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題名 | 某精神科醫院同院所處方重疊探討=Factors Associated with Overlapping Prescription in a Psychiatric Hospital |
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作者姓名(中文) | 鄭淑文; 李文光; 鄭淑文; |
作者姓名(外文) | Cheng, Shu-wen; Lee, Wen-guang; Cheng, Shu-wen; |
書刊名 | 藥學雜誌 |
卷期 | 33:1=130 2017.03[民106.03] |
頁次 | 頁127-132 |
分類號 | 418.81 |
語文 | chi |
關鍵詞 | 用藥日數重疊; 健保雲端藥歷; 用藥安全; Overlapping prescriptions; PharmaCloud system; Drug safety; |
中文摘要 | 目的:為確保民眾用藥品質,健保署已將民眾在國內醫療院所使用同樣藥物的用 藥日數重疊率,納入監測管理指標,其主要目的為避免病人重複拿藥,造成醫療資源 浪費。方法:以某一精神專科醫院2014年門診健保申報檔分析,主要針對使用抗精神 病藥物、抗憂鬱症藥物、安眠鎮靜藥物而有同藥理用藥日數重疊處方者進行整體描述 性統計,並以邏輯式迴歸分析預測其高風險族群。結果:處方重疊病人就診主訴診斷 以思覺失調症最常見,佔50.57%;處方重疊之藥物類別方面,以抗精神病藥物佔大 部份 (46.08%),其次為安眠鎮靜藥物 (35.80%)。用藥日數重疊與病人特質相關性高, 控制其他變項後,抗精神病藥物用藥日數重疊處方,以思覺失調症風險較高 (勝算比 1.63);抗憂鬱症藥物用藥日數重疊處方,以精神官能症風險較高 (勝算比4.48);安眠 鎮靜藥物用藥日數重疊處方,以精神官能症風險較高 (勝算比1.65)。結論:針對用藥 日數重疊之高風險族群病人,「健保雲端藥歷系統線上查詢」可即時查詢病人最近三 個月的用藥明細,且藉由藥師提供個別化之用藥諮詢與指導,確實可保障民眾用藥不 重覆,除提升醫療品質外,也確保病人用藥安全。 |
英文摘要 | Objective: In order to ensure the quality of the medicine usage in general, Health Bureau has put the overlapping prescriptions into assessment supervision. The main purpose of doing such supervision is to avoid repetitive medicine application and the waste of medical resources. Methods: To get the solid evidence of the outcome; we therefore analyzed the database of clinical outpatient services in one of the psychiatric hospitals in the year 2014. We studied and analyzed the overlapping prescriptions of antipsychotic drugs, antidepressants drugs, and sedative-hypnotic drugs. We used logical analysis to predict the highly possible risk takers. Results: The most common diagnosis of overlapping prescription was found Schizophrenia, accounting for 50.57%. Overlapping prescription was most likely to happen to patients with antipsychotic drugs, followed by sedative-hypnotic drugs, and then antidepressant drugs. Factors associated with overlapping prescriptions were highly related to the characteristics of the patients. After controlled for the other variables, the overlapping prescriptions in antipsychotic drugs were found higher risk in patients with the diagnosis of Schizophrenia (OR= 1.63); the overlapping prescriptions in antidepressant drugs were found higher risk in patients with the diagnosis of Neurosis (OR= 4.48); and the overlapping prescriptions in sedative-hypnotic drugs were found higher risk in patients with the diagnosis of Neurosis (OR= 1.65). Conclusions: In order to minimize the high risk takers of the overlapping prescriptions, there was a PharmaCloud System online for any recent three months checkup records of the patients. Furthermore, with the consultant and guidance from the pharmacists, we have kept off the overlapping prescriptions for improve the quality of the medical usage, and the drug safety issues. |
本系統之摘要資訊系依該期刊論文摘要之資訊為主。