都會型醫院藥師執行居家藥事照護之初探

目的：用藥安全是病人安全的首要目標。老年人、獨居長者、弱勢族群可能因老化、慢性病、於多處看診等問題，長期同時服用多種處方藥品而成為用藥關懷族群，本文藉由醫院藥師到宅訪視，探討民眾對居家藥事照護的需求。方法：本計畫自2014年6月1日至11月30日止，由本院藥師輪流至病人家中進行居家藥事服務，紀錄及評估病人的用藥情形、治療成效，與醫師討論並提供適切的建議，增進病人用藥安全。結果：共收案235人完成281次訪視，訪視後共提出678項專業建議，建議的內容以提供疾病自我照顧之指導與建議、處方問題評估建議、提供用藥知識及藥物使用指導等項目為主。本研究發現藥師訪視建議事項中，教育程度國中者對「用藥知識及藥物使用之指導」需求比例高於不識字、國小及高中(p = 0.006)；教育程度國中以下者對「用藥技巧及增加配合度」需求比率較高(p = 0.003)、年齡＜ 75歲者對「疾病自我照顧之指導及建議」需求比率較高(p = 0.002)。受訪個案對藥師訪視滿意度回答「滿意」及「非常滿意」占80.5%，74.5%的個案覺得藥師訪視對其「有幫助」。結論：透過本計畫的執行，建立藥師居家訪視服務的流程；藉此瞭解個案實際用藥情形，提供個人化的用藥指導與確認服用藥品的方式正確，對營造居家安全用藥的環境具正面效益。

關鍵字

藥事居家訪視；用藥安全；用藥指導

並列摘要

Objective: Medication Safety is a primary patient safety goal. The elderly, social vulnerable people are high risk groups of adverse drug events due to age and higher incidences of chronic disease, multiple medication use, improper medication behavior and usually have followed in many different hospitals. This study is aimed to evaluate the necessary of home pharmaceutical care services for patients. Methods: The study started from June to November, 2014, and pharmacists participated in to provide home pharmaceutical care services, including evaluation the appropriateness of drug use, the outcomes of the treatment, and then providing proper interventions to patients and physicians. Result: Totally, 281 visits were completed for 235 patients enrolled and 678 pharmaceutical care interventions were made. The top three types of interventions were: providing self-care knowledge to patients, drug-related problems identifications and suggestions and providing medicine information and education in medication use. Analyzing the need of different interventions and relationship of patients characteristics, The significant correlations were found that patients of junior high school educational level did need administration skills education (p = 0.003), and those ＜ 75 year-old did need self-care knowledge providing (p = 0.002). When compared the pharmacist’s intervention requirement of different educational level, we found the group of junior high school showed the higher proportion with requirement of medicine information and education in medication than those of illiterate, elementary school or high school group (p = 0.006). Through this study, we established the model of home pharmaceutical care services, identified and resolved numerous drug-related problems, provided personal medication therapy management, thus pharmacists intervention is beneficial for home-care patients with chronic diseases.

並列關鍵字

Pharmaceutical Home Care Services ； Medication Safety ； Patient Counseling

國際替代計量

都會型醫院藥師執行居家藥事照護之初探

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