老年人之多重用藥議題

Polypharmacy Issues in Older Adults

多重用藥是照顧老年人會面臨到的一項重要議題，此乃由於65歲以上的老年人，可能因罹患多種慢性疾病或是因癌症而使用藥物來控制不同的症狀。多重用藥常泛指同時使用五種或以上藥物，或是使用的藥物已超出其臨床治療所需。多重用藥易造成藥物交互作用、藥物不遵從性、及藥物不良反應等問題。雖然藥物是促進並維護老年人生活品質的一項重要因素，但是使用多重藥物亦可能增加他們罹病及死亡的風險，喪失個人生活之獨立功能，亦可能導致認知、身體與情感上的多重問題。本文旨在介紹老年人之多重用藥議題，以協助護理人員了解其角色功能，並提供臨床上可施行之相關策略以降低多重用藥的危險性，可行策略包括：（一）具備藥物相關知識；（二）具備用藥評估技能；（三）致力促進用藥安全；（四）進行病人教育。有鑒於此，護理人員須審視老年人所使用之藥物，了解影響藥物遵從性的原因並持續提供用藥的相關教育，以為老年人之健康把關。

Polypharmacy is a major concern in the care of older adults. People over 65 years of age frequently have multiple medical conditions and may have cancer, which requires multiple medications for treatment. The use of multiple medications increases the risk of drug-drug interactions, non-adherence, and adverse drug reactions. Polypharmacy is a term that refers to a high number of prescribed medications, usually five and above, or the use of more medications than is clinically justified. Although medications are an important factor in improving and maintaining the quality of life of older adults, polypharmacy increases the risks of morbidity and mortality, loss of functional independence, and a multiplicity of cognitive and physical problems in this population. This article examines issues related to polypharmacy in older adults and identifies nursing strategies and interventions to detect and prevent polypharmacy. Nursing strategies discussed include: (1) increasing patient knowledge of pharmacological issues, (2) increasing patient medication management competency, (3) promoting safe patient medication practices, and (4) enhancing patient education. Nurses must be familiar with medicine regimens, understand the primary factors that affect adherence, and participate in continuing education to enhance their ability to safeguard older adult patients.