頁籤選單縮合
題 名 | 藥師介入高危險藥物使用之成效=Impact of Clinical Pharmacist Intervention for the Use of High-risk Medications |
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作 者 | 陳意卿; 陳西蕙; 楊怡靜; 朱育瑩; 陳正強; | 書刊名 | 藥學雜誌 |
卷 期 | 35:2=139 2019.06[民108.06] |
頁 次 | 頁93-99 |
分類號 | 418.82 |
關鍵詞 | 高危險性心血管藥物; 用藥配合度; High-risk medications for cardiovascular diseases; Medication adherence; |
語 文 | 中文(Chinese) |
中文摘要 | 目的:高齡者因罹患多重慢性疾病,面臨複雜的用藥問題,若同時有高危險性心 血管藥物,則易有處方不適當、用藥錯誤與藥物不良反應等潛在風險,藥師應加強處 方評估與病人衛教,以提升病人用安全及自我照護能力,本研究探討藥師介入住院病 人首次使用高危險性心血管藥物之成效。 方法:採前瞻式研究,自105年5月至106年2月,針對 ≧ 65歲住院病人首次使用 digoxin 或抗凝血劑 (warfarin, acetylsalicylic acid, clopidogrel, dabigatran, apixaban) 之高危 險性心血管藥物者,住院期間進行處方適當性評估、提供用藥指導,出院後以電訪追蹤 是否有藥物不良反應,住院期間及出院後以問卷方式進行用藥知識與用藥配合度的前後 測。分析處方評估的藥物相關問題類型、比較藥師介入前後用藥知識與配合度之差異。 結果:共152人納入分析,病人平均年齡68.6 ± 9.9歲,其中63.1%的給藥行為非 由病人本人而是照顧者。首次使用高危險藥物以 acetylsalicylic acid 居多佔55.1%。處 方不適當率4.6%,藥師建議接受度85.7%。用藥知識前後測平均分數分別為1.7 ± 0.3 分與4.7 ± 0.1 (p < 0.001),用藥配合度前後測平均分數分別為3.1 ± 2.5分與0.6 ± 1.2 分 (p < 0.001),顯示衛教後用藥知識與配合度皆有提升。出院後的電訪中發現,有7位 病人反應的身體不適,與藥物的相關性較低而是病況未獲得控制所致。 結論:藥師主動介入高危險性心血管藥物之照護,不但及時攔截不適當處方,加 強正確用藥知識、提升用藥配合度,並得知用藥配合度低的原因,可提供醫療團隊照 護之參考。透過藥師主動發現病人自覺疑似藥物引起的不適反應,及時的評估與衛 教,避免病人因錯誤的用藥觀念而自行停藥,進而影響疾病的治療。 |
英文摘要 | Background: Older people are at greater risk of medication error and adverse drug effects. In this study, we investigated the impact of pharmacist-led intervention for the inpatients who had their first-time prescriptions of certain high-risk medications for cardiovascular diseases. Methods: This was a prospective study. From May 2016 to February 2017, inpatients age ≥ 65 who had their first-time prescriptions of high-risk medications for cardiovascular diseases (including digoxin, warfarin, acetylsalicylic acid, clopidogrel, dabigatran and apixaban) were included. During admission, the pharmacists collected information about patients' knowledge of their medications and information about their medication adherence through a questionnaire. The pharmacists then provided patients counseling. After discharge, patients' knowledge of their medications and medication adherence after counseling were again evaluated by telephone. Adverse drug effects were also recorded. Patients' knowledge of their medications and medication adherence before and after counseling were compared. Results: There were 152 patients included. The clinical pharmacist provided suggestion regarding the problematic prescriptions and the acceptance rate of the suggestions were 87.5%. The average scores of patients' knowledge of their medications before and after counseling were 1.7 ± 0.3 and 4.7 ± 0.1 respectively (p<0.001). The average scores of the medication adherence before and after counseling were 3.1 ± 2.5 and 0.6 ± 1.2 respectively (p<0.001). According to the telephone interview after discharge, seven patients reported physical discomfort which was not considered drug-related but rather disease-related. Conclusion: Pharmacists' participation in the care of patients using high-risk medications for cardiovascular disease promptly intercepted inappropriate prescriptions, enhanced patients' knowledge of their medications and medication adherence. |
本系統中英文摘要資訊取自各篇刊載內容。