論文 - 小林　典子

心不全患者のトリプルワーミー回避に関する歯薬連揆の新規モデル構築の契機となった1例

前瀬鞠、近藤恒吾、林直子、岩田紘樹、小林典子、岡本侑子、棧木裕紀、漆畑俊哉、山浦克典

2026年

研究論文（学術雑誌）, 共著, 査読有り

Use of Dysphagia-Inducing Drugs and Risk of Aspiration Pneumonia: A Cross-Sectional Analysis Using a Japanese Claims Database

Hayashi N., Yoshida M., Maida N., Kondo S., Ogawa M., Iwata H., Kobayashi N., Yamaura K.

Drugs Real World Outcomes 12 （ 4 ） 607 - 614 2025年12月

ISSN  21991154

　概要を見る

Background and Objectives: Oropharyngeal dysphagia (OD), a dysfunction in swallowing food or drink, can result from various diseases and adverse drug reactions. OD is a risk factor for aspiration pneumonia (AP). However, the specific drugs causing OD and their incidence rates are not fully understood. This study aimed to identify drugs associated with OD, their incidence rates, and AP risk factors in patients taking these drugs on the basis of the information provided in package inserts. Methods: This study identified candidate dysphagia-inducing drugs (CDIDs) from Japanese package inserts that listed OD as an adverse reaction. The age, sex, medications, and comorbidities of patients taking CDIDs were analyzed using the JammNet insurance database, purchased from JammNet Co., Ltd. (Tokyo, Japan). Results: Overall, 54 ingredients were identified as CDIDs. Out of 24,276 patients taking CDIDs, 146 (0.6%) were diagnosed with OD and 76 (0.3%) with AP. Among those with AP, 23 patients (30%) also had OD. OD or AP occurred in patients taking 28 (52%) of the 54 target ingredients. In addition, 13 ingredients had an adverse reaction incidence of 1% or greater for either condition. The top five CDIDs with the highest incidence rates for each diagnosis were clobazam, baclofen, zonisamide, tiapride hydrochloride, and topiramate. Incidence rates of OD and AP were significantly higher with multiple CDIDs than with a single drug (p < 0.05). Logistic regression analysis showed that AP occurrence was significantly associated with males, late-stage elderly individuals, a diagnosis of OD, and constipation. Conclusions: The results of this study suggest that careful attention should be given to the risk of AP when prescribing CDIDs, particularly for elderly male patients.

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Community pharmadsts'attitudes and experiences regarding the p『omotfon of vaccinations in Japan

Hiroki Iwata, Taiki Kirihara, Noriko Kobayashi, Yuki Nakamura, Tomoko Koike, Katsunori Yamaura

The Keio Journal of Medicine  2025年11月

研究論文（学術雑誌）, 共著, 査読有り

Sex Differences in Electrolyte Disturbances Among Diuretic Users According to Renal Function and Age

Maida N., Kondo S., Hayashi N., Iwata H., Kobayashi N., Yamaura K.

Drug Safety 48 （ 10 ） 1149 - 1159 2025年10月

ISSN  01145916

　概要を見る

Introduction: Diuretics are widely used in Japan for the treatment of hypertension and heart failure. Electrolyte disturbance is a common adverse reaction to diuretics and may be life-threatening. Previous studies have shown that diuretic-induced electrolyte disturbance is more common in women. Electrolyte balance is regulated by the kidneys, and renal function tends to decline with advancing age. Objective: The aim of this study was to identify patients at high risk of adverse reactions to diuretics, considering the effects of sex, renal function, and age on susceptibility to diuretic-induced electrolyte disturbance. Methods: Claims data for 67,135 patients on diuretics in Japan were sourced from DeSC Healthcare, Inc. The data covered the period from April 2020 to March 2021. Results: Analysis of patient numbers using the chi-squared test showed that hyperkalemia was more common in men than in women (326 vs. 271; p = 0.003) and that hypokalemia was more common in women than in men (413 vs. 285; p < 0.001). Odds ratios (ORs) with 95% confidence intervals (CIs) were calculated for women considering age and renal function (estimated glomerular filtration rate [eGFR]). In elderly patients aged ≥ 75 years, the odds of developing hypokalemia in women compared to men were 1.47 (95% CI 1.13–1.91) for eGFR 60–30 mL/min/1.73 m² and 2.05 (95% CI 1.08–4.10) for eGFR < 30 mL/min/1.73 m². Conclusion: Among women aged ≥ 75 years, those in lower eGFR groups (60–30 and < 30) had higher odds of hypokalemia compared to men. These data highlight the importance of monitoring for adverse reactions to diuretics, particularly hypokalemia, in elderly women with low eGFR.

