Potential Demand for Home-visit Pharmaceutical Care by Pharmacists and Examination of Home Patient Characteristics

少子高齢化の進展により，社会保障に係る財政負担は増加する一方であり，過大な訪問薬剤管理指導の請求は限られた保険財政を圧迫することになる．薬剤師は訪問指導が必要な患者を見極め，訪問薬剤管理指導を実施する必要がある．そこで，薬剤師未介入の患者宅を訪問し，患者に必要と思われる薬剤師の提供するサービスの種類およびサービスを必要とする患者の割合を調査した．また，薬剤師が継続して訪問する必要のある患者の割合を算出した．さらに，患者の属性も同時に調査し，薬剤師介入を必要とする患者と患者属性の関係を調べた．調査した患者の98％に服薬指導をはじめとした何らかの サービスが必要であった．また，在宅患者の60％が薬剤師の継続的な訪問を必要とした．さらに，比較的介護度の低いおよび独居の患者がより薬剤師の訪問を必要とした．薬剤師は，潜在的な患者が多数おり，かつ，重症度の低い時期に介入する必要があることを認識すべきである．While the fiscal burden on social security cost continues increasing due to the rapid aging of the population from the decline in the birth rate, excessive charges for pharmacist home-visit pharmaceutical management and guidance can increase pressure on limited public finances in the medical insurance system. Pharmacists need to provide these homevisit services based on their appropriate judgment about which patients need home-visit intervention. Targeting those patients at home without pharmacist intervention, we investigated the kind of pharmaceutical services needed for patients and the percentage of patients needing the intervention. We also computed the percentage of patients who needed ongoing visits from pharmacists. Simultaneously, we investigated those patients’ characteristics and examined the relationship between the characteristics and the patients who need pharmacist intervention. We found that 98% of the patients needed some home-visit pharmaceutical services including drug administration guidance, and that 60% needed ongoing visits from pharmacists. It was also shown that the need for pharmacists’ home-visit based intervention was high in elderly patients whose care level was relatively low and who lived alone. Pharmacists should recognize that there are many potential home patients who need their intervention, and that they should begin to intervene at the stage where severity of illness is low