To determine the``home pharmacy'' activities including preventive medicine in community pharmacies and their regional diŠerences, we conducted two questionnaire surveys of pharmacies belonging to the pharmacists' association in four areas, two metropolitan areas (Kita-tama area and Minato-ku in Tokyo) and two rural areas (Ueda-shi in Nagano and Aira-gun in Kagoshima) in 1998 and 2007. The questionnaire consisted of 42 questions including the scale and characteristics of the pharmacy, the oŠering of information to patients and information collection from patients, and activities related to home care medicine, environmental sanitation, and healthcare. Based on 14 factors in the questionnaire, an index of``Community Medicine Contributed by Home Pharmacies'' was evaluated to represent the extent of activity including preventive medicine in pharmacy. The median of the indexes in the four areas rose in 2007, and was the highest in Ueda-shi. However, the increase in the index was found to result from increases in activity related to clinical medicine such as the use of``Medication Notebooks'' and the circulation of``Pharmaceutical Instructions'' and did not result from increased activity related to preventive medicine. Factors to promote preventive medicine activity are discussed based on the data from Aira-gun where the greatest home care medicine activity occurred and from Ueda-shi where the greatest environmental sanitation and healthcare activities occurred.

In conclusion, with the remaining health burden due to mesothelioma, the changing landscape of asbestos exposure, and the many unanswered scientific questions, a nation-wide, real-time US mesothelioma registry is urgently needed. Methods for data sharing, linkage to existing tissue banks, and data access should be implemented and tested on a small scale before being implemented nationwide. One of the most practical outputs of these efforts would be the ability to conduct pragmatic trials that could be built out of a "real time" case capture system.