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Analysis of drug induced xerostomia using the Japanese Adverse D『ug Event Report Database

Shingo Kondo、Mari Maese, Nozomi Ito, Yuko Okamoto, Hiroki Iwata, Noriko Kobayashi, Katsunori Yamaura

BPB Reports 8 （ 5 ） 133 - 137 2025年10月

研究論文（学術雑誌）, 共著, 査読有り

Analysis of Factors Affecting Oral Bacterial Counts and Oral F『ailty Amon.g Community Pharmacy Users in Japan

Shingo Kondo、Kanon Maki, Naoko Hayashi, Yuko Okamoto, Hiroki Iwata, Noriko Kobayashi, Katsunori Yamaura

International Journal of Oral Care  2025年10月

研究論文（学術雑誌）, 共著, 査読有り

Loneliness and analgesic overuse among low-dose estrogen-progestin users in Japan

Fujimoto T., Iwata H., Kobayashi N., Kondo S., Yamaura K.

BMC Women S Health 25 （ 1 ）  2025年09月

　概要を見る

Purpose: Loneliness is related to menstrual disorders and medication use. Loneliness and pain are related and may be associated with analgesic use. The aim of this study was to investigate the prevalence of concomitant analgesic use and overuse, and to clarify factors associated with loneliness and analgesic overuse among women who are low-dose estrogen-progestin (LEP) users. Methods: Women in their 20s and 30s were randomly selected from a research company’s web panel (Macromill, Inc.) and LEP users were screened. The survey included analgesic concomitant use days per month and the Three-Item Loneliness Scale (TIL). Logistic regression analysis was performed with high TIL score (≥ 6) and analgesic use ≥ 10 days per month as the objective variables. Results: A total of 516 valid responses from LEP users were analyzed. Among them, 64.1% reported concomitant analgesic use on ≥ 1 day per month, 11.2% on ≥ 10 days per month, and 45.7% had high TIL score. High TIL score was significantly associated with concomitant analgesic use on ≥ 1 day per month (odds ratio [OR] 1.76, 95% confidence interval [95%CI] 1.18–2.63, p = 0.006). Concomitant analgesic use on ≥ 10 days per month was significantly associated with endometriosis (OR 5.25, 95%CI 2.15–12.81, p < 0.001) and concomitant analgesic use for low back pain (OR 4.67, 95%CI 1.65–13.18, p = 0.04). Conclusions: To our knowledge, this is the first detailed study to investigate concomitant analgesic use and overuse among LEP users. Loneliness was found to be prevalent in this population and was associated with concomitant analgesic use, potentially reflecting underlying patterns of frequent or habitual analgesic intake. Furthermore, concomitant analgesic overuse was linked to conditions such as endometriosis and low back pain, underscoring the importance of medication monitoring that takes into account both loneliness and the self-recording of menstrual symptoms. Greater attention by healthcare professionals to the psychosocial context of concomitant analgesic overuse and loneliness may facilitate more meaningful patient dialogue and contribute to improved quality of life.

