Journal of Pharmaceutical Communication
Vol.21 No.1 2023

原著論文

Evaluation of the relationship between pregnant/postpartum
women’s characteristics and pharmacy use experience in terms of
consultation needs with pharmacists
薬剤師への相談ニーズから見た妊産婦特性と薬局使用経験との関連性評価

Akito Ikeshita #,a,b, Atsunobu Sagara #,a, Takuya Azechi c,
Ayako Maeda-Minami d, Kayoko Sato a, Hidenori Kominato a,b,
Kazuhiro Torigoe a, Motohiko Sano a, Masako Horiuchi a,
Fumiaki Sato a, Etsuko Arita e, Tetsuro Yumoto *a , and Masayoshi Koinuma f
These authors contributed equally to this work.

#

池下

暁人＃，ａ，ｂ、相良佐野

篤信＃，ａ、畦地

元彦ａ、堀内拓哉ｃ、前田

正子ａ、里

絢子ｄ、里

史明ａ、有田香世子ａ、小湊悦子ｅ、湯本

英範ａ，ｂ、鳥越哲郎＊ａ、濃沼一宏ａ、

政美ｆ

Keyword ; C onsultation needs, pregnant/postpartum women’s characteristics, pharmacy use experience, pharmacists
キーワード；相談ニーズ、妊産婦特性、薬局使用経験、薬剤師
Abstract ; The Ministry of Health, Labor and Welfare, and professional associations have proposed the use of family
pharmacies/pharmacists as part of the health and medical care system for pregnant/postpartum women. In thisstudy, we clarified the consultation needs of pregnant/postpartum women with regard to the functions andcapabilities of pharmacies/pharmacists, and examined the relationship with background information on pregnant/postpartum women（number of births, age at the time of the response, and status of pharmacy use）.The counselingneeds of pregnant/postpartum women were categorized into four clusters: general health care items, health products
and over-the-counter medicines, prescription medicine, and general consultation. Additionally, each cluster was
associated with three factors of maternal background information. Regardless of whether they are primipara or
multipara, those who are relatively young in age group tend to 1）mainly consult with the attending obstetrician they
are visiting, 2）their consultation needs with pharmacists are in the area of self-care and self-medication, 3）according
to their childbirth experience, they Priority tends to shift from health products and over-the-counter medicines togeneral health care items. On the other hand, we concluded that those who are relatively older tend to 1）consolidate
their use of multiple pharmacies to some extent to their family pharmacies in accordance with their experience ofchildbirth, and 2）shift their consultation needs from general consultation to prescription medicines. It was thoughtthat these results are significant for pharmacies/pharmacists to practice a response that takes into account thecharacteristics of each pregnant/postpartum woman.
要旨；厚生労働省等は、妊産婦に対する保健・医療体制の一つとして、かかりつけ薬局・薬剤師の活用を提言している。
本研究では、薬局・薬剤師の機能・職能に対する妊産婦の相談ニーズを明らかとし、妊産婦の背景情報（出産回数、回答時の年齢、薬局の使用状況）との関連性も検討した。妊産婦の相談ニーズは、【健康管理項目一般】、【健康食品・一般用医薬品】、【医療用医薬品】、【全般的な相談】という４つのクラスターに分類され、各クラスターは、妊産婦の背景情報３因子で関連付けられた。初産婦・経産婦に関係なく、比較的年齢層が若い者は、１）受診中の産科が主体となり、２）
薬剤師への相談ニーズは、セルフケア・セルフメディケーションの領域であり、３）出産経験に準じて健康食品・一般用医薬品から健康管理項目一般へと優先順位がシフトする傾向があった。一方、比較的年齢層が高い者は、１）出産経
験に準じて複数の薬局使用からある程度かかりつけ薬局に使用が集約され、２）相談ニーズも全般的な相談から医療用医薬品へシフトされる傾向があった。本結果は、薬局・薬剤師が各妊産婦の特性を考慮した応対を実践する上で意義あるものと考える。

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Journal of Pharmaceutical Communication
Vol.21 No.1 2023

ａ Hoshi University
ｂ I&H Co., Ltd.
ｃ Department of Pharmacy, Juntendo University Hospitalｄ Faculty of Pharmaceutical Sciences, Tokyo University of Scienceｅ Kitasato University School of Pharmacy
ｆ Faculty of Pharmaceutical Sciences, Teikyo University of Science*Corresponding Author：Tetsuro Yumoto, 2-4-41 Ebara, Shinagawa-ku, Tokyo 142-8501, JAPAN
Tel: +81-3-5498-5840 Fax: +81-3-5498-5840 e-mail: t-yumoto@hoshi.ac.jp
所属：ａ

