台灣地區藥物相關危害高風險病患之藥物使用效果研究(I)-老人病患

中國醫藥大學機構典藏 China Medical University Repository, Taiwan > 中醫學院 > 中國藥學暨中藥資源學系暨碩博班 > 研究計畫 > Item 310903500/44617

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題名:	台灣地區藥物相關危害高風險病患之藥物使用效果研究(I)-老人病患
作者:	林香汶(Margaret Hsiang-Wen Lin);李采娟(Tsai-Chung Li);林正介(Cheng-Chieh Lin)
貢獻者:	藥學院藥學系;中國附醫藥劑部
日期:	2012-07-31
上傳時間:	2012-06-15 11:41:30 (UTC+8)
摘要:	由於轉診制?之?健全以及醫?環境走向專科化，病患本身及其家人傾向於尋求多項專科(包括傳統中醫)同時進?診治，而開?的處方可能呈現有多重用藥的現象。尤其是容?導致藥物相關危害之高風險病患(包括??病患)，其所衍生出?的用藥安全及醫?資源的?費是?可忽視的。針對潛在藥物相關危害之高風險病患，尤其是? ?人，本研究的主要目標是1)探討及描述此?病患藥物使用形態、趨勢、花費及與造成潛在藥物相關危害的相關因子；2)評估相關經濟、?床及人文效果及因藥物使用造成危害之相關負擔；3)探討此?病患藥物使用?為及其相關影響因子(如認知、態?及信仰等)；4)從?同醫?專業人員(包括醫師及藥師等)的角?，探討攸關於此?病患用藥之醫?照護品質(如用藥決策、藥物使用過程等)之相關影響因子。此三?三階段之研究，第一階段為回溯性資?分析，針對中國醫藥大學附設醫院看診、健保資?庫之承保戶及國民健康調查等資?庫，分析描述?人病患藥物使用趨勢、?當用藥及相關因子及效果。針對高風險藥物危害之?人病患及其醫?照護者，第二階段將進?質性研究，以探討病患藥物使用及其影響醫?照護品質的相關因素。第三階段為前趨性的橫斷式研究，依據第一、二階段研究結果設計出一前趨性調查，以進?評估及分析影響?人病患藥物使用(如順從性)與其影響醫?照護品質的相關因素及其效果間之關係。 In Taiwan, given the insufficient gatekeeper referral system and easiness to access medical specialists upon the provision of National Health Insurance (NHI), there is a tendency that patients ask for cares from the multi-disciplines, specialists (including Traditional Chinese Medicine) and primary care physicians simultaneously for the same disease(s). It might result in the duplication of prescriptions, potential inappropriate medication use (including polypharmacy) among frail patients, and raise the concerns of safety and waste of medical care resources. For those patients potentially at high risks of medication-related misadventure, specifically older patients, the major aims of this study are to 1) characterize their medication use, trends of pharmaceutical practice, as well as the associated factors for the extent of risks of medication-related misadventure, 2) evaluate the corresponding outcomes (i.e., economic, clinical and humanistic outcomes) and burden of misadventures due to medication use, and 3) explore the factors associated with their medication taking behaviors among patients of interest and the corresponding outcomes (e.g., knowledge, attitude, belief), 4) explore the factors associated with the quality of medical care (e.g., medication decision-making, medication use process) toward these patients of interest from professional providers’ perspectives (e.g., physicians, pharmacists). This study is composed of three phases in three years. The first phase is a retrospective database analysis to describe the trends of medication use (including misuse) and the corresponding, potential outcomes. All relevant data in the national databases of NHI and National Health Interview Survey (NHIS), and local database (e.g., China Medical University Hospital [CMUH]), etc. will be obtained and assessed. In the phase two, the prospective qualitative study will be conducted to explore the associated factors and/or barriers on medication-related practice from different perspectives (e.g., patient, family/caregiver, provider, governmental authority, health general public). In the phase three, based on the results obtained from the phase one and two, we will conduct a preliminary cross-sectional study through processing four general steps. Finally, the interrelationships between the factors of interest and the gap between different perspectives about medication prescribing, management and use, and outcomes if it is possible, will be examined.
顯示於類別:	[中國藥學暨中藥資源學系暨碩博班] 研究計畫

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