高血壓用藥型態及問題處方之分析

Study of Prescribing Patterns and Inappropriate Prescriptions for Hypertension

吳思筠(Shih-Yun Wu) ； 李佳利(Chia-Li Lee)

《北市醫學雜誌》 12卷4期 (2015/12) Pp. 322-332

https://doi.org/10.6200/TCMJ.2015.12.4.04

摘要

目的：分析高血壓病人的用藥型態與趨勢，以及了解高血壓用藥之問題處方，並藉此對本院現況提出品質促進方案，增進病人用藥安全。方法：以本院民國102年1~12月門診健保申報檔，擷取診斷碼前3碼為401至405之門診個案為研究對象。藥物統計採用ATC分類系統，問題處方主要為重複用藥及交互作用。結果：本研究共納入44,294筆處方，年齡層以40-79歲為主。藥物使用以血管緊縮素拮抗劑為最多，佔28.95%。每張處方平均藥品費用為564.13±386.13元，採用單一藥物治療的有26.06%，合併治療的有73.94%。問題處方方面，重複用藥發生率為0.37%，交互作用發生率為1.58%。結論：本研究呈現高血壓門診問題處方之現況，希望提供院方決策者有效的資訊，以制訂用藥相關策略，以提升高血壓病人用藥安全。

關鍵字

高血壓 ； 問題處方 ； 重複用藥 ； 交互作用

並列摘要

Objectives: Analysis of the pat terns of prescription and inappropriate prescriptions for patients with hypertension. Methods: A retrospective and cross-sectional analysis was performed. The data was collected from the outpatient services of Taipei City Hospital in 2013. The study subjects were identified by major diagnoses of ICD-9-CM codes 401. xx-405.xx. Inappropriate prescriptions were defined as duplicate medications and evidence of drug-drug interactions. Results: A total of 44,294 prescriptions were collected. Most of these patients were in the age stratum of 40-79 years. The most popular agent prescribed was angiotensin receptor blocker (ARBs, 28.95%). Expenditure analysis showed that the average cost of antihypertensive drugs in each prescription was 564.13.13±386.13 dollars; 26.06 % patients received monotherapy, and 73.94% received combination therapy. For inappropriate prescriptions, the frequency of duplicate medications and drug-drug interactions were 0.37% and 1.58%, respectively. Conclusions: This study demonstrated a picture of inappropriate prescriptions for HTN in 2013. The information may be used by policy-makers to enact relevant policies to ensure prescription safety for HTN patients.

並列關鍵字

Hypertension ； inappropriate prescription ； duplicated medication ； drug-drug interaction