Reduction in the number of drugs in elderly patients with polypharmacy by a multidisciprinary medication review using by electronic medical records

• Project/Area Number: 26460861
• Research Category: Grant-in-Aid for Scientific Research (C)
• Allocation Type: Multi-year Fund
• Section: 一般
• Research Field: Medical and hospital managemen
• Research Institution: Gifu University
• Principal Investigator: Hayashi Yuichi 岐阜大学, 医学部附属病院, 講師 (00392366)
• Research Collaborator: GODAI Ayumi ; SUZUKI Akio ; NISHIDA Shouhei ; INUZUKA Takashi ; ITOH Yoshinori ; KINOSADA Yasutomi
• Project Period (FY): 2014-04-01 – 2018-03-31
• Project Status: Completed (Fiscal Year 2017)
• Budget Amount: ¥2,990,000 (Direct Cost: ¥2,300,000、Indirect Cost: ¥690,000); Fiscal Year 2016: ¥780,000 (Direct Cost: ¥600,000、Indirect Cost: ¥180,000); Fiscal Year 2015: ¥780,000 (Direct Cost: ¥600,000、Indirect Cost: ¥180,000); Fiscal Year 2014: ¥1,430,000 (Direct Cost: ¥1,100,000、Indirect Cost: ¥330,000)
• Keywords: ポリファーマシー / 高齢者 / 多職種協働 / 電子カルテ / 多職種共同 / 多剤処方 / 電子カルテシステム

Outline of Final Research Achievements

Polypharmacy is a major problem for elderly patients in developed countries. Multidisciplinary medication review using next generation medical record system could reduce the number of drugs taken by elderly patients receiving polypharmacy, including drugs associated with falls, in both fallers and non fallers.

Research Products

• [Journal Article] 高齢者医療ハンドブック. ポリファーマシー. (2018)
  • Author(s): 林 祐一
  • Journal Title: 内科 Volume: 121 Pages: 960-963
• [Journal Article] Relationship between number of drugs and duration of hospital stay in elderly patients with neuromuscular disease. (2018)
  • Author(s): Nishida S, Hayashi Y, Suzuki A, Kobayashi R, Inuzuka T, Itoh Y.
  • Journal Title: Geriatr Gerintol Int Volume: in press
  • Peer Reviewed
• [Journal Article] Drug-induced pressure ulcers in a middle-aged patient with early stage of Parkinson’s disease. (2018)
  • Author(s): Hayashi Y, Shibata H, Kudo T, Nishida S, Ishikawa R, Suzuki A, Kimura A, Inuzuka T.
  • Journal Title: Intern Med. Volume: in press
  • NAID: 130006734434
  • Peer Reviewed
• [Journal Article] ポリファーマシー (2017)
  • Author(s): 林 祐一
  • Journal Title: 日本食品科学工学雑誌 Volume: 64 Pages: 517-518
  • NAID: 130006183023
  • Peer Reviewed
• [Journal Article] 高齢者のポリファーマシーの是正と電子カルテシステムの役割. (2017)
  • Author(s): 林 祐一、犬塚 貴
  • Journal Title: 医学のあゆみ. Volume: 262 Pages: 726-727
• [Journal Article] Reduction in the numbers of drugs administered to elderly in-patients with polypharmacy by a multidisciplinary review of medication using electronic medical records. (2017)
  • Author(s): Hayashi Y, Godai A, Yamada M, Yoshikura N, Harada N, Koumura A, Kimura A, Okayasu S, Mastuno Y, Kinosada Y, Itoh Y, Inuzuka T.
  • Journal Title: Geriatr Gerontol Int. Volume: 17 Pages: 653-658
  • Peer Reviewed
• [Journal Article] ウレアーゼ産生菌の尿路感染から高アンモニア血症を来した１例－薬剤性の尿閉が一因となり、意識障害を来したパーキンソン病症例． (2017)
  • Author(s): 安西将大、香村彰宏、林 祐一、西田承平、犬塚 貴．
  • Journal Title: 日本老年医学会雑誌 Volume: 54 Pages: 560-566
  • NAID: 130006247152
  • Peer Reviewed
• [Journal Article] Reduction in the numbers of drugs administered to elderly in-patients with polypharmacy by a multidisciplinary review of medication using electronic medical records. (2017)
  • Author(s): Hayashi Y, Godai A, Yamada M, Yoshikura N, Harada N, Koumura A, Kimura A, Okayasu S, Mastuno Y, Kinosada Y, Itoh Y, Inuzuka T.