星薬科大学

ｂ

I & H株式会社ｃ

順天堂大学医学部附属順天堂医院薬剤部

ｄ

東京理科大学薬学部ｅ

北里大学薬学部ｆ

帝京平成大学薬学部

１．Introduction

psychological aspects of pregnant/

The Ministry of Health, Labor andpostpartum women about the functions andWelfare and professional associations

capabilities of pharmacies/pharmacists torelated to pharmacists have proposed theconstruct and propose a new type ofactive use of family pharmacies/

support for pregnant/postpartum women.6）

pharmacists as part of the health andIn addition, with the primary purpose of

medical care system to enable pregnant/problem identification, we investigated andpostpartum women to safely bear and raise

analyzed the ease of psychologicalt h e i r c h i l d r e n i n t h e c o m m u n i t y . 1 , 2 ）I n

communication（hereafter referred to as

some areas, family pharmacies/pharmacists“ e a s e o f p s y c h o l o g i c a l a c c e s s ” ）w i t h

are practicing support for pregnant/pharmacists when they feel anxious about

postpartum women in collaboration withusing health products and medicines. The

the government and medical institutions,

results revealed that pharmacists are rated

andanoverviewofthishasbeen

at a certain level among diverse sources ofpreviously reported.3, 4）However, although

information, while pharmacists had

supporting pregnant/postpartum womenrelatively less ease of psychological accessby pharmacies/pharmacists is essentially awhen focusing on medical professionals. We

standard function, it has yet to be fully

also revealed that approximately 10% of theimplemented in society. Also, thewomen did not intend to self-report theirrecognition among pregnant/postpartum

pregnant/postpartum status at all or unless

women regarding support pregnant/asked for pharmacy pharmacists.6）

postpartum women by pharmacies/

In this study, we focused on the above-

pharmacists is low.5）

mentioned needs and clarified the items

Under these circumstances, wethat pregnant/postpartum womenconsidered it essential to clarify issues andspecifically want to consult withneedsfromthesubjectiveand

pharmacies and pharmacists（hereinafter7

Journal of Pharmaceutical Communication
Vol.21 No.1 2023

referred to as “consultation needs”）and

2.2. Analysis methods

analyzed the association between the

2.2.1 S i m p l e t a b u l a t i o n o f i t e m s t h a t

background information of pregnant/expectant mothers like to consult

postpartum women（number of births, age

with pharmacies and pharmacists

at the time of the response, and status of

The responses of pregnant/postpartum

p h a r m a c y u s e ）a n d t h e i r c o n s u l t a t i o nwomen to the survey question, “Whatneeds.

specifically would you like to consult with apharmacist during pregnancy,” were２．Methods

tabulated. The questions consisted of nine2.1. S u r v e y t a r g e t s a n d e t h i c a litems at two levels（yes/no）,the contents

considerationsof which are presented as follows: a）

F r o m F e b r u a r y 2 5th – 2 6th , 2 0 2 0 ,symptoms and timing to see a hospital, b）

preliminary online surveys were distributed

h e a l t h p r o d u c t s , c ）o v e r - t h e - c o u n t e r

to 50,000 registered investigation firmm e d i c i n e s（ i n t e r n a l u s e ）,d ）o v e r - t h e -randomized monitors（Macromill, Inc.,c o u n t e r m e d i c i n e s（ e x t e r n a l u s e ）,e ）Tokyo, Japan）of women in their teens toprescription medicines（internal use）,f）

those in their forties across Japan. The data

prescription medicines（external use）,g）

provided by 1,030 women who were eight

diet and nutrition, h）immunizations, and i）

months pregnant to <1 year postpartum

dental and oral health care.

（at the time of the survey）were extracted.
The monitors of the investigation firm had

2.2.2 Clustering of items that pregnant/been publicly recruited, and the total

postpartum women like to discuss

number of monitors as of February 2020

with pharmacies and pharmacists

was approximately 1.28 million. To prevent

Cluster analysis using the agglomerative

any falsified responses, a trapping survey

hierarchical clustering method waswas conducted every six months, andconducted using the nine survey questions

monitors were required to update

mentioned in section 2.2.1. The number ofnecessary registered information every

clusters was adopted as a clinically valid

year. The study was conducted bynumber with reference to the cube cluster

following the ethical guidelines for human-

criterion. Each cluster was named to reflect

based medical research. It was approved by

the characteristics of the cluster based on

the Institutional Review Board of Hoshi

the structure of the top items（about 3

University（2019-13）and the Institutional

items）or the items as a whole.

