COVID-19対策に伴う電話診療と部門連携強化による医薬品供給方法の構築

Material type: 文書・図像類

Author: 中島, 梓

Publisher: 慶應義塾大学

Publication date: 2020

Material Format: Digital

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Note (General)：: type:text新型コロナウイルス感染症（COVID-19）拡大防止の観点から、厚生労働省より「新型コロナウイルス感染症の増加に際しての電話や情報通信機器を用いた診療や処方箋の取扱いについて」が発出され、慢性疾患等を有する定期受診患者等が継続的な医療・投薬を必要とする場合に、電話診療等で処方するこ...

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Material Type: 文書・図像類
Title: COVID-19対策に伴う電話診療と部門連携強化による医薬品供給方法の構築
Author/Editor: 中島, 梓
Author Heading: 中島, 梓
Publication, Distribution, etc.: 慶應義塾大学
Publication Date: 2020
Publication Date (W3CDTF): 2020
Alternative Title: COVID-19 タイサクニトモナウデンワシンリョウトブモンレンケイキョウカニヨルイヤクヒンキョウキュウホウホウノコウチク
COVID-19 taisaku ni tomonau denwa shinryō to bumon renkei kyōka ni yoru iyakuhin kyōkyū hōhō no kōchiku
Telephone medical treatment measure and construction of pharmaceutical supply method in the departmental cooperation, accompanied with COVID-19
Periodical title: 学事振興資金研究成果実績報告書
Text Language Code: jpn
eng
Target Audience: 一般
Note (General): type:text
新型コロナウイルス感染症（COVID-19）拡大防止の観点から、厚生労働省より「新型コロナウイルス感染症の増加に際しての電話や情報通信機器を用いた診療や処方箋の取扱いについて」が発出され、慢性疾患等を有する定期受診患者等が継続的な医療・投薬を必要とする場合に、電話診療等で処方することは差し支えないとの見解がなされた。当院では長期処方の推奨、また、電話診療・院外処方箋発行の対応が開始された。そこで、本研究では院外処方箋発行率および処方動向の変化について調査し、在庫管理の適正化および医薬品供給方法の確立について検討した。電話診療を希望する患者の急増により、院外処方箋発行率は通常の10％からピーク時は61.7％にまで達した。定期的検査を必要とする医薬品を処方されている患者は、治療効果や安全性の評価が困難であることから、漫然とした電話診療や長期処方はせずに対面診療を行う方針となり、院外処方箋発行率は15％まで回復している。在宅自己注射は、衛生材料又は保険医療材料を患者等に直接支給する必要があるため、電話診療の場合でも院内処方とし、外来診察室、薬剤部が連携し、患者宅へ配送する業務フローを作成した。医薬品の流通状況について、海外においてCOVID-19に対する有効性を示唆する実験結果が報告された影響でオルベスコ®、フオイパン®は市場で品薄となり保険薬局での入手が困難となった。これらは当院の在庫が確保されていることを確認し、院内処方に切り替える対応を講じた。 COVID-19対策における院内の協力体制を構築することができた。院外処方箋発行率の増加に伴い一時的に調剤量は減少したが、院内処方において安定した医薬品供給が可能であった。時限的、特例的対応は長期化している。不要な来院の回避や、不特定多数の接触機会軽減を図りつつ、服薬アドヒアランスを良好に保つためには、今後オンライン服薬指導の環境を整備していく必要がある。 From the perspective of preventing the spread in new coronavirus infection (COVID-19), the Ministry of Health, Labour and Welfare issued a document entitled "Handling of medical treatment and prescriptions using telecommunications equipment devices in the event of an increase in COVID-19". It was agreed that it is acceptable to prescribe medications for patients with chronic diseases who need continuous medical care and medications through telephone medical treatment. Keio university hospital was started recommendation of long-term prescriptions, telephone medical treatment, and out-of-hospital prescriptions. In this study, we investigated change in the rate of out-of-hospital prescriptions issued, prescription trends, and distribution situation of pharmaceutical products. In addition, we examined the proper management of inventory and the establishment of pharmaceutical supply method. By the rapid increase of patients in hope of telephone medical treatment, the rate of out-of-hospital prescriptions issued reached 61.7% from normal 10% at one time. Patients who are prescribed medications that require regular testing have difficulty assessing effectiveness and safety of treatment. Our hospital provided face-to-face care without rambling telephone medical treatment or long-term prescriptions. Since then, the rate of out-of-hospital prescriptions issued has recovered to 15%. About the at-home self-injection, it was necessary to provide patients with hygiene materials or insurance medical care materials directly. Even in the case of telephone medical treatment, we made it in-hospital prescriptions. The outpatient consultation room and the pharmacy department worked together to create a workflow for delivery to the patient's home. With regard to the distribution situation of pharmaceutical products, due to the impact of the reporting of experimental results suggesting efficacy against COVID-19 overseas, Alvesco® Inhaler and FOIPAN® Tablets became scarce in the market and difficult to obtain at insurance pharmacies. We have confirmed that these medications are in stock at our hospital, and have taken steps to switch to in-hospital prescriptions. Dispensing volume of pharmaceuticals temporarily decreased due to an increase in the rate of out-of-hospital prescriptions issued. However, a stable supply of medicines was available for in-hospital prescriptions. In addition, we were able to build a cooperative system within our hospital through departmental collaboration. Time-limited and exceptional measures continue to be taken. In order to maintain good medication adherence while avoiding unnecessary hospital visits and reducing unspecified contact opportunities, it is necessary to improve the environment for online medication guidance in the future.
Access Restrictions: 限定公開
Data Provider (Database): 国立情報学研究所 : 学術機関リポジトリデータベース（IRDB）（機関リポジトリ）
https://irdb.nii.ac.jp
Original Data Provider (Database): 慶應義塾大学 : 慶應義塾大学学術情報リポジトリ