長期照護機構老人藥事照護成效分析

Pharmaceutical Care in Facilities Elderly

目的：本研究目的為藥師參與長期照護機構住民用藥適當性評估並建立藥於長機構中進行藥事照護及解決藥物相關治療問題之流程。方法：本研究由衛生署南投醫院藥劑科藥師分別對七家老人養護機構住民抽樣進行介入性用藥適當性評估、照會相關人員及藥物療效追蹤等藥事照護服務。結果：本次收案住民共115人，老人平均用藥為6.59種，藥物治療問題數為3.64種。評估老人潛在不適當用藥則有63人使用相關藥物。發現住民的用藥數目和住民身體健康狀況（罹患慢性疾病數）、就診醫院數目有關，且用藥數目多的住民亦有較多藥物治療問題。結論：藥師進行住民用藥評估後許多藥物治療問題經過介入並照會醫師、護理人員是可以獲得解決及預防的。

Objectives. To investigate the benefit of pharmaceutical care in long term care facilities in central Taiwan, including Nantou County, Taichung County and Changhua County. Methods. From 2010 March 1 to 2010 October 31, pharmacists from Nantou Hospital, Department of Health, Executive Yuan, R.O.C. visited seven long-term-care facilities in Central Taiwan. The appropriateness of dosage, dosing interval, route and dosage form was assessed for each prescription. Finally, the benefit of drug related problems intervention by pharmacists, physician and nurses were evaluated. Results. One hundred and fifteen residents were included for medication evaluation. On average, they were 75.53 years old, taking 6.59 medicines. After consulting with physician, nurses and caregivers, there were 72% drug related problems could be resolved or adverse drug reaction was discovered. Sixty three cases were appraised as potential inappropriate medication uses according to Beers criteria. Polypharmacy was also found in the elderly medication records. Conclusions. The elderly residents in the long-term-care facility were at high risk for drug-related problems. It is suggestive that regular pharmaceutical care should be conducted by pharmacists in the facilities in Taiwan. And, it is necessary for pharmacists to be involved through an explicit mechanism in the health care team of long-term-care facilities to ensure the medication safety.