高齡用藥安全把關及友善服務之營造

Gate-keeping Medication Safety and Establishing Friendly Service for Elderly Patients

近年來，65歲以上老年人口比率持續攀升，2015年6月底，甚至達12.2%。高齡長者的疾病種類多，同時合併使用多種藥物，再加上因多重疾病而到處求醫，對於藥物的使用和管理不當，常常會發生藥品相關的問題。因此，高齡用藥安全的把關，對於醫療院所而言，是很重要的課題。個案醫院實施下列多重的安全措施，以保障高齡長者用藥安全：(1)慢性病老年病人不適當用藥之探討與改善措施；(2)醫囑提供高齡長者用藥安全相關警示。(3)加強長者及其家屬的用藥教育。(4)健保雲端藥歷查詢及合理用藥評估之執行。(5)成立【高齡友善醫院推動小組】，並推動多項高齡長者友善服務方案。高齡長者的用藥安全，藉由醫師減少開立「潛在不適當用藥」，並透過「藥物醫囑安全警示系統」防止錯誤發生，藥師定期回饋全院同仁用藥相關問題，並持續進行醫資系統的品質改善，以及高齡長者提昇自我照顧知能，才能達到用藥安全的目標。

In recent years, the proportion of the population aged 65 and over has been escalating persistently. By the end of June 2015, the number has reached 12.2%. With their co-morbidities, polypharmacy, and inevitable help-seeking behaviors, drug-related complications have often emerged due to the inadequate use and management of medications. Therefore, it is very important for healthcare institutions to check and control the medication safety for the elderly patients. The Cathay General Hospital (CGH) has set up the following measures to secure the medication safety for elderly patients: 1.Measures to explore the Potential Inappropriate Medications (PIM) and refine the regimen for elderly patients with chronic diseases. 2.Drug safety alerts for elderly patients built within the CGH medical order system. 3.Reinforced education to elderly patients and their family in terms of medication use. 4.Implementation of the National Health Insurance (NHI) PharmaCloud System enquiry to evaluate the rational use of drugs. 5.Campaign for Senior-friendly Hospital to push forward several programs of elderly-specific services. The aim to medication safety for elderly patients can only be achieved by reducing the potential inadequate prescriptions through the error-preventing 'Medical Order Safety Alert System', by which pharmacists can feedback periodically to colleague on specific drug-related queries, as well as constantly maintain and refine the quality of medical information system. This aim, however, is not attainable without the cooperation of elderly patients to improve their knowledge and capability to care themselves.