醫院高就診次病人居家藥事照護成效

Outcomes of Home Pharmaceutical Care on Hospital High Users of Medical Resources

劉采艷(Tsai-Yen Liu) ； 黃欣怡(Sin-Yi Huang) ； 張維舜(Wei-Shuen Chang) ； 王仁宏(Jen-Hung Wang)

《臺灣臨床藥學雜誌》 25卷3期 (2017/07) Pp. 233-245

https://doi.org/10.6168/FJCP.2017.2503.06

摘要

目的：本研究透過某醫學中心院內計畫，由藥師輔導院內高診次病人，評估病人接受居家藥事照護後，其就醫態度、用藥認知與就診次數改善之成效。方法：本研究樣本來自東部某醫學中心100 位門診高診次病人，研究設計為橫斷研究，研究工具使用結構式問卷，共進行二次居家訪視與問卷調查，並給予適當衛教。研究結果變項為平均就診次數、就醫態度、用藥認知與用藥行為。統計分析進行描述性分析，並進行獨立樣本t 檢定與卡方檢定之差異性分析。結果：進行100 位高診次病人訪視前，前一年門診就診次數66 次；看診醫師達三位以上有69.8%；從醫護人員的衛教獲取醫藥知識者67.7%。經過藥師第二次訪視後，當年度平均就診次數降為42 次；接受看診醫師達三位以上降為63.4%；從醫護人員的衛教獲取醫藥知識者提高為77.1%。就醫態度與用藥認知皆達顯著差異 (p ＜0.05)，但用藥行為未達顯著差異。結論：醫院藥師可以透過院內資料庫，瞭解高診次病人不適當的就醫與用藥情形，進行居家訪視輔導，除能降低病人就診次數，也能提升病人的用藥安全。

關鍵字

高就診次 ； 居家藥事照護 ； 就醫態度 ； 用藥認知

並列摘要

Objective: This study was conducted through a home pharmaceutical care at a medical center, by the hospital pharmacist counseling high users of medical resources (HUMR). Patients were assessed on the improved of medical attitudes, medication cognition and behavior; the number of reductions of visits. Methods: Include 100 HUMR outpatient clinics of a medical center in eastern Taiwan, The study design was a cross-sectional, research tools use structured questionnaires, a total two times home visits and questionnaires, and give appropriate health education. The results were as follows: the average number of visits, medical attitude, medication cognition and behavior. Statistical analysis was performed descriptively and independent sample t-test with difference analysis of chi - square test. Results: Before visit by pharmacists, the average number of outpatient visits in the previous year was 66 times year, visiting doctors up to 3 or more 69.8%, from the health care personnel to obtain medical knowledge 67.7%. After visit, the average number of visits reduced to 42 times, receiving more than 3 doctors reduce to 63.4%, from the health care personnel to obtain medical knowledge increased to 77.1%. There were significant differences in medical attitude and medication cognition (p ＜ 0.05), but the medication behavior have not significant difference. Conclusions: Hospital pharmacists can use medication data to understand the HUMR outpatient clinics inappropriate medical, conduct home visits and counseling. In addition to reducing the number of patient visits, but also improve patient safety medication.

並列關鍵字

High Users of Medical Resources ； Home Pharmaceutical Care ； Attitudes toward the Use of Medical Resources ； Awareness of Drug Use