poster_26P2-pm1-099淵村第143回年会0309
コロナ禍における地域連携薬局の役割
Role of Community Pharmacy in the Corona Disaster
○淵村 佳奈、濱邉 恵梨奈、隈元 正太郎、上東 由美、楠元 俊英
・ すずな調剤薬局
すずな調剤薬局は地域連携薬局として基幹病院、在宅訪問クリニック、近隣の医療機関と積極的に連携することで中心静脈栄養を必要とする医療的ケア児、麻薬持続皮下注（PCAポンプ）を用いたがん末期患者に至るまで幅広く医療を提供し、約100件/月以上の訪問薬剤管理指導を行っている。
2021年12月24日に新型コロナウイルスの治療薬としてラゲブリオ（一般名 モルヌピラビル）が特例承認されてから、一般医薬品と同様の流通に至るまでラゲブリオ対応薬局として約150件の新型コロナウイルス陽性者の治療に携わった。
コロナ経口薬ラゲブリオは、特に高齢者、その中でも要支援、要介護を有する高齢者への治療が最も重要と考え、薬局から15キロ圏内の医療機関、主に在宅医療を行うクリニック、基幹病院の地域連携室等に対し、電話やFAX等で薬剤の処方について説明を行った。一方で薬局では在宅訪問時、日常の感染対策、24時間対応の体制構築を行った。そのなかでも薬局内で陽性者が出た場合の中心静脈栄養の輸液・医療材料の供給について基幹病院薬剤部との薬薬連携、在宅医療における在宅医、訪問看護ステーションスタッフとの多職種連携についても報告する。
当薬局のラゲブリオ対応薬局としての実績としてラゲブリオの投薬患者の９割を鹿児島県内の７か所の在宅医療クリニックから依頼を受け、投薬後のラゲブリオ服用患者は、服用初日を含め少なくとも患者5名（3％）が亡くなり、年齢層も80代の方が多くを占めた。
今回の経験から地域医療におけるすずな調剤薬局の地域連携薬局の重要な役割として今後も未知の感染症や災害等への対応、危機管理能力向上、地域の住民、医療機関への情報発信が責務であると考える。
Suzuna Pharmacy provides a wide range of medical care, from children in medical care requiring central venous nutrition to terminal cancer patients using continuous subcutaneous narcotic infusion (PCA pump), through active collaboration with the core hospital, home-visit clinics, and neighboring medical institutions as a community collaborative pharmacy, and provides more than 100 visits per month for drug management guidance. The company also provides more than 100 home visits per month.
Since the special approval of Ragebrio (generic name: mornupiravir) for the treatment of the novel coronavirus on December 24, 2021, the company has been involved in the treatment of approximately 150 novel coronavirus-positive patients as a Ragebrio-compatible pharmacy until the drug was distributed in the same way as ordinary drugs.
Considering the treatment of the oral coronavirus drug Ragebrio to be most important, especially for the elderly, especially those requiring support and care, the pharmacies explained the prescription of the drug by telephone and fax to medical institutions within 15 km of the pharmacies, clinics mainly providing home care, and the regional coordination office of the main hospital. At the same time, pharmacies established a system for daily infection control and 24-hour responses during home visits. Among these, we also report on the drug-pharmaceutical collaboration with the pharmacy department of the core hospital regarding the supply of infusions and medical supplies for central venous nutrition in the event of a positive patient in the pharmacy and the multidisciplinary collaboration with home physicians and home nursing station staff during home medical care.
As for our pharmacy’s performance as a Ragebrio-compatible pharmacy, 90% of Ragebrio medication patients were requested by seven home healthcare clinics in Kagoshima Prefecture, and at least five patients (3%) who took Ragebrio died after receiving the medication, including on the first day of taking the medication, and most of them were in their 80s in age group.
Based on this experience, we believe that Suzuna Compounding Pharmacy’s important role as a community collaborative pharmacy in community healthcare will continue to be to respond to unknown infectious diseases and disasters, improve crisis management capabilities, and disseminate information to local residents and medical institutions.
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