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研究生(外文):Shu-Wen Kang
論文名稱(外文):The Evaluation of the Elderly Medication Appropriateness in Yunlin County of Taiwan
指導教授(外文):Bor-Wen Cheng
口試委員(外文):Hsueh-Yi LuCheng-min Chao
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
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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。
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
摘要 i
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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