医師・看護師・薬剤師の連携による地域医療の質の向上―忘れがちな障害，爪白癬の治療を通して―

Onychomycosis often remains undiagnosed by physicians during patient home visits. Prescriptions of antifungal medications require blood tests because of possible side effects, especially in patients with liver dysfunction. However, the general condition of onychomycosis patients in home care is often unstable; thus, antifungal use may be contraindicated. Although onychomycosis is a dermatological disease, visiting physicians should perform initial treatment as a part of home medical care. In general, home-visting physicians should be prepared to respond to initial treatment in areas other than their specialized field of medical training. This study revealed problems in: 1）methods of recording the course of treatment; 2）recognition of differences in needs among medical professionals; and 3）changes in the burdens experienced by patients. In aging societies, the focus continues to shift from hospital-based to home-based medical care and treatment delivery has changed from specialists to medical care teams. Healthcare should provide continuous treatment for various medical issues such as hypertension, hyperlipidemia, cardiovascular disease, nutritional management, and palliative care to patients and their families. Teams of physicians, visiting nurses, and pharmacists play important roles in home-based professional medical care. Using the treatment of onychomycosis as an example, it was possible to identify methods to improve the lifestyles of home-based patients.