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研究生:康淑雯
研究生(外文):Shu-Wen Kang
論文名稱:雲林縣老人用藥適當性之研究
論文名稱(外文):The Evaluation of the Elderly Medication Appropriateness in Yunlin County of Taiwan
指導教授:鄭博文鄭博文引用關係
指導教授(外文):Bor-Wen Cheng
口試委員:呂學毅趙正敏
口試委員(外文):Hsueh-Yi LuCheng-min Chao
口試日期:2015-07-09
學位類別:碩士
校院名稱:國立雲林科技大學
系所名稱:工業工程與管理系
學門:工程學門
學類:工業工程學類
論文種類:學術論文
論文出版年:2015
畢業學年度:103
語文別:中文
論文頁數:58
中文關鍵詞:老年人用藥適當性Beers Criteria潛在性不適當用藥
外文關鍵詞:the elderlymedication appropriatenessBeers Criteriapotentially inappropriate usage of medication
相關次數:
  • 被引用被引用:1
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  • 下載下載:10
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老年人因老化現象,使得生理情形與於大多數的年輕族群產生差異,在藥物使用上的考量上需要藥師多加留意是否會產生交互作用。用藥疏失也可能導致藥物不良反應的產生。由上論述產生本研究的目的,希望能清楚知道社區老年人用藥適當性,提供老年人會遇到的用藥問題,並進行用藥諮詢指導,以增加病人用藥的安全,並提升藥師專業能力。
研究對象為雲林縣65歲以上老年人為主,有243人。研究期間為:2013年 05月~2013年10月,每月一次訪視,共訪視6次。藥事人員進行訪視並填寫用藥紀錄。以2012 Beers Criteria為依據,進行老人用藥適當性評估,利用羅吉斯回歸分析各相關變項,使用SPSS 19版統計套裝軟體進行分析。
研究結果顯示:平均每人罹患3.02±1.34種疾病、服用6.7種藥品、不適當用藥盛行率88.5%、疾病數與用藥數為發生「潛在性不適當用藥」的重要因子,本研究對象為65歲以上老年人,其年齡分層對於「潛在性不適當用藥」盛行率影響不大。
藉由以上研究資料之結果,提供老人用藥問題,建議藥師需不斷的自我進修及參加繼續教育課程,增進老年病患的用藥知識、用藥整合、簡化服藥品項,將老年人用藥的危險性減低,提升藥事照護能力與品質、提供相關人員遇到老年人用藥問題時具體諮詢與解決方案,提昇老年人照顧的水準與品質,期待病人用藥安全上有更大的助益。
關鍵詞:老年人、用藥適當性、Beers Criteria、潛在性不適當用藥

Due to the phenomenon of aging, the elderly do not possess the same physiological health as the young. Regarding drug use, pharmacists will have to pay more attention to their interaction with the elderly in order to prevent incorrect or negligent drug use as these behaviors can lead to adverse reactions. The aim of this study was to understand safe medication usage and the difficulties in engaging in this behavior among the elderly. The aim was also to determine good drug counseling and medication to increase patient’s safety and enhance the pharmacists’ professional competence.
The subjects were 65 years old or older and living in Yunlin. There were 243 participants, and they received monthly visits from May to October in 2013; in other words, there were a total of six visits. Pharmaceutical Affairs personnel visited and filled in the patients’ medication records. Berers criteria was utilized to assess the appropriateness of medication used. Data were analyzed by means of a logistic regression analysis of the relevant variables using the SPSS version 19 statistical software package for analysis.
The results showed the average elderly person suffering from 3.02 ± 1.34 diseases and taking 6.7 kinds of drugs. Also, improper use of medication was prevalent in 88.5% of cases and led to a number of diseases and also to use of further medication. The prevalence of age stratification "potentially inappropriate medication ' had little effect to 65 elderly.
Results of this study suggests pharmacists need to constantly undergo self-training and participate in continuing education programs to enhance their knowledge about the use of medication among elderly patients and to learn how to integrate or simplify pharmaceutical items. These efforts will reduce the risk of wrong usage of drugs among the elderly and enhance the capacity and quality of pharmaceutical care. By providing personnel specific advice and solutions to enhance the level and quality of the care they provide to the elderly, we can look forward to safer usage of medications.

Keywords: the elderly, medication appropriateness, Beers criteria, potentially inappropriate usage of medication
目錄
摘要 i
ABSTRACT ii
誌謝 iv
目錄 v
表目錄 vii
圖目錄 ix
第一章、緒論 1
1-1研究背景及動機 2
1-2研究目的 3
1-3研究流程 5
第二章、文獻回顧 6
2-1老年潛在性不適當用藥情形 6
2-2多重用藥與不良用藥相關研究 7
2-3藥師於不適當用藥之影響 11
2-4不適當用藥評估工具 13
第三章、研究方法 15
3-1研究資料彙整作業 15
3-2研究假設及研究架構 15
3-3各變項界定與定義 16
3-4 統計分析方法 18
第四章、研究結果 19
4-1敘述性統計 19
4-1-1研究對象基本資料 19
4-1-2個案罹患疾病類別統計 20
4-1-3研究個案罹患疾病數統計 21
4-1-4研究個案用藥數統計 22
4-2老年人「潛在性不適當用藥」之處方基本資訊 22
4-2-1「潛在性不適當用藥」的盛行率-藥物使用劑量不正確 22
4-2-2「潛在性不適當用藥」的盛行率-性別差異 23
4-2-3「潛在性不適當用藥」的盛行率-年齡層差異 23
4-2-4「潛在性不適當用藥」的盛行率-多重用藥 24
4-2-5「潛在性不適當用藥」的盛行率-用藥品項 24
4-2-6「潛在性不適當用藥」藥品的使用及可能的副作用 26
4-2-7「潛在性不適當用藥」-實際發生交互作用之探討 28
4-3老年人「潛在性不適當用藥」之處方探討 31
4-4老年人「潛在性不適當用藥」之盛行率與影響因子的探討 35
4-4-1卡方檢定分析結果 35
4-4-2羅吉斯回歸檢定分析結果 36
第五章、結論與建議 38
5-1結論 38
5-2建議 41
參考文獻 43
附錄一、機構同意人體研究/人體試驗證明書 47
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