ArticleBMC health services research2025
Effectiveness of the kakaritsuke-yakuzaishi (family pharmacist) system for underage individuals in Japan: a cohort study using a health insurance claims database.
Article in BMC health services research, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
2 citing papers in PubMed.
- Community pharmacy transformation under universal health coverage: Implementation barriers, cultural determinants, and cross-national lessons from Japan's ongoing transition - A narrative review.Exploratory research in clinical and social pharmacy · 2026Review
- Association of family pharmacist continuity with patient-reported satisfaction in patients with metastatic cancer: a nationwide cross-sectional study.Journal of pharmaceutical health care and sciences · 2026Article
Corrections and comments
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Authors and funding
1 author.
Funding
Abstract
backgroundThe kakaritsuke-yakuzaishi system (hereafter called the family pharmacist system), which provides more pharmaceutical services in exchange for higher fees than do general pharmacy practices, was introduced in Japan in April 2016. This cohort study aimed to describe the characteristics of patients who used the family pharmacist system and assess its effectiveness in the pharmaceutical management of underage individuals. It also evaluated the effect modifications of age, number of types of drugs, and number of medical facilities used on the effectiveness of the system.
methodsThis study comprised underage individuals who visited pharmacies every six months between April 2017 and March 2020 from the Japan Medical Data Centre health insurance database, categorizing them as users and non-users of the family pharmacist system. The claim rates (per 1,000 person-visits) of fees for adjusting leftover drugs and preventing therapeutic duplication and drug interactions (TDDIs) were calculated as endpoints. Group comparisons were performed by applying a generalized estimation equation to groups whose characteristic variables were balanced by the inverse probability of treatment weighting. The effect modifications on the endpoints were assessed based on the relative excess risk due to interaction (RERI) of the candidate variables.
resultsThe eligible cohort comprised 200,673 underage patients (users: 6,109; non-users: 194,564). Users tended to be younger patients, who received prescriptions for more drug types and used more medical facilities than non-users did. Regarding the fee for adjusting leftover drugs, the claim rates were 0.6 for users and 0.4 for non-users (incidence rate ratio [IRR]: 1.6; 95% confidence interval [CI]: 0.9-2.9). Regarding the fee for preventing TDDIs, the claim rates were 4.8 for users and 3.7 for non-users (IRR: 1.3; 95% CI: 1.1-1.4). No effect modification was detected in RERI.
conclusionsThis study demonstrated that the family pharmacist system improved TDDI prevention among underage individuals. However, its effectiveness was consistent regardless of the characteristics related to the utilization of the family pharmacist system, indicating that the trend of positively applying the system to those with these characteristics was not supported. The operation of the system may be reconsidered for the efficient allocation of medical resources.
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