臺灣兒童用藥安全與醫師開立處方行為之評估：系統動態學之觀點

Drug formulation used in pediatric patients should be appropriate, safe, as well as be adapted to children’s needs. The use of inadequate drug formulation and the pulverizing medicine phenomenon are widespread in Taiwan. Many existing treatments are not suitable for children, which often leads to medical malpractice. Although the advocacy of pediatric drug safety from non-government organization, the improving regulations from government regarding current clinical situations remain stagnant. In order to evaluate the pediatric drug safety issue, this essay uses system dynamics approach to analyze the results that come from different prescribing behaviors. The analyses found out problems generated from pulverized medicine caused drug safety, drug efficacy, and cost issues, causing the decrease of the relative safety and efficacy of treatment, illustrated by balancing loops in the system dynamics. On the other hand, the reinforcing loops in the system dynamics generated from pediatric drug formulations created incentives to drive doctors to prescribe more pediatric drug formulations, leading to better drug safety and drug efficacy of treatment for children. Therefore, the system dynamics depicts the whole structure of pediatric drug safety issue came from different prescribing behaviors, letting us have a clear picture to address this problem. Four key issues that need to be addressed to stimulate the further improvement for pediatric drug safety in the medical system are identified: (1) building the network of medical institutions to promote pediatric safety; (2) set up online platforms and use of existing data to transmit more medication knowledge; (3) collect more clinical feedback and patients’ outcome to improve the development and the utilization of pediatric drug formulation (4) take the responsibility of saving more medical resources, helping government to save the cost in order to address drug safety and many other issues.