臺灣博碩士論文加值系統

目 錄
指導教授推薦書
口試委員會審定書
誌謝 iii
中文摘要 iv
英文摘要 v
目錄 vi
圖目錄 ix
表目錄 x
第一章　緒論 1
第一節　研究背景 1
第二節　研究動機與目的 4
第二章　文獻探討 6
第一節　腦中風 6
第二節　高血壓 9
第三節　複方製劑治療上的特色 13
第四節　處方持有率(MPR)和定義每日劑量(DDD) 15
第五節　文獻小結 18
第三章　研究方法 19
第一節　研究架構與假說 19
第二節　研究材料及對象 20
第三節　研究變項 23
第四節　統計分析方法 25
第四章　研究結果與討論 27
第一節　單、複方製劑處方人數及處方箋年度變化 27
第二節　研究對象基本特性分析 30
第三節　處方持有率(MPR)和消耗的DDD數(DDDs） 33
第四節　研究對象二次中風住院相關因素羅吉斯迴歸分析 37
第五章　結論與建議 41
第一節　結論 41
第二節　建議 42
第三節　研究限制 43
參考文獻 45

附錄一 ARB&;CCB複方製劑藥物品項，2008~2013 51
附錄二 ARB單方藥物品項，2008~2013 52
附錄三 CCB單方藥物品項，2008~2013 54
附錄四 ARB&;CCB複方製劑藥物品項，2014/07給付 57
附錄五 ARB&;CCB複方製劑藥物品項參考價及DDDs，2014/07給付 58
附錄六 ARB單方製劑藥物品項參考價及DDDs，2014/07給付 59
附錄七 ARB單方製劑藥物品項參考價及DDDs，2014/07給付 61

圖目錄
圖3-1. 研究架構 20
圖3-2. 資料處理流程 22

表目錄
表 4-1. ARB與CCB單、複方處方人數與處方箋數變化 28
表 4-2. 研究對象特性與單、複方藥品分布差異檢定 32
表 4-3. ARB與CCB單、複方使用者處方持有率、DDDs分析 36
表 4-4. ARB與CCB單、複方藥物平均給付參考價、DDDs 37
表 4-5. 研究對象二次中風住院相關因素羅吉斯迴歸分析 39

Alhusban, A., &; Fagan, S. C. (2011). Secondary prevention of stroke in the elderly: a review of the evidence. Am J Geriatr Pharmacother, 9(3), 143-152. doi: 10.1016/j.amjopharm.2011.04.002
Amarenco, P., &; Labreuche, J. (2009). Lipid management in the prevention of stroke: review and updated meta-analysis of statins for stroke prevention. The Lancet Neurology, 8(5), 453-463. doi: http://dx.doi.org/10.1016/S1474-4422(09)70058-4
Andrade, S. E., Kahler, K. H., Frech, F., &; Chan, K. A. (2006). Methods for evaluation of medication adherence and persistence using automated databases. Pharmacoepidemiol Drug Saf, 15(8), 565-574; discussion 575-567. doi: 10.1002/pds.1230
Bailey, J. E., Wan, J. Y., Tang, J., Ghani, M. A., &; Cushman, W. C. (2010). Antihypertensive medication adherence, ambulatory visits, and risk of stroke and death. J Gen Intern Med, 25(6), 495-503. doi: 10.1007/s11606-009-1240-1
Bangalore, S., Kamalakkannan, G., Parkar, S., &; Messerli, F. H. (2007). Fixed-Dose Combinations Improve Medication Compliance: A Meta-Analysis. The American Journal of Medicine, 120(8), 713-719. doi: http://dx.doi.org/10.1016/j.amjmed.2006.08.033
Bloom, B. S. (1998). Continuation of initial antihypertensive medication after 1 year of therapy. Clin Ther, 20(4), 671-681. doi: 10.1016/S0149-2918(98)80130-6
Bourgault, C. S., M.Brisson, M.Marentette, M. A.Gregoire, J. P. (2005). Persistence and discontinuation patterns of antihypertensive therapy among newly treated patients: a population-based study. J Hum Hypertens, 19(8), 607-613.