  • Journal Title: Geriatric Gerontol International Volume: 17 Issue: 4 Pages: 653-658
  • DOI: 10.1111/ggi.12764
  • Peer Reviewed / Acknowledgement Compliant
• [Journal Article] Central hypothermia associated with Alexander disease. A case report. (2017)
  • Author(s): Hayashi Y, Nagasawa M, Asano T, Yoshida T, Kimura A, Inuzuka T.
  • Journal Title: Clin Neurol Neurosurg Volume: 157 Pages: 31-33
  • DOI: 10.1016/j.clineuro.2017.03.013
  • Peer Reviewed
• [Journal Article] Neuropathological findings from an autopsied case showing posterior reversible encephalopathy syndrome-like neuroradiological findings associated with premedication including tacrolimus for autologous peripheral blood stem cell transplantation. (2017)
  • Author(s): Hayashi Y, Kimura A, Nakamura H, Mimuro M, Iwasaki Y, Hara A, Yoshida M, Inuzuka T.
  • Journal Title: J Neurol Sci Volume: 375 Pages: 382-387
  • DOI: 10.1016/j.jns.2017.02.030
  • Peer Reviewed / Acknowledgement Compliant
• [Journal Article] Reply to: Amyotrophic lateral sclerosis with frontotemporal dementia (ALS-FTD) syndrome as a phenotype of Creutzfeldt-Jakob disease (CJD)? A case report. (2017)
  • Author(s): Hayashi Y, Inuzuka T
  • Journal Title: J Neurol Sci Volume: 375 Pages: 489-489
  • DOI: 10.1016/j.jns.2017.02.055
  • Peer Reviewed
• [Journal Article] Reversible splenial lesion of the corpus callosum associated with meningococcal meningitis. (2017)
  • Author(s): Hayashi Y, Yasunishi M, Hayashi M, Asano T, Kimura A, Inuzuka T.
  • Journal Title: J Neurol Sci Volume: 373 Pages: 81-82
  • DOI: 10.1016/j.jns.2016.12.035
  • Peer Reviewed
• [Journal Article] IVIG treatment for repeated hypothermic attacks associated with LGI1 antibody encpehalitis (2017)
  • Author(s): Hayashi Y, Yamada M, Kimura A, Inuzuka T.
  • Journal Title: Neurol Neuroimmunol Neuroinflamm Volume: in press
  • Peer Reviewed / Open Access
• [Journal Article] A multidisciplinary medical network approach is crucial for increasing the number of autopsies for prion disease [Reply to: How can we increase the numbers of autopsies for prion disease? A model system in Japan] (2017)
  • Author(s): Hayashi Y, Inuzuka T.
  • Journal Title: J Neurol Sci Volume: in press
  • Peer Reviewed
• [Journal Article] Acute-onset severe occipital neuralgia associated with high cervical lesion in patients with neuromyelitis optica spectrum disorder (2017)
  • Author(s): Hayashi Y, Koumura A, Yamada M, Kimura A, Shibata T, Inuzuka T.
  • Journal Title: Headache Volume: in press
  • Peer Reviewed
• [Journal Article] Case of adult-onset neuronal intranuclear hyaline inclusion disease with negative electroretinogram. (2017)
  • Author(s): Yamada W, Takekoshi A, Ishida K, Mochizuki K, Sone J, Sobue G, Hayashi Y, INuzuka T, Miyake Y.
  • Journal Title: Doc Ophthalmol Volume: in press
  • Peer Reviewed
• [Journal Article] Increased cerebrospinal fluid progranulin correlates with interleukin-6 in the acute phase of neuromyelitis optica spectrum disorder. (2017)
  • Author(s): Kimura A, Takemura M, Saito K, Serrero G, Yoshikura N, Hayashi Y, Inuzuka T.
  • Journal Title: JOURNAL OF NEUROIMMUNOLOGY Volume: 305 Pages: 175-181
  • DOI: 10.1016/j.jneuroim.2017.01.006
  • Peer Reviewed / Int'l Joint Research
• [Journal Article] Comparison of cerebrospinal fluid profiles in Alzheimer’s disease with multiple cerebral microbleeds and cerebral-amyloid angiopathy related inflammation. (2017)
  • Author(s): Kimura A, Takemura M, Kuniaki S, Yoshikura N, Hayashi Y, Harada N, Nishida H, Nakajima H, Inuzuka T.
