{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,22]],"date-time":"2026-09-22T07:09:23Z","timestamp":1790060963155,"version":"4.0.1"},"reference-count":22,"publisher":"Cambridge University Press (CUP)","issue":"1","license":[{"start":{"date-parts":[[2026,9,22]],"date-time":"2026-09-22T00:00:00Z","timestamp":1790035200000},"content-version":"unspecified","delay-in-days":264,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc-sa\/4.0\/"}],"content-domain":{"domain":["cambridge.org"],"crossmark-restriction":true},"short-container-title":["Prehosp. Disaster med."],"published-print":{"date-parts":[[2026]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec id=\"S1049023X26109042_as1\">\n                    <jats:title>Introduction:<\/jats:title>\n                    <jats:p>On March 24, thirteen days after the 2011 Great East Japan Earthquake (GEJE), the Ishinomaki Zone Joint Relief Team (IZJRT) started the Melon Pan System \u2013 an ad hoc pharmaceutical coordination system \u2013 for the first time in Japan to efficiently prescribe, dispense, deliver, and explain medication to patients in evacuation centers and at their homes. The Japan Red Cross (JRC) Ishinomaki Hospital, a disaster base hospital (DBH), serves as a coordination hub for emergency medical teams (EMTs), pharmacists, and medication supplies.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"S1049023X26109042_as2\">\n                    <jats:title>Study Objective:<\/jats:title>\n                    <jats:p>This study aimed to retrospectively examine trends in medication needs and delivery before (Phase A: March 11 to March 23; 13 days) and after (Phase B: March 24 to April 5; 13 days) the system\u2019s implementation.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"S1049023X26109042_as3\">\n                    <jats:title>Methods:<\/jats:title>\n                    <jats:p>Using an anonymized disaster medical record (DMR) database, patient characteristics, number of new and returning patients, prescription numbers, prescribed medications, and prescription durations in Phase A and Phase B were compared. The locations of the evacuation centers with significant improvements in Phase B were identified on a map.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"S1049023X26109042_as4\">\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>There were 3,830 new patients in Phase A and 6,984 in Phase B. The number of returning patients increased significantly during Phase B. The overall number of prescriptions increased 2.6-times (353.7\/day versus 935.2\/day) and the number of prescribed medications increased 3.1-times (764.1\/day versus 2,367.8\/day) in Phase B. The median prescription duration of anti-hypertensive drugs increased from seven days (95% confidence interval [CI], 2-14 days) in Phase A to nine days (95% CI, 3-30 days) in Phase B (P &lt; 0.0001), suggesting that medication was efficiently delivered to people in need. The effect of the system was more prominent in evacuation centers located within the tsunami-inundated areas or remote areas (&gt;10km from the JRC Ishinomaki Hospital), considering that 33 (89.2%) of the 37 evacuation centers where prescriptions increased more than three-fold and 39 (94.9%) of the 41 evacuation centers where the prescription started in Phase B were located in such areas.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"S1049023X26109042_as5\">\n                    <jats:title>Conclusion:<\/jats:title>\n                    <jats:p>The ad hoc pharmaceutical coordination system was effective and necessary, enabling EMTs to focus on patient care and pharmacists to provide personalized pharmaceutical assistance, especially in evacuation centers with limited access. The Melon Pan system was the first pharmaceutical coordination model to be developed in Japan to improve disaster health management.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1017\/s1049023x26109042","type":"journal-article","created":{"date-parts":[[2026,9,22]],"date-time":"2026-09-22T06:43:49Z","timestamp":1790059429000},"update-policy":"https:\/\/doi.org\/10.1017\/policypage","source":"Crossref","is-referenced-by-count":0,"title":["Pharmaceutical Coordination in the Ishinomaki Zone after the 2011 Great East Japan Earthquake Improved the Disaster Health Management"],"prefix":"10.1017","volume":"41","author":[{"given":"Yoshiro","family":"Tanno","sequence":"first","affiliation":[{"name":"Tohoku University Hospital"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1115-4932","authenticated-orcid":false,"given":"Shinichi","family":"Egawa","sequence":"additional","affiliation":[{"id":[{"id":"https:\/\/ror.org\/01dq60k83","id-type":"ROR","asserted-by":"publisher"}],"name":"Tohoku University"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ryutaro","family":"Arita","sequence":"additional","affiliation":[{"name":"Tohoku University Hospital"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shin","family":"Takayama","sequence":"additional","affiliation":[{"name":"Tohoku University Hospital"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6086-671X","authenticated-orcid":false,"given":"Motohiro","family":"Tsuboi","sequence":"additional","affiliation":[{"id":[{"id":"https:\/\/ror.org\/01dq60k83","id-type":"ROR","asserted-by":"publisher"}],"name":"Tohoku University"},{"name":"Japanese Red Cross Saitama Hospital"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hyejeong","family":"Park","sequence":"additional","affiliation":[{"id":[{"id":"https:\/\/ror.org\/01dq60k83","id-type":"ROR","asserted-by":"publisher"}],"name":"Tohoku