[Advanced Pharmaceutical Management Functions in Home Pharmaceutical Care].

In 1994, community pharmacists first started patient-visiting services under health insurance coverage. There are a wide variety of home-care patients for whom pharmacists provide care. They include elderly patients with chronic disease, pediatric home-care patients with or without special needs, patients with dementia, cancer patients receiving palliative care, and others. Pharmacies engaging in home pharmaceutical care should establish an adequate system in terms of the following aspects: 1) number of pharmacists; 2) availability of a sterile dispensing room; 3) stock of medical narcotics; and 4) stock of medical supplies. Nevertheless, it is impossible for every pharmacy to provide home pharmaceutical care in the same fashion, since many factors, such as the vision of the pharmacy proprietor, business size, experience and expertise of pharmacists, and regional characteristics vary. A survey of 149 pharmacies authorized to dispense injection drugs in Tokyo clarified the profile of pharmacies specializing in home pharmaceutical care based on the number of patients served, number of patients receiving at-home end-of-life care, amount of medical narcotics in stock, etc. The results revealed that specialized pharmacies were required by home-care patients who were highly dependent on medical treatment. In the future, as the number of home-care patients with high medical treatment dependence is expected to continue rising, an evaluation of pharmacies meeting the needs of these patients should be undertaken from the viewpoint of advanced pharmaceutical management functions.