Review Board of HANSHIN Dispensing
Pharmacy（19009S）.The survey response

2.2.3 E v a l u a t i o n o f t h e r e l a t i o n s h i p

indicated consent to participate in the

between background information on

study.

pregnant/postpartum women andtheir need for consultation withpharmacists.

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Journal of Pharmaceutical Communication
Vol.21 No.1 2023

2.2.3.1 Background information on pregnant

background information data in section

women（number of births, age at the

2.2.3.1. The background information oftime of response, and experience using

pregnant/postpartum women was analyzed

pharmacies）

using a composite variable of the number of

The number of births was categorizedbirths and age at the time of response, plus

into two levels: primipara and multipara.

the experience of using a pharmacy. JMP

The age at the time of response was

Pro 16.2（SAS Institute, Cary, NC, USA）

classified into three levels based on Jenks’

was used for data analysis regarding thecategorical classification, and a composite

sections 2.2.1 to 2.2.3.

variable of these variables was created.
The experience of using a pharmacy during

３．Results

the most recent pregnancy was categorized

3.1 S i m p l e t a b u l a t i o n o f i t e m s t h a t

into four levels: family pharmacy, family

pregnant/postpartum women like topharmacy and other pharmacies, otherconsult with pharmacists

pharmacies, and obstetrics consultation

The top five items accounted for over-only（no pharmacy use）.

the-counter medicines（internal use; 52.5%）,
p r e s c r i p t i o n m e d i c i n e s（ i n t e r n a l u s e ;2.2.3.2 E v a l u a t i o n o f t h e r e l a t i o n s h i p

5 1 . 9 % ）,o v e r - t h e - c o u n t e r m e d i c i n e s

between maternal background（ e x t e r n a l u s e ; 3 6 . 4 %）,h e a l t h p r o d u c t s

information and consultation with（ 3 2 . 2 % ）,a n d p r e s c r i p t i o n m e d i c i n e spharmacies and pharmacists（Figure 1）.
（external use; 31.9%）

Multiple Correspondence Analysis（MCA）was conducted using the clusters
created in section 2.2.2 and the maternal

Figure 1: List of items pregnant/postpartum women would like to consult with pharmacists during pregnancy.

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Journal of Pharmaceutical Communication
Vol.21 No.1 2023

Figure 2: The clustering of items that pregnant/postpartum women would like to discuss with pharmacists. Cluster 1
as general health care items, cluster 2 as health products and over-the-counter medicines, cluster 3 asprescription medicines, and cluster 4 as general consultation were named.

3.2 C lustering of items that pregnant/maternal background information（number

postpartum women like to discussof births, age at the time of response）andwith pharmacists

four clusters was examined using MCA. As

The characteristics of pregnant/

shown in Figure 3 , the higher the value forpostpartum women were structured bydimension one, the higher the age at timecluster analysis based on their consultationof response, and the higher the value forneeds with pharmacists and were classified

dimension two, the more likely the womeni n t o f o u r c l u s t e r s（ F i g u r e 2 ）. A f t e rwere multipara. Among primipara, cluster 2

examining the characteristics of each（health products and over-the-countercluster, we were able to name cluster 1 asmedicines）was found to be associated withgeneral health care items, cluster 2 asprimipara under 28 years of age, cluster 4

health products and over-the-counter（general consultation）with primipara overmedicines, cluster 3 as prescription

3 3 y e a r s o f a g e , a n d c l u s t e r 1（ g e n e r a l

medicines, and cluster 4 as general

health care items）with multipara under 28

consultation.

years of age and cluster 3（prescription
medicines）with multipara over 28 years of

3.3 E v a l u a t i o n o f t h e r e l a t i o n s h i page（Figure 3）.

between maternal background

The relationship between the three

information and the need forfactors of maternal background information

consultation with pharmacies and（number of births, age at the time ofpharmacists

response, and experience using a

The relationship between two factors ofpharmacy）and four clusters was examined
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Journal of Pharmaceutical Communication
Vol.21 No.1 2023

Figure 4: T he relationship between three factors ofmaternal background information（number ofbirths, age at the time of response, andexperience using a pharmacy）and the fourclusters.

