醫師對老年用藥的態度及知識

Physicians' Attitude and Knowledge toward Prescription for Geriatric Patients

本文的研究目的為了解開方醫師對老年用藥的知識及態度。本研究於2007年10月至2008年12月間，針對參與「老年用藥安全門診」研究的開方醫師（139名）進行問卷調查。內容包括老年處方相關問題之態度及知識與老年處方行為自評。134位同意受訪，共完成有效問卷98份，完成率為73.1%。受訪醫師中，僅有9位（9.3%）醫師過去三年中曾接受超過五小時的老人用藥教育，也僅有21.6%的受訪醫師知道有「Beers老年潛在性不適當用藥指南」。但大部分的醫師（93.9%）表示有相關課程願意接受訓練。大部分的受訪醫師執行臨床工作時能大致遵行老人處方開立準則。具有老年醫學專科的受訪醫師較其他專科醫師會使用較低的起始劑量（93.8% vs 64.6%, p=0.02）。老年專科醫師（87% vs 57%, p=0.04）有更高的比例會替老年病患評估有無增加新藥的適應症。國內老年醫學相關教育資源仍不足，加強老年用藥相關教育是重要的。

The study aims to evaluate the physicians' attitude and knowledge toward geriatric prescribing. Prescribers (N=139) of participants enrolled in the medication safety review clinic (MSRC) study conducted at the National Taiwan University Hospital system were invited to fill a self-administered questionnaire regarding their demographic data, practice related characteristics and knowledge of prescribing for the elderly. Among them, 134 agreed to participate and 98 (73.1%) returned the questionnaires. The mean age was 46.9 years and 92.9% were men. Only nine physicians (9.3%) received more than five hours of formal education on geriatric prescribing principles in the last 3 year. Only 21% knew Beers criteria for potentially inappropriate medications in older adults. However, the majority (93.9%) agreed to receive related training if provided. Even without formal training most physicians followed certain geriatric prescribing principles. Geriatricians, as compared with others, were more likely to start lower medication doses for elders than adults (93.8% vs 64.6%, p=0.02). They were also more likely to evaluate indications for under-prescription to add new drugs (87% vs 57%, p=0.04). In Taiwan, the resources for education on geriatric prescribing are lacking. It is necessary to incorporate such education in undergraduate and postgraduate medical trainings.