頁籤選單縮合
題 名 | 臺灣藥事服務的環境分析(1)=Analysis of the Quality of Pharmaceutical Care Environment in Taiwan (1) |
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作 者 | 梁亦松; 何藴芳; 王四切; 洪永泰; 王惠珀; | 書刊名 | 藥學雜誌 |
卷 期 | 29:1=114 2013.03[民102.03] |
頁 次 | 頁8-17 |
分類號 | 418 |
關鍵詞 | 藥事服務民意調查; 環境品質調查; 臨床藥學分散服務分散風險; Pharmaceutical service poll; Clinical pharmacy; Phamacovigilance planning; |
語 文 | 中文(Chinese) |
中文摘要 | 緣起:臨床藥學 (clinical pharmacy) 以人本照護,分散服務分散風險為依歸。為檢視我國藥事服務的環境品質及落實臨床藥學的客觀環境、探討臨床藥學配合長期照護政策的環境條件,本研究進行民眾對於藥事服務之認知、需求及滿意度調查。 方法:本調查於2012年11月30日至12月2日採隨機抽樣電話訪問台閩地區年滿20歲以上民眾,完成1,105有效樣本,以95%信賴度估計,抽樣誤差在±2.95個百分點。 結果與討論:(一) 本研究提出藥事服務的場域調查,結果顯示 (1) 民眾以醫院 (41.4%)、診所 (34.0%)、及社區藥局 (16.8%) 為主要場域,只有45.4%受訪者有拿處方箋到社區藥局調劑的經驗。受服務的內容以藥品調劑 (47.3%)、用藥指導 (17.3%) 及藥物諮詢 (18.5%) 為主,75.1%民眾未接受過「藥事照顧」服務;(2) 民眾對藥事服務的認知為以調劑為主,將「藥事照顧」定位為嚴重的及老人的服務。民眾反映藥師有主動提供用藥指導的佔了65.6%,有回答民眾提出藥事諮詢要求的只佔了44.8%。(二) 在人本服務的前題下,本研究提出藥事服務的需求及環境品質調查,結果顯示(1) 75.7%民眾自覺處在安全的用藥環境;(2) 對藥師專業的認同度為62.5%;(3) 對醫藥分業的滿意度高達84.3%;(4) 對醫院/診所/藥局以外之其他通路的藥事服務滿意度接近59.4%;然而 (5) 對衛生單位在藥品廣告管理之成效持負面評價的則佔了53.6%。(三) 在分散服務分散風險的前題下,本研究提出藥事服務的場域需求調查,結果顯示 (1) 83.7%的民眾同意自己可以選擇藥局;(2) 對處方集中在醫院調劑的認同度高,對醫院處方箋釋出率只有0.4%,認為太少的 (38.5%) 與認為差不多 (37.8%) 的比例相當;(3) 認為基層診所處方箋釋出率30%差不多的則佔了50%。(四) 藥品的可及性 (accessibility) 直接影響民眾調劑場域之選擇,美國以學名藥法 (Hatch-Waxman Act),日本二代健保以藥品智財權 (學名藥法) 規範藥品給付,以提昇藥品的可及性,成功落實臨床藥學分散服務分散風險。因此本調查探討民眾對以學名藥取代原廠藥的認同度,結果顯示 (1) 不同意學名藥取代的比例 (47%) 大於同意 (43%) 的;(2) 不同意學名藥取代的與學歷低的民眾呈正相關。(五) 藥事服務的場域滿意度比較則顯示醫院與社區藥局可以提供較多的藥事諮詢。 結論:整體而言,台灣民眾對用藥的認知、藥師服務的角色、藥事服務的環境品質、以及醫藥分業的意義仍缺乏鑑別力,但是社區藥局提供較多藥事諮詢獲得民眾較大程度的認同,則顯示台灣在落實分散服務,分散風險,以達到臨床藥學的人本藥事照護,還有努力的空間。 |
英文摘要 | Background: Scattered pharmacy service leading to risk prevention is a pre-requisite for implementing phamacovigilance planning. Decentralized pharmaceutical care is also a fundamental issue in the endeavor of long-term care in aged society. This study aims to analyze the social and environmental quality of pharmaceutical care in Taiwan. Methods: Citizens’ appraisal on the need and their satisfaction of pharmaceutical care was investigated via a survey study. The survey was conducted on Taiwanese residents at age 20 and beyond, selected by random sampling. Telephone interview was executed from November 30 to December 2, 2012 with a valid sample size of 1,105. The estimated sampling error within 95% confidence level is within ± 2.95%. Data was validated before the statistical analysis was conducted. Results and discussion: (1) Current sites of pharmacy service are investigated. The majority goes to hospitals (41.4%), clinics (34.0%) and community pharmacies (16.8%). Curreny pharmacy service is basically dispensing (47.3%), direction for medication (18.5%) and consultation (17.3%). About 62.5% responded with satisfaction on pharmacy service. The majority (75.7%) considered they are living in an environment of safe medication. About 84.3% are satisfied with the Separation of Dispensing from Prescription. However 53.6% expressed their dissatisfaction on government control of drug advertisement. (2) The site of pharmacy service in need was investigated. The majority (83.7%) agreed to choose sites for service at their own will. However only 45.4% of citizens expressed experience of prescription dispensing in community pharmacy. About 37.8% agreed and 38.5% disagreed with low prescription release rate (0.4%) released from hospital to community pharmacy for dispensing. About 50.0% agreed with current 30% release rate of prescriptions released from clinics to community pharmacy for dispensing. The respondents reflected that pharmacists in community pharmacy and hospitals provide more consultation than pharmacists in the clinics. (3) The use of generic drugs is a key element in fulfill the accessibility of prescription drugs in community pharmacy service. The adoption of generic drug use by the citizens was thus conducted. The disagreed (47.0%) of generic drug use is higher than the agreed (43.0%). The disagreed is largely in the population of lower educational level. Conclusion: This study reflected the public opinion on pharmacy service. Taiwanese in general are satisfied with current centralized pharmacy service, a service of dispensing by definition. About 75.1% responded with no experience in pharmaceutical care. Although a scattered personalized pharmaceutical care is the theme, most of the citizens considered clinical pharmacy is only needed for the seriously ill and the elderly. |
本系統中英文摘要資訊取自各篇刊載內容。