接受居家照護老年人發生潛在性不適當用藥相關因素探討

Factors Associates with the Use of Potential Inappropriate Medication among the Elderly Receiving Homes Care Service

洪尤鳳(You-Feng Huang) ； 許菀玲(Shiu-Wan Ling) ； 彭淑梅(Shu-Mei Peng) ； 王琤(Jeng Wang)

《長庚科技學刊》 14期 (2011/06) Pp. 1-12

https://doi.org/10.6192/CGUST.2011.6.14.1

摘要

隨著醫療科技的進步，人類壽命得以延長，但是罹患多重慢性疾病的人也隨之增多，因此，許多住院老人出院後，仍需要持續的居家照護，對於用藥物的需求也不曾間斷。近年來，老人用藥安全議題開始受到重視，有學者利用健保局資料庫，了解門診和急診老人不適當用藥情形，但是對於居家老人潛在性不適當用藥的情形卻仍不明確。所以，本研究的目的是以Beers Criteria爲用藥率則，了解接受居家護理個案使用不適當用藥的盛行率及其相關影響因素。本研究採方便取樣，以回溯性研究方式，找出100位接受居家護理個案爲研究對象，收集其最近一個月的用藥情形，經編碼建檔，以spss17.0軟體進行描述性統計和推論性統計分析。結果：個案平均年齡爲79.03(±9.83)歲，（範圍45歲至104歲），巴氏量表利量爲重度依賴。潛在性不適當用藥的盛行率爲28%，經單因子變異數分析，和不適當用藥有相關。是可唯一預測潛在性不適當用藥的因素，最常使用的潛在性不適當用藥爲Cimetidine和Benzodiazepine。研究結果可以協助居家護理人員理解潛在性不適當用藥的盛行率和影響因素，並將安全用藥的概念推展至接受居家照護的老人身上。此外，醫療機構應建立藥物處方電腦監控系統，輔助醫囑開立的決策過程，辦理醫護人員用藥安全的在職教育訓練，使潛在性不適當用藥的風險降至最低。

關鍵字

居家照護 ； 老年人 ； 潛在性不適當用藥

並列摘要

The population of Taiwan is ageing. Thus, incidents of chronic illness are increasingly likely and the need for the use of medication is growing. Recently, increased attention has been given in Taiwan to the issue of the safe use of medication. Researchers have utilized data from the National Health Insurance (NHI) program to attain knowledge about potentially inappropriate use of medication (PIM). However, no PIM study has been done of the home-care population in Taiwan. Therefore, the purpose of this study is to establish the prevalence rate of PIM and examine the factors associated with PIM for Taiwan's home-care patients. A study was conducted using recruited 100 subjects. SPSS 17.0 statistic software was used to analyze the data. The results of the study show that the average age of the subjects was 79.03 (±9.83), and ranged from 45 to 104. Most of the patients were severely dependent. The prevalence rate of PIM was 28%. The amount of medication used was the only predictor of PIM, with a 5% variance. Cimetidine and Benzodiazepine were the most frequently used medications with PIM. Promoting knowledge about PIM for home-care nurses may decrease PIM. Hospitals may consider establishing a computer monitoring system regarding prescriptions. PIM-related in-service education may also be beneficial for nurses and physicians. The findings of this study can be used as a reference for researchers examining similar situations.

並列關鍵字

home care services ； elderly ； potentially inappropriate use of medication PIM