摘要
台灣65歲以上老年人口占總人口比例已於2016年12月達13.2%，而國人平均壽命已超過80歲。老年人隨著年齡的增加，導致各種生理機能退化，罹病的種類多，用藥的機率與種類也隨之增加，也出現老年病症候群，衍生而來的是多方面的複雜性照護需求。老年人的藥物動力學及藥效學因年齡增長產生變化，也因此成為藥物不良反應的高風險族群。藥物依從性在老年人用藥中也扮演重要的角色，需要適時的評估用藥情形及給予衛教才能確保其正確用藥。老年人用藥問題可大致從處方及疾病診斷評估是否有用藥無相符適應症及交互作用；若能實際訪視老年人了解其用藥情形，藉由周全性老年評估發現的狀況以及老人潛在不適當用藥準則輔助，即可進一步評估用藥的適當性；最後，考慮老年人生存餘命、生活品質、疾病末期及藥物中長期使用效益等面向，篩選出非必要用藥並評估是否需要調整。老年人的用藥問題十分複雜，且會隨著老年人的生理、疾病、心理等各種急慢性的情形變化而改變，周全性老年評估可用於評估老年人的老年病症候群及相關問題，也可與老年人的藥物評估結合以提供更全面性的建議。老年人用藥問題需定期重新審視，才能確認問題並給予最適當的介入，讓老年人接受最適合的藥物治療。
並列摘要
In December 2016, the percentage of people aged 65 years and over in the total population had reached 13.2% in Taiwan where the average life expectancy exceeds 80 years. Aging induces progressive decline in physiological functions and enhances the risk of multimorbidity, polypharmacy, and geriatric syndrome, thereby causing complex care problems. Pharmacokinetics and pharmacodynamics change with aging; older adults are at increased risk of adverse drug reactions. Medication adherence too plays an important role in the treatment of the elderly. Appropriate evaluation and patient education are needed to ensure accurate and effective medication. Medication-related problems, including medication without indication, drug-drug interaction, and drug-disease interaction, can be assessed by reviewing prescription and diagnosis. Direct interview with an elderly patient, supplemented by the application of CGA (comprehensive geriatric assessment) and PIM (potential inappropriate medication) criteria, helps further verify the appropriateness of medication. Moreover, issues like life expectancy, quality of life, terminal illness and long term benefit of medication should be taken into consideration to expedite screening of unnecessary medication and adjustment in medication for the elderly. Medication-related problems in elderly patients are complicated and change with their physiological and psychological conditions and the state - acute or chronic- or their diseases. In addition to evaluating geriatric syndromes and care-related issues, CGA can also be incorporated into pharmaceutical evaluation to conclude a more comprehensive advice for the elderly. Regular review of medication-related problems is essential for ensuring appropriate intervention and optimal medication use in the elderly.