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口腔乾燥を誘発する薬剤の 齢患者に対する処 実態と要因

近藤 慎吾，佐野 邦大，林 直子，藤島 清太郎，岩田 紘樹，小林 典子，山浦克典

医療薬学 51 （ 6 ） 355 - 365 2025年06月

研究論文（学術雑誌）, 共著, 査読有り

Practical training reduces aspiration-linked gaps in pressure uker education for pharmacy students

Kondo S, Mirna R. Okui R, Iwata H, Kawamoto Y, Kobayashi N, Furuta K, Yamaura K

Drug Discov Ther 19 （ 2 ） 90 - 95 2025年05月

研究論文（学術雑誌）, 共著, 査読有り

腎機能の低下者に対して注慈が必要なOTC医薬品の解析

近藤慎吾、前瀬鞠、古堅彩子、岩田紘樹、小林典子、山浦克典

薬局薬学 17 （ 1 ） 126 - 135 2025年04月

研究論文（学術雑誌）, 共著, 査読有り

Identification of Issues Related to Enteral Nutrients Using a Database of Near-miss Events from Community Pharmacies

Kondo S., Maese M., Iwata H., Kobayashi N., Yamaura K.

Keio Journal of Medicine 74 （ 2 ） 86 - 95 2025年

ISSN  00229717

　概要を見る

Undernutrition is a common risk after surgery or during periods when oral dietary intake is challeng-ing. Enteral nutrients, frequently utilized in nutritional management, are drugs associated with multi-ple contraindications involving pathology and allergy, and they require careful attention in dispensing. However, the occurrence of nutrition-related incidents in community pharmacies remains unknown. This study aimed to identify issues regarding the safety of pharmacotherapy in patients requiring enteral nutrition using the database of Project to Collect and Analyze Pharmaceutical Near-Miss Event Information. We highlighted the critical information that pharmacists should focus on to prevent acci-dents and elucidated the details and prescription drugs of cases that matched the search for “Nutrition (all included)” in Japanese. There were 475 cases reported between January 2009 and September 2023. Of these, 347 cases (73%) were classified as “inquiry about prescription and provision of information to prescribing physician” (Category II) and 115 cases (24%) were classified as “drug dispensing” (Cat-egory I). In both cases, the top five drugs were enteral nutrients. Among the life-threatening Category II cases, 9 cases were for pathological contraindications including severe liver or renal dysfunction, 6 cases were for adverse reactions including diarrhea, and 5 cases were for allergies or patient constitutions. Notably, the incidence of adverse reactions was higher than in data for the latest annual reports. Therefore, pharmacists should be mindful while dealing with prescriptions involving possible contrain-dications in patients requiring enteral nutrition. Pharmacists should contribute to the provision of safe pharmacotherapy by remaining vigilant against dispensing errors.

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Community Pharmacists’ Perceptions and Needs Regarding Oral Healthcare Advice in Japan

Iwata H., Yoshida R., Hayashi N., Kobayashi N., Fujimoto K., Yamaura K.

Keio Journal of Medicine 74 （ 4 ） 205 - 213 2025年

ISSN  00229717

　概要を見る

It is desirable for community pharmacists to be involved in promoting and maintaining the oral health of local residents. In this study, we conducted a questionnaire survey of Japanese community pharmacists to understand the actual conditions and the attitudes of these pharmacists regarding oral healthcare advice. A web-based anonymous self-administered questionnaire survey was completed by community pharmacists from March 26 to 29, 2021. We received responses from 324 pharmacists. A majority of respondents (66.0%) regarded dealing with “daily oral health issues and oral care” as a role of community pharmacists. Respondents also reported being consulted by patients or customers about mouth ulcers (70.1%) and xerostomia (54.6%). However, the frequency of consumer inquiries about these oral conditions was less than once per week. Just over half of the respondents (52.2%) said they were confident about dealing with mouth ulcers, whereas less than 40% were confident about handling other oral problems. The most common anxiety was a “lack of knowledge about appropriate responses to oral symptoms” (60.2%). The respondents desired education and training (75.6%) to better promote oral health-related activities. Japanese community pharmacists believe that they have a role to play in oral health issues and oral care, but their level of confidence in their ability to respond to oral health issues is low. Pharmacists are concerned about their lack of knowledge about oral healthcare and they desire more opportunities for education and training so that they can perform pharmacy-based maintenance and promotion of oral healthcare for local residents.

