between July and December 2015. The mean number of outpatient chemotherapy treatments per day before and after CSTD introduction was 15 ± 6 and 14 ± 5, respectively (P = 0.947). The mean preparation time by pharmacists before and after introduction was 21 ± 9 and 24 ± 9 minutes, respectively (P = 0.002). The mean time of nursing preparation before and after introduction was 29 ± 16 and 25 ± 14 minutes, respectively (P = 0.068). The mean time of patients waiting for chemotherapy before and after introduction was 36 ± 17 and 37 ± 17 minutes, respectively (P = 0.735). Based on the mean differences between the medical fee income and the cost of CSTD per month, we estimated that the annual cost associated with the introduction of CSTD for all outpatient to administer HDs was approximately JPY 21,000,000. After April 2016, we estimated that the amount of increase of the medical fee income of CSTD was approximately JPY 2,000,000 per year. These results suggest that the medical fee income should be increased so CSTD can be implemented for all outpatients.

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外来化学療法におけるがん患者指導管理料3の臨床的アウトカムと医療経済効果の推算

河添　仁, 矢野安樹子, 田坂祐一, 中内香菜, 田中　守, 田中亮裕, 薬師神芳洋, 荒木博陽

医療薬学 ((一社)日本医療薬学会) 42 ( 4 ) 228 - 236 2016.04

Research paper (scientific journal), Joint Work, Lead author, Accepted, ISSN 1346-342X

We retrospectively evaluated the clinical outcomes of pharmaceutical interventions relating to outpatient chemotherapy and estimated their associated economic impact between August 2014 and August 2015. We developed a novel pharmaceutical system, involving JPY1,164,000 allocated to a total of 582 patients. There were 117 proposals for pharmaceutical interventions, 106 (90.6%) of which were accepted by physicians. The number of proposals for supportive therapy was 56, 29 (51.8%) of which significantly decreased the grade of chemotherapy-induced adverse events compared to before pharmaceutical interventions (P < 0.001). The number of reductions in grade 1, 2, and 3 events was 14, 11 and 4, respectively. In this study, the potential economic costs associated with reduction of grade 1, 2 and 3 chemotherapy-induced adverse events were calculated as JPY112,000, JPY112,000, and JPY2,140,000, respectively, based on the costs paid by the Adverse Drug Reaction Relief System of the Pharmaceuticals and Medical Devices Agency. According to this cost calculation, we estimated that the total cost saving associated with the clinical outcomes of pharmaceutical interventions was JPY11,360,000. This is the first study to estimate the economic impact associated with the clinical outcomes of pharmaceutical interventions for outpatient chemotherapy. These results suggest that pharmaceutical interventions contribute to the quality and safety of outpatient chemotherapy by decreasing chemotherapy-induced adverse events.

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トラマドール/アセトアミノフェン誘発悪心・嘔吐における予防対策の有用性と関連因子

芳野知栄, 河添　仁, 井門敬子, 田中亮裕, 田中　守, 荒木博陽

日本緩和医療薬学会雑誌 8 ( 4 ) 99 - 102 2015.12

Research paper (scientific journal), Joint Work, Accepted

抗がん剤の調製から投与までの医療従事者に対する抗がん剤曝露対策の評価

上野昌紀, 河添　仁, 済川聡美, 中内香菜, 竹内　茜, 井門静香, 恒岡菊江, 樋口則子, 岡本千恵, 田中　守, 田中亮裕, 朝井洋晶, 薬師神芳洋, 荒木博陽

医療薬学 ((一社)日本医療薬学会) 41 ( 11 ) 811 - 820 2015.11

Research paper (scientific journal), Joint Work, Accepted

The BD PhasealTM administration set, a new device for the BD PhasealTM closed system drug transfer device (CSTD), can prevent the occupational exposure of health caregivers to antineoplastic agents during all stages of the treatment process from preparation to administration. Further, a revised nursing approach for administration may prevent inadvertent antineoplastic agent spills. In this study, we compared the exposure levels of cyclophosphamide (CPA) and paclitaxel (PTX) between conventional methods and the new method described above; by sampling drug absorption sheets (a sampling sheet method) was used. In both methods, CPA was prepared using the BD PhasealTM CSTD and PTX was a plastic needle open system. For the new method, CPA was administered using the BD PhasealTM administration set and PTX was the revised nursing administration approach. Five pharmacists undertook the preparation process, and five nurses the administration process. Within the administration process using the conventional method, the following levels were detected: CPA 1.67 ng/cm2 and PTX 0.077 ng/cm2. No measurable levels were detected with the new method. For the preparation process, no CPA was detected, but PTX was detected. These results suggest that the use of the BD PhasealTM administration sets and the revised nursing administration approach is useful for preventing the occupational exposure of health caregivers to antineoplastic agents; this applies to both the preparation process and the administration processes.

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オキサリプラチンの静脈炎および血管痛の危険因子の解析と加温投与ならびに温罨法による予防効果の評価

