Identification of individuals benefiting from the kakaritsuke-yakuzaishi (family pharmacist) system in Japan: a retrospective cohort study using an employment-based health insurance claims database

Association between having a primary care physician and health behavioral intention in Japan: results from a nationwide survey

INTRODUCTION

Introducing a primary care physician (Kakaritsuke-I: KI) system to improve the efficiency of the health care system has been controversial in Japan. This study aimed to determine the relevance of KI to an individual's health behavioral intentions.

METHODS

We used data from a nationwide, population-based internet survey (N = 5,234) to conduct a cross-sectional regression analysis. Additionally, we used a propensity score matching method to mitigate the potential endogenous biases inherent in the decision to have a KI.

RESULTS

KI was positively associated with various behavioral intentions. For example, the probabilities of intending to eat a well-balanced diet and engaging in moderate exercise were 12.8 (95% confidence interval [CI]:9.5-16.1) percentage points and 7.2 (95% CI: 3.9-10.4) percentage points higher, respectively, among those with a KI than among those without a KI. A KI equally increased the likelihood of getting vaccinated against coronavirus (in November 2021) by 7.5 (95% CI: 5.2-9.8) percentage points.

CONCLUSIONS

Although further analysis is needed to examine the effect of KI on health, the results of this study suggest the potential benefits of policy measures to promote the KI system.

Telephone follow-up contributes to improving adherence and treatment duration in patients with hepatocellular carcinoma treated with lenvatinib

BACKGROUND AND AIM

This study aimed to investigate whether telephone follow-up by clinical pharmacists for unresectable hepatocellular carcinoma (HCC) patients treated with lenvatinib (LEN) contributes to improved adherence and treatment duration for LEN.

METHODS

This retrospective study enrolled 132 patients with HCC who were treated with LEN. The patients were classified into non-telephone follow-up (n = 32) or telephone follow-up groups (n = 100) [the latter group was further classified into family-pharmacist (FP) telephone follow-up (n = 18), or hospital family-pharmacist (HFP) telephone follow-up (n = 82) groups].

RESULTS

The progression-free survival (PFS) in the telephone follow-up group was significantly higher than that in the non-telephone follow-up group (PFS 6.1 months vs 3.7 months, P = 0.001, respectively). Although treatment duration was significantly longer in the telephone follow-up group than in the non-telephone follow-up group [median treatment duration: 10.4 months vs 4.1 months, P = 0.001, respectively.], no significant differences were noted between the HFP telephone follow-up group and FP telephone follow-up groups (10.3 months vs 13.3 months, P = 0.543). Self-interruption and adverse-event discontinuation in the HFP-telephone follow-up group were significantly lower than those in the FP-telephone and non-telephone groups (0% vs 11.1% vs 18.8%; P < 0.001, 25.6% vs 33.3% vs 53.1%; P = 0.022, respectively).

CONCLUSIONS

Telephone follow-up contributes to prolonged treatment duration for LEN in patients with HCC treated. Moreover, telephone follow-up with an HFP may further improve treatment adherence.