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学習成果基盤型の薬学教育モデル・コア・カリキュラムに基づく実務実習の先導から実装後の取り組み評価

河添 仁，岩田 紘樹，石川 春樹，近藤 憐吾，地引 綾，横山 雄太，小林 典子，鈴木 小夜，山浦 克典，中村 智徳

医療薬学 50 （ 9 ） 455 - 464 2024年09月

研究論文（学術雑誌）, 共著, 査読有り

Sex-related differences regarding headache triggered by low barometric pressure in Japan

Fujimoto T., Iwata H., Kobayashi N., Kondo S., Yamaura K.

BMC Research Notes 17 （ 203 ）  2024年07月

研究論文（学術雑誌）, 共著, 査読有り

　概要を見る

Purpose: The prevalence of migraine headache is higher in women. Low barometric pressure is a factor in headache triggering, but sex-related differences have not been identified. The purpose of this study was to examine sex-related differences in headache triggered by low barometric pressure. Methods: Study subjects aged 20–49 years were randomly selected from a research company’s (Macromill, Inc.) web panel. Those with chronic migraine or tension-type headache invited to complete a web-based self-administered questionnaire. Logistic regression analysis was performed with the objective variable as the Headache Impact Test-6 (HIT-6) high scores (56 or more) or headache triggered by low barometric pressure. Results: Participants were 332 women and 337 men in the headache population. HIT-6 high scores were associated with age at headache occurrence 20 years or younger (OR: odds ratio 1.85, 95% CI: confidence interval 1.15–2.99, p = 0.012) and headache triggered by low barometric pressure (OR 2.11, 95%CI 1.51–2.94, p < 0.001). Headache triggered by low barometric pressure was significantly associated with women (OR 2.92, 95%CI 2.12–4.02, p < 0.001). Conclusions: Headache triggered by low barometric pressure were related to sex-related differences. It was suggested that a sex-specific treatment approach for headache triggering is needed.

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Lack of information on gender differences in the package inserts of prescription drugs in Japan.

Narumi Maida, Shingo Kondo, Masanori Ogawa、Naoko Hayashi、Hiroki Iwata, Noriko Kobayashi、Katsunori Yamaura

Drug Discoveries & Therapeutics  17 （ 6 ） 396 - 403 2023年12月

研究論文（学術雑誌）, 共著, 査読有り

実務実習を修了した上級生が関わるセルフメディケーション実習の学修効果

筒井和斗、小林典子、中村友紀、岩田紘樹、山浦克典

薬学教育 7 2023年07月

研究論文（学術雑誌）, 共著, 査読有り

実務実習終了時における到達度評価を向上させる要因は何か？

石川春樹，河添　仁，岩田紘樹，中村友紀，地引綾，横山雄太， 小林典子，鈴木小夜，山浦克典，中村智徳

医療薬学 49 （ 4 ） 173 - 182 2023年04月

研究論文（学術雑誌）, 共著, 査読有り

Most dentists approve of oral health check-ups for local residents at community pharmacies and desire collaboration with community pharmacists

Hiroki Iwata, Keisuke Nakamura, Noriko Kobayashi, Kazuko Fujimoto, Naoko Hayashi, Katsunori Yamaura

Drug Discoveries & Therapeutics 16 （ 6 ） 309 - 32 2022年12月

研究論文（学術雑誌）, 査読有り

診療所が保有する患者情報の共有による薬局における効果的な服薬フォローアップ法確立のための探索研

吉村悠平、林直子、今津嘉宏、森田清子、鶴田奈津子、岩田紘樹、小林典子、藤本和子、川本嘉子、山浦克典

医療薬学 48 （ 10 ） 443 - 453 2022年10月

研究論文（学術雑誌）, 査読有り

薬剤師によるアンチ・ドーピング活動推進のためのスポーツサプリメントに関する学習の課題と対策

大場法隆、香取諒太、藤本和子、小林典子、岩田紘樹、山浦克典

医療薬学 48 （ 9 ） 405 - 41 2022年09月

査読有り