  • Journal Title: Journal of Neurology Volume: 264 Issue: 2 Pages: 373-381
  • DOI: 10.1007/s00415-016-8362-2
  • Peer Reviewed / Open Access / Acknowledgement Compliant
• [Journal Article] Association between naturally occurring anti-amyloid β autoantibodies and medial temporal lobe atrophy in Alzheimer's disease (2017)
  • Author(s): .Kimura A, Takemura M, Saito K, Yoshikura N, Hayashi Y, Inuzuka T.
  • Journal Title: J NEUROL NEUROSUR PSYCHIATRY Volume: 88 Issue: 2 Pages: 126-131
  • DOI: 10.1136/jnnp-2016-313476
  • Peer Reviewed / Open Access
• [Journal Article] 高齢者のポリファーマシーの是正と電子カルテシステムの役割 (2017)
  • Author(s): 林 祐一、犬塚 貴
  • Journal Title: 医学のあゆみ Volume: in press
  • Acknowledgement Compliant
• [Journal Article] 持続性アンギオテンシンⅡタイプⅠ受容体拮抗薬の投与に伴い慢性リチウム中毒を呈した高齢者の1例. (2016)
  • Author(s): 林 祐一、西田承平、竹腰 顕、村上宗玄、山田 恵、木村暁夫、鈴木昭夫、犬塚 貴．
  • Journal Title: 日本老年医学雑誌 Volume: 53 Pages: 244-249
  • Peer Reviewed / Acknowledgement Compliant
• [Journal Article] An autopsy-verified case of FTLD-TDP type A with upper motor neuron-predominant motor neuron disease mimicking MM2-thalamic-type sporadic Creutzfeldt-Jakob disease. (2016)
  • Author(s): Hayashi Y, Iwasaki Y, Takekoshi A, Yoshikura N, Asano T, Mimuro M, Kimura A, Satoh K, Kitamoto T, Yoshida M, Inuzuka T.
  • Journal Title: Prion. Volume: 10(6) Issue: 6 Pages: 492-501
  • DOI: 10.1080/19336896.2016.1243192
  • Peer Reviewed
• [Journal Article] Preserved regional cerebral blood flow in the occipital cortices, brainstem, and cerebellum of patients with V180I-129M genetic Creutzfeldt-Jakob disease in serial SPECT studies. (2016)
  • Author(s): Hayashi Y, Yoshikura N, Takekoshi A, Yamada M, Asano T, Kimura A, Satoh K, Kitamoto T, Inuzuka T.
  • Journal Title: J Neurol Sci. Volume: 370 Pages: 145-151
  • DOI: 10.1016/j.jns.2016.09.043
  • Peer Reviewed
• [Journal Article] Improvement of memory recall by quercetin in rodent contextual fear conditioning and human early-stage Alzheimer's disease patients. (2016)
  • Author(s): Nakagawa T, Itoh M, Ohta K, Hayashi Y, Hayakawa M, Yamada Y, Akanabe H, Chikaishi T, Nakagawa K, Itoh Y, Muro T, Yanagida D, Nakabayashi R, Mori T, Saito K, Ohzawa K, Suzuki C, Li S, Ueda M, Wang MX, Nishida E, Islam S, Tana, Kobori M, Inuzuka T.
  • Journal Title: NeuroReport Volume: 27 Issue: 9 Pages: 671-676
  • DOI: 10.1097/wnr.0000000000000594
  • Peer Reviewed / Acknowledgement Compliant
• [Journal Article] Reduction in the numbers of drugs administered to elderly in-patients with polypharmacy by a multidisciplinary review of medication using electronic medical records. (2016)
  • Author(s): Hayashi Y, Godai A, Yamada M, Yoshikura N, Harada N, Koumura A, Kimura A, Okayasu S, Mastuno Y, Kinosada Y, Itoh Y, Inuzuka T.