University"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hiroyuki","family":"Sasaki","sequence":"additional","affiliation":[{"id":[{"id":"https:\/\/ror.org\/01dq60k83","id-type":"ROR","asserted-by":"publisher"}],"name":"Tohoku University"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Takeshi","family":"Kanno","sequence":"additional","affiliation":[{"name":"Tohoku University Hospital"},{"name":"Jichi Medical University"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tadashi","family":"Ishii","sequence":"additional","affiliation":[{"name":"Tohoku University Hospital"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"56","published-online":{"date-parts":[[2026,9,22]]},"reference":[{"key":"S1049023X26109042_ref15","doi-asserted-by":"publisher","DOI":"10.1017\/dmp.2017.63"},{"key":"S1049023X26109042_ref13","unstructured":"13. Higashimatsusima City. Reconstruction from the Great East Japan Earthquake. https:\/\/www.city.higashimatsushima.miyagi.jp\/shisei\/shinsaifukko\/fukkyu-fukko-ayumi\/fukkokirokushi.files\/ReconstructionRecordHMC_web_01.pdf. Accessed June 20, 2025."},{"key":"S1049023X26109042_ref2","doi-asserted-by":"publisher","DOI":"10.1620\/tjem.243.1"},{"key":"S1049023X26109042_ref22","doi-asserted-by":"publisher","DOI":"10.1016\/B978-0-443-18987-6.00024-5"},{"key":"S1049023X26109042_ref10","doi-asserted-by":"publisher","DOI":"10.1620\/tjem.248.73"},{"key":"S1049023X26109042_ref8","unstructured":"8. Japan Pharmaceutical Association. Activity Report in the 2011 Great East Japan Earthquake [in Japanese]. https:\/\/www.nichiyaku.or.jp\/files\/co\/activities\/katsudo_hokoku.pdf. Accessed April 7, 2026."},{"key":"S1049023X26109042_ref19","doi-asserted-by":"publisher","DOI":"10.1017\/S1049023X23004831"},{"key":"S1049023X26109042_ref12","unstructured":"12. Kyoto Encyclopedia of Genes and Genomes (KEGG). 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Population of Miyagi Prefecture by Age and Sex, 2010 Population Census (in Japanese). https:\/\/www.e-stat.go.jp\/stat-search\/files?page=1&layout=datalist&toukei=00200521&tstat=000001039448&cycle=0&tclass1=000001047504&tclass2=000001047506&stat_infid=000012665881&tclass3val=0. Accessed August 2, 2025."},{"key":"S1049023X26109042_ref14","unstructured":"14. Ihinomaki City. Ishinomaki City Newsletter, Extra Edition for the Disaster [in Japanese]. https:\/\/www.city.ishinomaki.lg.jp\/cont\/10151000\/1000\/7279\/041409.pdf. Accessed August 4, 2025."},{"key":"S1049023X26109042_ref11","doi-asserted-by":"publisher","DOI":"10.1620\/tjem.251.207"},{"key":"S1049023X26109042_ref7","doi-asserted-by":"publisher","DOI":"10.1017\/S1049023X14001095"},{"key":"S1049023X26109042_ref16","doi-asserted-by":"publisher","DOI":"10.1017\/S1049023X2300050X"},{"key":"S1049023X26109042_ref18","unstructured":"18. Ministry of Health, Labor, and Welfare of Japan. The current prefectural assignment of disaster pharmaceutical coordinators [in Japanese]. https:\/\/www.mhlw.go.jp\/content\/001492275.pdf. Accessed April 14, 2026."},{"key":"S1049023X26109042_ref1","volume-title":"WHO Guidance on Research Methods for Health and Disaster Risk Management","author":"Egawa","year":"2021"},{"key":"S1049023X26109042_ref3"},{"key":"S1049023X26109042_ref9","unstructured":"9. Japan Society of Health Information Management. Consensus Report on Disaster Medical Records 2018. Revised Ver. 3 [in Japanese]. https:\/\/jhim-e.com\/pdf\/2018\/2018kiroku_doc_v3.pdf. Accessed July 8, 2025."},{"key":"S1049023X26109042_ref21","volume-title":"WHO Guidance on Research Methods for Health Emergency and Disaster Risk Management","author":"Vigneri","year":"2021"}],"container-title":["Prehospital and Disaster Medicine"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.cambridge.org\/core\/services\/aop-cambridge-core\/content\/view\/S1049023X26109042","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,9,22]],"date-time":"2026-09-22T06:43:56Z","timestamp":1790059436000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.cambridge.org\/core\/product\/identifier\/S1049023X26109042\/type\/journal_article"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026]]},"references-count":22,"journal-issue":{"issue":"1","published-online":{"date-parts":[[2026]]}},"alternative-id":["S1049023X26109042"],"URL":"https:\/\/doi.org\/10.1017\/s1049023x26109042","relation":{},"ISSN":["1049-023X","1945-1938"],"issn-type":[{"value":"1049-023X","type":"print"},{"value":"1945-1938","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026]]},"assertion":[{"value":"\u00a9 The Author(s), 2026. Published by Cambridge University Press on behalf of World Association for Disaster and Emergency Medicine","name":"copyright","label":"Copyright","group":{"name":"copyright_and_licensing","label":"Copyright and Licensing"}},{"value":"This is an Open Access article, distributed under the terms of the Creative Commons Attribution-NonCommercial-ShareAlike licence (https:\/\/creativecommons.org\/licenses\/by-nc-sa\/4.0\/), which permits non-commercial re-use, distribution, and reproduction in any medium, provided the same Creative Commons licence is used to distribute the re-used or adapted article and the original article is properly cited. The written permission of Cambridge University Press or the rights holder(s) must be obtained prior to any commercial use.","name":"license","label":"License","group":{"name":"copyright_and_licensing","label":"Copyright and Licensing"}},{"value":"This content has been made available to all.","name":"free","label":"Free to read"}],"article-number":"e22"}}