藥事照護門診之全人照護

Holistic Health Care in a Pharmaceutical Care Clinic

彭姿蓉(Tzu-Rong Peng) ； 李麗俐(Li-Li Lee) ； 蔡芳佩(Fang-Pei Tsai) ； 吳大圩(Ta-Wei Wu)

《北市醫學雜誌》 18卷1期 (2021/03) Pp. 65-74

https://doi.org/10.6200/TCMJ.202103_18(1).0007

摘要

目的：藥事照護門診主要是藥師在獨立的空間與病人執行藥事照護，藥師於電子醫囑病歷註記紀錄病人疾病用藥相關資料，以供其他醫療人員參考及幫助病人解決並減少藥品相關的問題，進而促進藥事照護品質。本文初步探討藥事照護門診全人照護之服務成果。方法：本研究收集2019年5月至2020年2月藥事照護門診服務之所有藥事照護評估與建議進行分析。統計分析結果以平均值 ± 標準差，或百分比表示。結果：2019年5月至2020年2月藥事照護門診總共服務126人次，平均年齡66.8 ± 12.5歲。病人口服藥品品項數平均為6.2 ± 3.2項，其中有藥品交互作用佔23.0%，在用藥配合度的量測，2020年1月至2020年2月共量測31人次，90.3%的病人為中高服藥配合度。臨床藥事介入為36件（28.6%），其中以建議處方17件（47.2%）為最多，主要以建議用藥劑量／頻次問題與病人用藥遵從性問題居多。臨床藥事介入成效以使用抗凝血藥病人轉介至藥事照護門診三個月後，平均TTR（time in therapeutic range）由未介入前的54.4%上升至69.5%（p = 0.03）。所有使用抗凝血藥品之病人皆無出血事件，僅1人（1.5%）發生栓塞事件。結論：本研究之藥事照護門診即以全人照護的模式照護病人，進而增加病人藥品療效及減少藥品副作用的發生。

關鍵字

藥事照護門診 ； 全人照護 ； 服藥順從性

並列摘要

Objective: The pharmaceutical care clinic is a unit mainly for the pharmacists to perform pharmaceutical care for patients in an independent space. Pharmacists use the electronic medical records to document and organize patient-specific medical information for the reference of other medical staff, assist patients in solving and reducing drug-related problems, and as such, elevate the quality of medical care. Methods: This study collected the records of medical care evaluations and recommendations from pharmaceutical care service from May 2019 to February 2020. Statistical analysis results were expressed as mean ± standard deviation or percentage. Results: The pharmaceutical care clinic provided services to 126 patients, of whom the average age was 66.8 ± 12.5. The average number of oral drugs used was 6.2 ± 3.2, of which the proportion of drug interactions was 23.0%. During this period, medication adherence of 31 patients were assessed and the results showed that 90.3% of them had medium to high medication compliance. The number of medical care interventions was 36 (28.6%), among which 17 were recommended prescriptions (47.2%). The main recommendations were dosage/frequency problems and patient compliance issues. The effectiveness of interventions for patients using anticoagulant drugs three months after pharmaceutical care intervention compared to that before intervention increased from an average time in therapeutic range (TTR) of 69.5% to 54.4% (p = 0.03). All patients using anticoagulant drugs had no bleeding events, and only 1 person (1.5%) had an embolism event. Conclusions: The pharmaceutical care clinic in this study provides a holistic-care model in patient healthcare which helps increase patient drug efficacy and reduces drug-related side effects.

並列關鍵字

pharmaceutical care clinic ； holistic health care ； medication compliance