  • Journal Title: Geriatric Gerontol International Volume: in press
  • Peer Reviewed / Acknowledgement Compliant
• [Journal Article] Improvement of memory recall by quercetin in rodent contextual fear conditioning and human early-stage Alzheimer's disease patients. (2016)
  • Author(s): Nakagawa T, Itoh M, Ohta K, Hayashi Y, Hayakawa M, Yamada Y, Akanabe H, Chikaishi T, Nakagawa K, ItohY, Muro T, Yanagida D, Nakabayashi R, Mori T, Saito K, Ohzawa K, Suzuki C, Li S, Ueda M, Wang MX, Nishida E , Islam S, Tana, Kobori M, Inuzuka T.
  • Journal Title: Neuro Report Volume: in press
  • Peer Reviewed
• [Journal Article] Decreased regional cerebral blood flow in the bilateral thalami and medulla oblongata determined by an easy Z-score (eZIS) analysis of 99mTc-ECD-SPECT images in a case of MM2-thalamic-type sporadic Creutzfeldt-Jakob disease (2015)
  • Author(s): Hayashi Y, Iwasaki Y, Yoshikura N, Asano T, Hatano T, Tastumi S, Satoh K, Kimura A, Kitamoto T, Yoshida M, Inuzuka T.
  • Journal Title: J Neurol Sci Volume: 358 Pages: 447-452
  • Peer Reviewed
• [Journal Article] Identification of target antigens of antiendothelial cell antibodies against human brain microvascular endothelial cells in healthy subjects. (2015)
  • Author(s): Kimura A, Sakurai T, Yoshikura N, Koumura A, Hayashi Y, Ohtaki H, Chousa M, Seishima M, Inuzuka T
  • Journal Title: Curr Neurvasc Res Volume: 12 Pages: 25-30
  • Peer Reviewed
• [Journal Article] B-cell-activating factor belonging to the tumor necrosis factor family (BAFF) and a proliferation-inducing ligand (APRIL) levels in cerebrospinal fluid of patients with meningoencephalitis (2015)
  • Author(s): Kimura A, Yoshikura N, Koumura A, Hayashi Y, Inuzuka T.
  • Journal Title: J Neurol Sci Volume: 352 Pages: 79-83
  • Peer Reviewed
• [Journal Article] Identification of target antigens of naturally occurring autoantibodies in cerebrospinal fluid. J Proteomics (2015)
  • Author(s): Kimura A, Yoshikura N, Koumura A, Hayashi Y, Kobayashi I, Yano T, Inuzuka T.
  • Journal Title: J Proteomics Volume: 128 Pages: 450-457
  • Peer Reviewed
• [Presentation] ポリファーマシーとどう向き合うか．入院を契機とした高齢者のポリファーマシー是正と電子カルテシステムの役割． (2017)
  • Author(s): 林 祐一
  • Organizer: 日本老年医学会
• [Presentation] Polypharmacy in elderly patients and a role of electronic medical record system. (2017)
  • Author(s): Yuichi Hayashi, Takashi Inuzuka
  • Organizer: The 2nd Geriatric Innovation forum
  • Int'l Joint Research
• [Presentation] A search for drugs with increased risk for worse clinical outcomes in elderly patients receiving multi-drug therapy. (2017)
  • Author(s): Nishida S, Suzuki A, Hayashi Y, Kobayashi R, Inuzuka T, Itoh Y.
  • Organizer: The 77th FIP World Congress of Pharmacy and Pharmaceutical Sciences.
  • Int'l Joint Research
• [Presentation] Necessity of a drug-related item for a geriatric inpatient fall assessment tool. (2017)
  • Author(s): Hayashi Y, Nishida S, Tamai S, Suzuki A, Kimura A, Itoh Y, Inuzuka T.
  • Organizer: The 77th FIP World Congress of Pharmacy and Pharmaceutical Sciences.
  • Int'l Joint Research
• [Presentation] Polypharmacy in elderly patients and a role of electronic medical record system. (2017)
  • Author(s): Hayashi Y, Inuzuka T.