Boussageon, R., Bejan-Angoulvant, T., Saadatian-Elahi, M., Lafont, S., Bergeonneau, C., Kassaï, B., . . . Cornu, C. (2011). Effect of intensive glucose lowering treatment on all cause mortality, cardiovascular death, and microvascular events in type 2 diabetes: meta-analysis of randomised controlled trials (Vol. 343).
Chiang, C.-E., Wang, T.-D., Li, Y.-H., Lin, T.-H., Chien, K.-L., Yeh, H.-I., . . . Chen, J.-H. (2010). 2010 Guidelines of the Taiwan Society of Cardiology for the Management of Hypertension. Journal of the Formosan Medical Association, 109(10), 740-773. doi: 10.1016/s0929-6646(10)60120-9
Cramer JA1, Roy A, Burrell A, CJ, F., Fuldeore MJ, Ollendorf DA, &; PK, W. (2008). . Value health, 11, 44-47.
Cushman, M. D., Gregory W. Evans, M. A., Robert P. Byington, P. D., David C.Goff, J., M.D. Ph.D., Richard H. Grimm, J., M.D., Ph.D.., Jeffrey A. Cutler, M. D., . . . FaramarzIsmail-Beigi, M. D., Ph.D. (2010). Effects of Intensive Blood-Pressure Control in Type 2 Diabetes Mellitus. New England Journal of Medicine, 362(17), 1575-1585. doi: doi:10.1056/NEJMoa1001286
Dahlöf, B., Devereux, R. B., Kjeldsen, S. E., Julius, S., Beevers, G., de Faire, U., . . . Wedel, H. (2002). Cardiovascular morbidity and mortality in the Losartan Intervention For Endpoint reduction in hypertension study (LIFE): a randomised trial against atenolol. The Lancet, 359(9311), 995-1003. doi: 10.1016/s0140-6736(02)08089-3
Degli Esposti, L., Saragoni, S., Buda, S., &; Degli Esposti, E. (2014). Drug adherence to olmesartan/amlodipine fixed combination in an Italian clinical practice setting. Clinicoecon Outcomes Res, 6, 209-216. doi: 10.2147/CEOR.S55245
Elliott, W. J. (2009). Improving Outcomes in Hypertensive Patients: Focus on Adherence and Persistence With Antihypertensive Therapy. The Journal of Clinical Hypertension, 11(7), 376-382. doi: 10.1111/j.1751-7176.2009.00138.x
Furie, K. L., Kasner, S. E., Adams, R. J., Albers, G. W., Bush, R. L., Fagan, S. C., . . . Wentworth, D. (2010). Guidelines for the Prevention of Stroke in Patients With Stroke or Transient Ischemic Attack: A Guideline for Healthcare Professionals From the American Heart Association/American Stroke Association. Stroke, 42(1), 227-276. doi: 10.1161/STR.0b013e3181f7d043
Gilmer, T. P., Ojeda, V. D., Barrio, C., Fuentes, D., Garcia, P., Lanouette, N. M., &; Lee, K. C. (2009). Adherence to antipsychotics among Latinos and Asians with schizophrenia and limited English proficiency. Psychiatr Serv, 60(2), 175-182. doi: 10.1176/appi.ps.60.2.175
Go, A. S., Mozaffarian, D., Roger, V. L., Benjamin, E. J., Berry, J. D., Blaha, M. J., . . . Stroke Statistics, S. (2014). Heart disease and stroke statistics--2014 update: a report from the American Heart Association. Circulation, 129(3), e28-e292. doi: 10.1161/01.cir.0000441139.02102.80
Gradman, A. H., Basile, J. N., Carter, B. L., &; Bakris, G. L. (2010). Combination therapy in hypertension. Journal of the American Society of Hypertension, 4(1), 42-50. doi: http://dx.doi.org/10.1016/j.jash.2010.02.005
Group, P. C. (2001). Randomised trial of a perindopril-based blood-pressure-lowering regimen among 6105 individuals with previous stroke or transient ischaemic attack. The Lancet, 358(9287), 1033-1041.
