多重用藥因子於居家訪視案例之量性探討

目的：本院針對就醫不便之弱勢族群，以團隊包括醫師、藥師、營養師及社工之方式，開始從醫院走入社區進而到宅服務以強化居家照護的功能。藥師於居家訪視時，收集所有藥品包括不同院所、非處方用藥進行整合，藉此機會本研究欲探討影響居家訪視個案多重用藥之因子。方法：本計畫為結合本院「醫院型家庭責任醫師制度試辦計畫執行之前瞻性研究，由居家訪視藥師紀錄評估病人用藥清單，計算病人之每日用藥頻次及顆數，以量化的方式計算藥品總量後，分析相關因素如性別、年齡等，評估是否為影響多重用藥之因子。結果：結果發現有顯著影響用藥總量之項目包括：失智症嚴重程度評估是否大於2分、是否患有心臟病及藥品項目數。無顯著性者包括：高血壓、腦血管疾病、教育程度等。結論：老年人之多重用藥可能導致不良反應增加、配合度下降等影響，此次更發現失智嚴重度及心臟病可能與病患藥品總量有關，因此對於心血管疾病的預防及失智的照顧應多加重視。

關鍵字

居家；老人；多重用藥；每日藥量

並列摘要

Objectives: Our hospital has established an interdisciplinary medical team, including doctors, pharmacists, dietitians and social workers in order to provide continuous home care for elderly patients. Pharmacist's role is to strengthen pharmaceutical home care. Prescription evaluation, adverse drug reaction (ADR), and other medication-related problems will be examined during pharmacist pharmaceutical home care. Methods: The study collaborated with family physician system and communityintegrated health care. Patient's daily medication-taking frequency and drug amount are recorded during pharmaceutical home care. Analysis with patient's gender, age, education level or the disease types etc., were used to find out the main factors associated with polypharmacy. Results: It was found that dementia severity and with/without heart disease shows a significant impact on patient's daily medication-taking amount. Others such as hypertension, cerebral vascular disease, or patient's gender, education level show no influence on polypharmacy. Conclusions: Polypharmacy in elderly patients might increase the risks of ADR and lower the medication compliance. Dementia severity and heart disease have the association with daily drug amount, the relationship will be further studied.

並列關鍵字

Home Visit ； Elderly ； Polypharmacy ； Daily Drug Amount

國際替代計量

多重用藥因子於居家訪視案例之量性探討

全文下載

主題瀏覽