{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,18]],"date-time":"2026-09-18T13:33:08Z","timestamp":1789738388926,"version":"4.0.1"},"reference-count":19,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2022,5,21]],"date-time":"2022-05-21T00:00:00Z","timestamp":1653091200000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2022,5,21]],"date-time":"2022-05-21T00:00:00Z","timestamp":1653091200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"funder":[{"DOI":"10.13039\/501100001691","name":"Japan Society for the Promotion of Science","doi-asserted-by":"publisher","award":["JP20K16102"],"award-info":[{"award-number":["JP20K16102"]}],"id":[{"id":"10.13039\/501100001691","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["BMC Health Serv Res"],"published-print":{"date-parts":[[2022,12]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec>\n                <jats:title>Background<\/jats:title>\n                <jats:p>The kakaritsuke-yakuzaishi system (henceforth, the family pharmacist system) which provides more health services than those by general pharmaceutical practice, was implemented in Japan in April 2016. To distribute medical resources and medical care expenditures appropriately, identifying the possible major beneficiaries of this system is essential. By analyzing administrative claims data through this retrospective cohort study, we identified modifiers of the potential benefits of the system. Further, we integrated the identified modifiers into a scoring system that indicates the possible benefitting subpopulations.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Methods<\/jats:title>\n                <jats:p>We obtained data about individuals under 75\u00a0years old routinely using community pharmacies in Japan from the JMDC database. We classified the individuals as users or non-users. We used claims related to \u201cchoufukutouyaku-sougosayoutou-boushi-kasan (additional therapeutic duplication and drug interaction [TDDI] prevention fees)\u201d filed between April 2018 and March 2020, which indicate that individuals\u2019 prescriptions were modified to adjust leftover drugs or to avoid TDDI as indicators of potential benefit. We estimated adjusted absolute risk differences and 95% confidence intervals for product terms using multiple generalized linear regression models. We included the factors whose 95% confidence interval lower limits did not reach 0 in the multiple logistic regression models for developing a scoring system.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Results<\/jats:title>\n                <jats:p>The eligible cohort included 162,340 individuals (1,214 users and 161,126 non-users). The leftover drugs adjustment significantly increased for individuals prescribed antidepressants. However, as only one modifier was identified, we did not develop a scoring system for the leftover drugs adjustment. For TDDI prevention, the following factors were included in the scoring system: being female, being prescribed\u2009\u2265\u20096 drug types, using\u2009\u2265\u20092 medical institutions, and being prescribed proton pump inhibitors, antibiotics, probiotics, or traditional Japanese herbal medicines. The developed scoring system for TDDI prevention scored \u201cfemale\u201d and \u201ctraditional Japanese herbal medicines prescription\u201d factors higher than other factors.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Conclusions<\/jats:title>\n                <jats:p>Individuals who are female or prescribed traditional Japanese herbal medicines, or antidepressants may benefit significantly from the family pharmacist system.<\/jats:p>\n              <\/jats:sec>","DOI":"10.1186\/s12913-022-08093-0","type":"journal-article","created":{"date-parts":[[2022,5,21]],"date-time":"2022-05-21T13:04:23Z","timestamp":1653138263000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":12,"title":["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"],"prefix":"10.1186","volume":"22","author":[{"given":"Ryo","family":"Iketani","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Keiko","family":"Konomura","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2022,5,21]]},"reference":[{"key":"8093_CR1","doi-asserted-by":"publisher","first-page":"1106","DOI":"10.1016\/S0140-6736(11)60828-3","volume":"378","author":"N Ikegami","year":"2011","unstructured":"Ikegami N, Yoo BK, Hashimoto H, et al. Japanese universal health coverage: evolution, achievements, and challenges. Lancet. 2011;378:1106\u201315.","journal-title":"Lancet"},{"key":"8093_CR2","doi-asserted-by":"publisher","first-page":"2008","DOI":"10.1345\/aph.1H221","volume":"40","author":"S Yamamura","year":"2006","unstructured":"Yamamura S, Yamamoto N, Oide S, Kitazawa S. Current state of community pharmacy in Japan: practice, research, and future opportunities or challenges. Ann Pharmacother. 2006;40:2008\u201314.","journal-title":"Ann Pharmacother"},{"key":"8093_CR3","first-page":"330","volume":"55","author":"Y Uetsuka","year":"2012","unstructured":"Uetsuka Y. Characteristics of Japan\u2019s healthcare systems and the problems. Japan Med Assoc J. 2012;55:330\u20133.","journal-title":"Japan Med Assoc J"},{"key":"8093_CR4","volume-title":"Separation of dispensing and prescribing drugs in Japan","author":"K Ura","year":"2014","unstructured":"Ura K. 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The need for informed consent was waived by the Ethics Committee of the National Institute of Public Health because the present study used a commercial database accumulating administrative claims data.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethics approval and consent to participate"}},{"value":"Not applicable.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Consent for publication"}},{"value":"The authors declare that they have no competing interests.","order":4,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}}],"article-number":"682"}}