臺灣潛在性不適當用藥評估工具的發展與應用

老年人因器官老化或疾病影響，對於藥物的吸收、作用與代謝也隨之改變。且隨著年齡增加身體功能下降與慢性病盛行比例增加，老年人使用藥物的機會與比例也隨之增加。特定一些藥物稱為「潛在性不適當藥物」，它們對於老年人較容易產生不良反應，且治療效果不明確或有其他較安全的替代藥物。隨著老年醫學的發展，各國陸續發展「潛在性不適當藥物」準則給予臨床人員參考、進行研究等運用。本篇文章主要介紹臺灣版準則的發展與應用，期能讓護理師了解老年用藥的相關知識與臺灣本土研究結果。

關鍵字

潛在性不適當用藥；條列式準則；老年人；多重用藥

並列摘要

The absorption, action, and metabolism characteristics of drugs change in older adults due to factors including the normal process of aging and the impacts of disease on organ functions. Changes in the profile and proportions of drug use among older adults increase with increases in the severity of functional decline and the prevalence of chronic diseases. Drugs that are classified as ＂potentially inappropriate medications＂ (PIMs) carry a higher risk of causing adverse reactions in older adults, provide uncertain therapeutic benefits, or may be substituted by alternative drugs that are generally safer to use. Researchers have developed criteria for PIMs in geriatric medicine that are applicable to clinical practice and research. This article introduces the development and application of the PIM-Taiwan criteria to help nurses better understand the current knowledge related to medication use among older adults and the results of related research in Taiwan.

並列關鍵字

potentially inappropriate medications ； explicit criteria ； older adults ； polypharmacy

參考文獻

American Geriatrics Society 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 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

Chang, C. B., & Chan, D. C. (2010). Comparison of published explicit criteria for potentially inappropriate medications in older adults. Drugs & Aging, 27(12), 947–957. https://doi.org/10.2165/11584850-000000000-00000

Chang, C. B., Chen, J. H., Wen, C. J., Kuo, H. K., Lu, I. S., Chiu, L. S., ... Chan, D. C. (2011). Potentially inappropriate medications in geriatric outpatients with polypharmacy: Application of six sets of published explicit criteria. British Journal of Clinical Pharmacology, 72(3), 482–489. https://doi.org/10.1111/j.1365-2125.2011.04010.x

Chang, C. B., Lai, H. Y., Yang, S. Y., Wu, R. S., Liu, H. C., Hsu, H. Y., ... Chan, D. C. (2014). Patient- and clinic visit-related factors associated with potentially inappropriate medication use among older home healthcare service recipients. PLOS ONE, 9(4), e94350. https://doi.org/10.1371/journal.pone.0094350

國際替代計量

臺灣潛在性不適當用藥評估工具的發展與應用

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