Figure 3: T he relationship between two factors ofmaternal background information（number ofbirths and age at the time of response）andfour clusters.

using MCA. As shown in Figure 4, thesupport system to support pregnant/higher the value for dimension one, thepostpartum women, the functions andhigher the age at the response, and thecapabilities of pharmacies/pharmacists arehigher the value for dimension two, therequired more than ever before, however,more likely the multipara. Among

there has not been sufficient research on

primipara, women under 28 years of age

the needs of social pharmacy in this area.

had not used a pharmacy, which clearly

The analysis in this study focused on therelated to cluster 2（health products andconsultation needs of pregnant/postpartum

over-the-counter medicines）.The women

women to pharmacies/pharmacists. As a

who were 28 years old or older had

result, it was found that the counselingexperience using a family pharmacy orneeds of pregnant/postpartum womenother pharmacies, which was clearly

were statistically classified into foura s s o c i a t e d w i t h c l u s t e r 4（ g e n e r a lclusters: general health care items, healthconsultation）.Among multipara, women

products and over-the-counter medicines,

under 28 years of age had no experience

prescription medicines, and generalusing a pharmacy, which was clearlycounseling. In addition, each cluster was

associated with cluster 1（general healthassociated with three factors: number ofc a r e i t e m s ）.T h e 2 8 - y e a r - o l d o r o l d e rbirths, age at the time of response, andwomen had an experience using a family

experience using pharmacies, which arepharmacy and showed an association withbackground information of pregnant/cluster 3（prescription medicines）.

postpartum women. The following is a
discussion of maternal characteristics based

４．Discussion

on the findings obtained.

In building a comprehensive community

Those in the relatively young age group11

Journal of Pharmaceutical Communication
Vol.21 No.1 2023

of primipara and under 28 years of age arepriority. On the other hand, the relatively

generally considered less likely to haveolder age group of multipara wasunderlying medical conditions. 7）Therefore,

associated with experience in using a

it was thought that attending obstetricians

family pharmacy and the need for（no experience with pharmacy use）wereconsultation on prescription medicines,

listed as medical institutions/facilities they

which may explain why they had more

had used during pregnancy and that theiropportunities to require medical visits, i.e.,

consultation needs with pharmacists wereincreased drug use, compared to primipara.

also for health products and over-the-Based on the above, the characteristics ofcounter medicines related to self-care andpregnant/postpartum women can be

self-medication before and after pregnancy.

summarized based on their consultation

On the other hand, the phenomenon ofneeds with pharmacies/pharmacists andwomen’s marriage and childbearing ages

their background of pregnant/postpartum

becoming higher is occurring against the

women. Regardless of whether they are

backdrop of women’s increased social

primipara or multipara, those who are

a d v a n c e m e n t s . 8 , 9 ）T h e r e f o r e , i t w a s

relatively young in age group tend to 1）

thought that primipara and those inmainly consult with the attending

relatively older age groups used both theiro b s t e t r i c i a n t h e y a r e v i s i t i n g , 2）t h e i rfamily pharmacies and other pharmacies

consultation needs with pharmacists are infor general consultation due to a variety of

the area of self-care and self-medication, 3）

health and childbirth-related concerns

according to their childbirth experience,caused by a history of underlying medical

and they Priority tends to shift from healthconditions and advancing age.

products and over-the-counter medicines to

The relatively young age group ofgeneral health care items. On the othermultipara and those under 28 years of age

hand, we concluded that those who are

were thought to use the same obstetrician

relatively older tend to 1）consolidate their

they were seeing（no prior pharmacy use）

use of multiple pharmacies to some extent

due to the same health background as

to their family pharmacies in accordance

primipara, and the same self-care and self-with their experience of childbirth, and 2）

medication areas were also identified as

shift their consultation needs from general

their counseling needs. The reason why the

consultation to prescription medicines.

needs for consultation with pharmacists

Traditionally, the proportion of pregnant/were health management items such as the

postpartum women among store visitors

timing of medical examinations,who consult with pharmacists has been low,

vaccinations, and diet/nutrition in the same

making it difficult for pharmacists to gainarea was thought to be that the top items

experience in supporting pregnant/for consultation needs（health products andpostpartum women. We believe that theover-the-counter medicines）were resolved

findings of this study are significant forthrough the first birth experience, andpharmacies/pharmacists with diverse work

interest and concern shifted according tostyles in promoting support for pregnant/12

Journal of Pharmaceutical Communication
Vol.21 No.1 2023

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