Clinical behavior of Japanese community pharmacists for preventing prescription drug overdose

AIM: Prescription drug abuse, including benzodiazepines, is a growing health problem in Japan. This study examined the community pharmacist's clinical behavior regarding patients who overdose on prescribed drugs, and explore the possibility of overdose prevention by community pharmacists. METHODS: We surveyed all registered community pharmacies with dispensing functions (n=1867) in the Saitama Pharmaceutical Association. An anonymous self-administered questionnaire was mailed to each pharmacy. Respondents were asked about clinical behavior such as medication counseling and referral to the prescriber if prescription drug overdose was identified. RESULTS: Among respondents, 26% of community pharmacists reported clinical experience of working with patients who overdosed on prescribed drugs in the previous year. Half of respondents evaluated their practice such as medication counseling and referral to the prescriber as "good". On multivariable analysis, a "poor" self-evaluation of referral to the prescriber was significantly associated with the following perceptions: "Insufficient confidence in communication with prescribers" (odds ratio, 2.7; 95% confidence interval: 1.4-5.3), and "To avoid trouble with prescribers" (odds ratio, 1.7; 95% confidence interval: 1.0-2.7). CONCLUSION: Our results show that Japanese community pharmacists could prevent prescription drug abuse in their practice. However, the pharmacists who have insufficient confidence in communication with prescribers and who are afraid of troubles with a prescriber, reported "poor" self-evaluation for referral to the prescribers. All prescribers should understand the importance of the referral by community pharmacists, to assist the community pharmacists to play a critical role in prevention of prescription drug abuse. Language: en