  • Organizer: The 2nd Geriatrics Forum
  • Place of Presentation: 名古屋
  • Int'l Joint Research
• [Presentation] 高齢者のポリファーマシーの是正と次世代型電子カルテシステムの役割 (2017)
  • Author(s): 林 祐一
  • Organizer: 岐阜医学奨励賞受賞者講演会
  • Place of Presentation: 岐阜
  • Invited
• [Presentation] 入院時の高齢者院内転倒予測率向上に関する検討 (2016)
  • Author(s): 林 祐一、玉井小百合、西田承平、小林 亮、鈴木昭夫、 中口節子、山田 恵、木村暁夫、犬塚 貴
  • Organizer: 第58回日本老年医学会学術集会
  • Place of Presentation: 金沢
  • Year and Date: 2016-06-09
• [Presentation] Differences in 11C-PIB-PET imaging patterns between Alzheimer’s disease patients with and without cerebral cortical/subcortical microbleeds. (2016)
  • Author(s): Hayashi Y, Shinoda J, Yoshikura N, Waza M, Nishida H, Asano Y, Kimura A, Inuzuka T.
  • Organizer: The 68th Annual Meeting of American Academy of Neurology
  • Place of Presentation: Vancouver
  • Year and Date: 2016-04-19
  • Int'l Joint Research
• [Presentation] Differences in 11C-PIB-PET imaging patterns between Alzheimer’s disease patients with and without cerebral cortical/subcortical microbleeds. (2016)
  • Author(s): Hayashi Y, Shinoda J, Yoshikura N, Waza M, Nishida H, Asano Y, Kimura A, Inuzuka T
  • Organizer: The 68th Annual Meeting of American Academy of Neurology.
  • Place of Presentation: Vancouver, Canada
  • Year and Date: 2016-04-19
  • Int'l Joint Research
• [Presentation] 入院時の高齢者転倒予測率向上に関する研究 (2016)
  • Author(s): 林 祐一、玉井小百合、西田承平、小林 亮、鈴木昭夫、中口節子、山田 恵、 木村暁夫、犬塚 貴
  • Organizer: 第58回日本老年医学会総会
  • Place of Presentation: 金沢
• [Presentation] Acute-onset severe occipital headache associated with high cervical myelitis in neuromyelitis optica spectrum disorder patients. (2016)
  • Author(s): Hayashi Y, Koumura A, Yamada M, Kimura A, Shibata T, Inuzuka T.
  • Organizer: The 6th Asia Regional Conference for Headache
  • Place of Presentation: Seoul
  • Int'l Joint Research
• [Presentation] An autopsy-verified case of FTLD-TDP with upper motor neuron predominant motor neuron disease mimicking MM2-thalamic-type sporadic Creutzfeldt-Jakob disease. (2016)
  • Author(s): Hayashi Y, Iwasaki Y, Takekoshi A, Yoshikura N, Kimura A, Satoh K, Kitamoto T, Yoshida M, Inuzuka T.
  • Organizer: Prion 2016
  • Place of Presentation: Tokyo
  • Int'l Joint Research
• [Presentation] SPECT findings during end-stage V180I gCJD. (2015)
  • Author(s): Hayashi Y, Yoshikura N, Takekoshi A, Yamada M, Kimura A, Inuzuka T.
  • Organizer: APPS 2015
  • Place of Presentation: 金沢
  • Year and Date: 2015-09-04
  • Int'l Joint Research
• [Presentation] 入院により多剤処方が解消される高齢者の臨床的特徴 (2015)
  • Author(s): 林 祐一、山田 恵、吉倉延亮、原田斉子、香村彰宏、木村暁夫、犬塚 貴
  • Organizer: 第29回日本老年学会総会、第57回日本老年医学会学術集会
  • Place of Presentation: 横浜
  • Year and Date: 2015-06-14
• [Presentation] 入院により多剤処方が解消される高齢者の臨床的特徴 (2015)
  • Author(s): 林 祐一, 山田 恵, 吉倉 延亮, 原田 斉子, 香村 彰宏, 木村 暁夫, 犬塚 貴
  • Organizer: 日本老年医学会総会
  • Place of Presentation: 横浜市
  • Year and Date: 2015-06-14
• [Presentation] 入院により極端に薬剤数が増減する高齢者の臨床的特徴 (2014)
  • Author(s): 林 祐一, 山田 恵, 吉倉 延亮, 原田 斉子, 香村 彰宏, 木村 暁夫, 犬塚 貴
  • Organizer: 日本老年医学会総会
  • Place of Presentation: 福岡市
  • Year and Date: 2014-06-12
• [Remarks] 次世代型電子カルテシステムによる高齢者多剤処方の是正効果に関する研究
  • URL: http://www.med.gifu-u.ac.jp/neurology/concerned.html