台灣青光眼盛行率及青光眼局部眼用製劑之處方趨勢研究

Prevalence of Glaucoma and Prescribing Trends of Topical Anti-Glaucoma Medications in Taiwan

陳怡菁(Yi-Ching Chen)

指導教授 ： 詹道明

高雄醫學大學/藥學院/藥學研究所碩士在職專班/碩士(2011年)

https://doi.org/10.6832/KMU.2011.00064

摘要

目的：青光眼為全球導致失明的第二大病因。在臺北市，青光眼更是造成失明的首要因素，因此青光眼是一個不可忽視的疾病。了解近年來的青光眼盛行率以及藥物臨床使用之現況，可作為醫師照護病人的參考，也可提供擬定健保藥品給付政策之有關當局一些重要的資訊。
方法：本研究係利用全民健康保險研究資料庫之2004年至2008年的承保抽樣歸人檔，以回溯性研究法分析病患特性、盛行率的變化，以及青光眼局部眼用製劑的處方趨勢及用藥模式。
結果：青光眼5年平均的總盛行率為0.72%，呈現逐年上升的趨勢。青光眼局部眼用製劑處方率以β-阻斷劑最高，佔了40%，其次則為前列腺素衍生物的27%。處方率成長幅度最明顯的是複方製劑，5年內增加了9.1%。每張處方平均用藥種類數為1.32種，有28%的處方使用兩種以上的青光眼局部眼用製劑；合併用藥以兩種最多，佔24.2%，同時處方三種的佔3.7%，同時處方四種的只有0.1%，沒有超過4種的合併用藥。
結論：在青光眼局部眼用製劑當中，我國仍以β-阻斷劑處方率最高，與美、日等國以前列腺素衍生物為主的情況有所不同。我們發現同時使用多種單方用藥的處方，有部分是可以用複方藥品取代的。由於複方藥品具有使用上的便利性，並減少角膜對眼藥水防腐劑的暴露量，能夠提高病患的遵醫囑性，因此以複方青光眼局部眼用製劑取代單方的合併用藥，是個值得推廣的用藥模式。

關鍵字

青光眼 ； 盛行率 ； 青光眼用藥 ； 處方趨勢 ； 健保資料庫

並列摘要

PURPOSE: Glaucoma is the second leading cause of blindness worldwide and the first leading cause of blindness in Taipei- the capital of Taiwan. We investigated the prevalence of glaucoma and prescribing patterns of topical anti-glaucoma agents in recent years in order to provide useful information for health care providers and policy makers.
METHODS: We conducted a retrospective study between 1 January 2004 and 31 December 2008 using claims data from the National Health Insurance Research Database (NHIRD). We investigated the patient characteristics, changes in trend of prevalence and prescribing patterns of topical anti-glaucoma agents in Taiwan.
RESULTS: The 5-year average prevalence of glaucoma was 0.72%, it showed significantly increase by year. Among the anti-glaucoma agents, β-blockers were the most frequently prescribed, accounting for 40% of the prescriptions, followed by 27% of prostaglandin analogues. Fixed-combination agents showed the largest growth in prescribing rate which increased by 9.1% during the study period. The average number of anti-glaucoma agents per prescription was 1.32. Twenty-eight percent of prescriptions were multi-bottle combination therapy, 24.2% on 2 medications, 3.7% on 3 medications, and 0.1% on 4 medications. None of the prescriptions had more than 4 medications prescribed in it.
CONCLUSIONS: Beta-blockers were the most frequently prescribed topical anti-glaucoma agents in Taiwan. We found that some prescriptions of multi-bottle combination therapy have the same components with approved fixed-combination formulation. Fixed-combination formulation has advantages over multi-bottle combination therapy in terms of better adherence, less preservative exposure. Therefore multi-bottle combination therapy replaced by a fixed-combination formulation is recommended for prescription.

並列關鍵字

glaucoma ； prevalence ； anti-glaucoma medications ； prescribing rate ； National Health Insurance Research Database

參考文獻

英文部分

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