Hankey, G. J. (2014). Secondary stroke prevention. The Lancet Neurology, 13(2), 178-194. doi: 10.1016/s1474-4422(13)70255-2
James, P. A., Oparil, S., Carter, B. L., Cushman, W. C., Dennison-Himmelfarb, C., Handler, J., . . . Ortiz, E. (2014). 2014 evidence-based guideline for the management of high blood pressure in adults: report from the panel members appointed to the Eighth Joint National Committee (JNC 8). JAMA, 311(5), 507-520. doi: 10.1001/jama.2013.284427
Julius, S., Kjeldsen, S. E., Weber, M., Brunner, H. R., Ekman, S., Hansson, L., . . . Zanchetti, A. (2004). Outcomes in hypertensive patients at high cardiovascular risk treated with regimens based on valsartan or amlodipine: the VALUE randomised trial. The Lancet, 363(9426), 2022-2031. doi: 10.1016/s0140-6736(04)16451-9
Kasanuki, H., Hagiwara, N., Hosoda, S., Sumiyoshi, T., Honda, T., Haze, K., . . . Investigators, H.-C. (2009). Angiotensin II receptor blocker-based vs. non-angiotensin II receptor blocker-based therapy in patients with angiographically documented coronary artery disease and hypertension: the Heart Institute of Japan Candesartan Randomized Trial for Evaluation in Coronary Artery Disease (HIJ-CREATE). Eur Heart J, 30(10), 1203-1212. doi: 10.1093/eurheartj/ehp101
Koyanagi, R., Hagiwara, N., Yamaguchi, J., Kawada-Watanabe, E., Haruta, S., Takagi, A., . . . Investigators, H.-C. (2013). Efficacy of the combination of amlodipine and candesartan in hypertensive patients with coronary artery disease: a subanalysis of the HIJ-CREATE study. J Cardiol, 62(4), 217-223. doi: 10.1016/j.jjcc.2013.04.004
Law, M. R. p., Wald, N. J. p., Morris, J. K. s. l., &; Jordan, R. E. r. a. (2003). . British Medical Journal, 326(Volume 326(7404), 28 June 2003, p 1427).
Lawes, Bennett, D. A., Feigin, V. L., &; Rodgers, A. (2004). Blood pressure and stroke: an overview of published reviews. Stroke, 35(3), 776-785. doi: 10.1161/01.STR.0000116869.64771.5A
Lawes, C. M. M., Hoorn, S. V., &; Rodgers, A. (2008). Global burden of blood-pressure-related disease, 2001. The Lancet, 371(9623), 1513-1518. doi: 10.1016/s0140-6736(08)60655-8
Lewington S, C. R., Qizilbash N, Peto R, Collins R; Prospective Studies Collaboration. (2002). Age-specific relevance of usual blood pressure to vascular mortality: a meta-analysis of individual data for one million adults in 61 prospective studies. The Lancet, 360(9349), 1903-1913. doi: 10.1016/s0140-6736(02)11911-8
Mancia, G., Fagard, R., Narkiewicz, K., Redán, J., Zanchetti, A., Böhm, M., . . . members:, L. o. a. F. (2013). 2013 Practice guidelines for the management of arterial hypertension of the European Society of Hypertension (ESH) and the European Society of Cardiology (ESC): ESH/ESC Task Force for the Management of Arterial Hypertension. J Hypertens, 31(10), 1925-1938 1910.1097/HJH.1920b1013e328364ca328364c.
