The following is an extract from the White paper by Ministry of Health and Welfare, JapanPromoting the Separation of Dispensing and Prescribing
(1) Current Status of the Separation of Dispensing and PrescribingAs the society ages and the disease pattern changes, combined use and long-term use of drugs is becoming more common, and appropriate use of drugs is becoming a serious issue. The separation of dispensing and prescribing is essential to promoting appropriate use of drugs. Under this system, a patient' s medication records are kept at the patient' s family pharmacy (patient medication profiles), so that the pharmacy can check the combination of drugs prescribed by different hospitals and doctors, and prevent the occurrence of duplicate dispensing and drug interactions. In the past, dispensing was not sufficiently separated from medical practice in Japan, because the custom was for patients to receive drugs from doctors, and there was not an adequate system for accepting prescriptions at pharmacies. There have been rapid advances in recent years, however; the separation rate in 1994 was 18.1%, and it is expected to rise further in the future.
(2) Issues and Efforts in the Separation of Dispensing and PrescribingAlthough there has been some progress in the separation of dispensing and prescribing, issues include the existence of pharmacies located near medical institutions which only accept prescriptions from those institutions (gate-front pharmacy), and pharmacies which have improper connections with such medical institutions (secondary pharmacy). If the separation of dispensing and prescribing is to contribute to improving the quality of medical care by encouraging the proper use of drugs, it is necessary to promote a system in which patients receive drugs from their family pharmacies (separation through a focused pharmacy system), even if they are being treated at more than one medical institution (see p. 372). In order to support such a system, the Ministry of Health and Welfare is implementing measures including the establishment of Separation Support Centers to stockpile medicines, collect and disseminate drug information and fill prescriptions at night and on holidays, as well as educational activities aimed at the public. In fiscal 1996, the Ministry will establish guidelines for plans to separate dispensing and prescribing according to local circumstances, and promote their appropriate separation to benefit of community medical care.
| Separation Through a Focused Pharmacy System in the
Ueda Region
(Nagano Prefecture) Not only is there a high degree of separation of dispensing and prescribing in the Ueda region, but there is well-established separation through a focused pharmacy system, with about 80% of residents having their family pharmacies. According to one member of the Ueda Pharmaceutical Association, Individual pharmacists must contribute to the community by considering what can be done for patients and consumers, and taking the initiative in doing what they think is right. When the National Nagano Hospital decided in 1978 to issue prescriptions to be filled outside the hospital, the Pharmaceutical Association went to the hospital and listened to patients, and obtained the trust of patients by providing information to doctors and offering drug administration guidance based on patient medication records, as a service to patients. This is reflected in the words of local residents, who say, We choose our family pharmacies depending on how they treat their patients. It seems that the success of separation through a focused pharmacy system in the Ueda region was largely due to the unity and enthusiasm of the Pharmaceutical Association, as well as the acceptance of separation by doctors, and the trust that residents have in their pharmacists. |