簡介老人藥品使用適當性之評估工具

Introduction to Tools for Assessing Medication Use Appropriateness in Older Adults

何秀玉(Hsiu-Yu HO) ； 羅美芳(Meei-Fang LOU)

《護理雜誌》 66卷4期 (2019/08) Pp. 20-28

https://doi.org/10.6224/JN.201908_66(4).04

摘要

老人潛在不適當藥品（potentially inappropriate medication, PIM）使用盛行率很高，乃是一個嚴重的社區健康照護問題，老人PIM使用會增加不良藥品事件、跌倒、住院、急診求診等問題，而導致醫療費用支出增加。本文目的在介紹藥品適當性的判定準則，並簡介幾種常見的藥品適當性評估工具，包括藥品適當性指標（Medication Appropriateness Index）、Beers準則系列六種、老人處方篩檢工具（Screening Tool of Older Person's Prescriptions, STOPP）和提醒醫師正確治療篩檢工具（Screening Tool to Alert doctors to Right Treatment, START）系列二種、泰國準則，以及臺灣版潛在性不適當用藥（PIM-Taiwan）準則，以利臨床醫護人員於臨床實務中可視情況加以應用。

關鍵字

潛在不適當藥品 ； 老人 ； Beers準則 ； STOPP/START ； 泰國準則 ； PIM-Taiwan準則

並列摘要

The prevalence of potentially inappropriate medication (PIM) use is high, presenting a serious public health problem. In older adults, PIM increases the risks of adverse drug events, falls, hospitalizations, and emergency treatments as well as related medical expenses. The currently popular criteria for determining medication appropriateness and several common medication appropriateness assessment tools are introduced in this paper, including the Medication Appropriateness Index, the Beers criteria series, the Screening Tool of Older Person's Prescriptions (STOPP) and the Screening Tool to Alert doctors to Right Treatment (START) series, Thailand criteria, and the PIM-Taiwan criteria, with the goal of facilitating their application by medical professionals in clinical practice.

並列關鍵字

potentially inappropriate medication ； elderly ； Beers criteria ； STOPP/ START ； Thailand criteria ； PIM-Taiwan criteria

參考文獻

陳姿吟、李季黛、周明岳、薛光傑、杜明勳（2011）．簡介老人用藥準則之工具．家庭醫學與基層醫療，26（9），370–376。[Chen, T. Y., Lee, C. T., Chou, M. Y., Hsueh, K. C., & Tu, M. S. (2011). Introduction to the medication criteria for the elderly. Family Medicine & Primary Medical Care, 26(9), 370–376.] https://doi.org/10.6965/FMPMC.201109.0370

American Geriatrics Society 2012 Beers Criteria Update Expert Panel. (2012). American Geriatrics Society updated Beers criteria for potentially inappropriate medication use in older adults. Journal of the American Geriatrics Society, 60(4), 616–631. https://doi.org/10.1111/j.1532-5415.2012.03923.x

American Geriatrics Society 2015 Beers Criteria Update Expert Panel. (2015). American Geriatrics Society 2015 updated Beers criteria for potentially inappropriate medication use in older adults. Journal of the American Geriatrics Society, 63(11), 2227–2246. https://doi.org/10.1111/jgs.13702

Beers, M. H. (1997). Explicit criteria for determining potentially inappropriate medication use by the elderly. An update. Archives of Internal Medicine, 157(14), 1531–1536. https://doi.org/10.1001/archinte.1997.00440350031003

Beers, M. H., Ouslander, J. G., Rollingher, I., Reuben, D. B., Brooks, J., & Beck, J. C. (1991). Explicit criteria for determining inappropriate medication use in nursing home residents. Archives of Internal Medicine, 151(9), 1825–1832. https://doi.org/10.1001/archinte.1991.00400090107019