中内香菜, 河添　仁, 宮嶋理沙, 和泉千恵子, 六角由紀, 恒岡菊江, 樋口則子, 藤原光子, 児島　洋, 薬師神芳洋

癌と化学療法 (癌と化学療法社) 42 ( 11 ) 1397 - 1400 2015.11

Research paper (scientific journal), Joint Work, Accepted

学習成果の定量的評価を用いた外来化学療法室実習プログラムの導入と評価

済川聡美, 河添　仁, 上野昌紀, 田中亮裕, 田中　守, 荒木博陽

医療薬学 ((一社)日本医療薬学会) 41 ( 6 ) 442 - 449 2015.06

Research paper (scientific journal), Joint Work, Accepted

A quantitative evaluation method has not yet been established for pharmacy students in relation to learning achievements and their hospital-based practical training. We therefore developed an outpatient chemotherapy educational program to address this issue. To assess the learning achievements quantitatively, we carried out four examinations - twice at the halfway point (first) and at the program's term-end (second); a perfect score was 100. This study was conducted between May and November 2013 and 24 pharmacy students participated. The results showed that the first and second mean scores relating to their cytotoxic agent handling knowledge were 91.5 ± 5.2 and 99.1 ± 1.8, respectively. The first and second mean scores relating to preparation skills for vials (how to handle anticancer drugs) were 68.5 ± 13.1 and 78.9 ± 18.5, respectively. For their preparation skills (using closed systems to handle anticancer drugs) the mean scores were 85.2 ± 13.1 (first) and 97.0 ± 3.7 (second). The first and second mean scores about the processes involved in solving chemotherapy-related patient problems were 52.1 ± 23.7 and 77.8 ± 21.9, respectively. All of the scores were significantly increased at the end of the program compared with scores halfway through. These results suggest that our program may be useful for supporting pharmacy students to learn more effectively during their hospital-based practical training in Japan.

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Risk Factors for Discontinuation of S-1 Adjuvant Chemotherapy for Gastric Cancer

Kawazoe H, Shimasaki M, Ueno M, Sumikawa S, Takatori S, Namba H, Yoshida M, Sato K, Kojima Y, Watanabe Y, Moriguchi T, Tanaka A, Araki H

Journal of Cancer (IVYSPRING INTERNATIONAL PUBLISHER) 6 ( 5 ) 464 - 469 2015.03

Research paper (scientific journal), Joint Work, Lead author, Accepted

Purpose: The aim of this study was to clarify the risk factors for discontinuing tegafur/gimeracil/oteracil potassium (S-1) adjuvant chemotherapy following gastrectomy in patients with gastric cancer.
Methods: We retrospectively investigated patients with curatively-resected gastric cancer who received S-1 adjuvant chemotherapy. S-1 was administered orally at 80-120 mg/day, depending on body surface area, on days 1-28 every 6 weeks for 1 year. The dose and treatment schedule were modified at the clinicians' discretion, according to toxicity.
Results: Seventy-one patients were included in the study, 26 of whom discontinued S-1 therapy. The relapse-free survival rates in the S-1-completed and S-1-discontinuation groups at 5 years post-surgery were 88.1% and 55.8%, respectively. The overall survival rates in the S-1-completed and S-1-discontinuation groups at 5 years post-surgery were 89.4% and 59.8%, respectively. The hazard ratios for relapse and death were significantly lower in the S-1-completed group compared with those in the S-1-discontinuation group (0.18; p<0.001 and 0.19; p=0.002, respectively). Multivariate logistic regression analysis revealed that S-1 discontinuation was significantly associated with an initial overdose of S-1, having stage I cancer, creatinine clearance <66 mL/min, and a side effect of nausea.
Conclusions: These results suggest that assessing renal function to avoid initial overdose of S-1, together with the early management of side effects, may support the continuation of S-1 adjuvant chemotherapy in patients with gastric cancer.

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実務実習におけるがん化学療法レジメンの構成を学ぶ実習の試み

岡本千恵, 木村博史, 桝田麻矢, 安永大輝, 田坂祐一, 立川登美子, 河添　仁, 田中亮裕, 末丸克矢, 荒木博陽

日本病院薬剤師会雑誌 50 ( 9 ) 1122 - 1125 2014.09

Research paper (scientific journal), Joint Work, Accepted

S-1における院外処方せんを利用した双方向性の情報共有の取り組みとその評価

河添　仁, 上野昌紀, 済川聡美, 田中　守, 田中亮裕, 荒木博陽

医療薬学 ((一社)日本医療薬学会) 40 ( 8 ) 441 - 448 2014.08

Research paper (scientific journal), Joint Work, Lead author, Accepted

Community pharmacies play a significant role in home healthcare. However, patient information from hospitals is not shared with community pharmacies. We attempted the bidirectional sharing of patient information regarding chemotherapy between hospitals and community pharmacies. We developed a “medicine message board,” which was a modified prescription format. Hospital pharmacists recorded information regarding patients taking tegafur/gimeracil/oteracil (S-1) on the message board. In turn, community pharmacists monitored side effects in the S-1 patients and returned the information by fax to our hospital also using the message board. A medical clerk entered the side effects into the electronic medical record, providing feedback to doctors. We distributed questionnaires to community pharmacies around our hospital between December 2013 and January 2014 and assessed their understanding using a five-point Likert scale (where 1 = insufficiency and 5 = sufficiency). The results showed that the mean scores on understanding about the presence or absence of cancer notification before and after the initiation of the message board were 2.10 ± 1.02 and 4.20 ± 1.06, respectively. The mean understanding about the name of a cancer patient's disease before and after the message board was 2.25 ± 0.91 and 4.45 ± 0.83, respectively. All these differences were significant. Understanding about the purpose of treatment, dose adjustments of S-1 due to body surface area and renal function, administration schedule, presence or absence of combination chemotherapy, pharmaceutical instructions, treatment adherence, and side effects monitoring were also significantly improved in community pharmacies after the initiation of the message board. These results suggest that there is scope to improve the support provided to oral chemotherapy patients by hospitals and community pharmacists.

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がん診療連携拠点病院に勤務する医師の「高額医療」と「限度額適応認定証」の認識

薬師神芳洋, 森田純子, 矢野琢也, 松久哲章, 河添　仁, 児島　洋, 岡田憲三, 亀井治人, 原　雅道, 藤井元廣, 松野　剛, 谷水正人, 新海　哲

癌と化学療法 (癌と化学療法社) 41 ( 5 ) 605 - 610 2014.05

Research paper (scientific journal), Joint Work, Accepted

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