Mohan, K. M., Wolfe, C. D., Rudd, A. G., Heuschmann, P. U., Kolominsky-Rabas, P. L., &; Grieve, A. P. (2011). Risk and cumulative risk of stroke recurrence: a systematic review and meta-analysis. Stroke, 42(5), 1489-1494. doi: 10.1161/STROKEAHA.110.602615
Ohkubo, T., Asayama, K., Kikuya, M., Metoki, H., Obara, T., Saito, S., . . . Imai, Y. (2004). Prediction of ischaemic and haemorrhagic stroke by self-measured blood pressure at home: the Ohasama study. Blood Pressure Monitoring, 9(6), 315-320.
Perkovic, V., Huxley, R., Wu, Y., Prabhakaran, D., &; MacMahon, S. (2007). The burden of blood pressure-related disease: a neglected priority for global health. Hypertension, 50(6), 991-997. doi: 10.1161/HYPERTENSIONAHA.107.095497
Roger, V. L., Go, A. S., Lloyd-Jones, D. M., Benjamin, E. J., Berry, J. D., Borden, W. B., . . . Stroke Statistics, S. (2012). Heart disease and stroke statistics--2012 update: a report from the American Heart Association. Circulation, 125(1), e2-e220. doi: 10.1161/CIR.0b013e31823ac046
RS1, V., Beiser A, Seshadri S, Larson MG, Kannel WB, D'Agostino RB, &; D., L. (2002). . JAMA, 287, 1003-1010.
Schroeder, K., Fahey, T., &; Ebrahim, S. (2004). How can we improve adherence to blood pressure–lowering medication in ambulatory care?: Systematic review of randomized controlled trials. Archives of Internal Medicine, 164(7), 722-732. doi: 10.1001/archinte.164.7.722
Thrift, A. G., Dewey, H. M., Macdonell, R. A. L., McNeil, J. J., &; Donnan, G. A. (2001). Incidence of the Major Stroke Subtypes: Initial Findings From the North East Melbourne Stroke Incidence Study (NEMESIS). Stroke, 32(8), 1732-1738. doi: 10.1161/01.str.32.8.1732
Tseng, M.-C., &; Lin, H.-J. (2009). Readmission after hospitalization for stroke in Taiwan: Results from a national sample. Journal of the neurological sciences, 284(1), 52-55.
Van Wijk, B. L., Klungel, O. H., Heerdink, E. R., &; de Boer, A. (2006). Generic substitution of antihypertensive drugs: does it affect adherence? Ann Pharmacother, 40(1), 15-20. doi: 10.1345/aph.1G163
Wald, D. S., Law, M., Morris, J. K., Bestwick, J. P., &; Wald, N. J. (2009). Combination Therapy Versus Monotherapy in Reducing Blood Pressure: Meta-analysis on 11,000 Participants from 42 Trials. The American Journal of Medicine, 122(3), 290-300. doi: http://dx.doi.org/10.1016/j.amjmed.2008.09.038
WHO. (2014). Guidelines for ATC classification and DDD assignment 2014,Oslo, 2013
WHO Collaborating Centre for Drug Statistics Methodology

Wuwei Feng, M., MS, Robert M. Hendry, M., Robert J. Adams, M., &; MS. (2010). Risk of recurrent stroke, myocardial infarction, or death in hospitalized stroke patients. Neurology, 74, 6.
台灣腦中風學會. (2008). <台灣腦中風防治指引2008.pdf>: 台灣腦中風學會
行政院衛生福利部. (2013). 民國101年醫療統計年報.
行政院衛生福利部. (2014). 民國102年死因統計年報. 衛生福利部統計處.
徐麗娟. (2012). 固定複方藥物與法規考量. 當代醫藥法規, 15.
廖建彰, 李采娟, 林瑞雄, &; 宋鴻樟. (2006). 2000年台灣腦中風發生率與盛行率的城鄉差異. 臺灣公共衛生雜誌, 25卷(3期 ), 8.