提升偏遠山區精神病人服藥遵從率專案之成效

The Effect of a Project to Enhance Drug Compliance of Psychiatric Patients Who Live in Remote Mountainous Areas

本專案目的以病人及家屬為中心，提升偏遠山區精神病人服藥遵從率。本院於2010年1月1日至12月31日收集60位精神病人服藥遵從率僅有13.33%。專案實施期間為2011年1月1日至12月31日，經現況分析確立問題為：病人缺乏疾病及藥物認知、家屬未督促服藥、醫療團隊缺乏溝通機制及平台、未提供便利諮詢方法、藥物副作用。擬定對策有：衛生教育指導、設計疾病藥物評估單、實行行為約定、舉辦團體衛生教育課程及家屬座談會、藥物監測日記、提供24小時諮詢電話、增加電話關懷次數、增加藥物討論會。實施後病人服藥遵從率由13.33%提升至66.67%達目標值，顯示專案推行後能有效提升偏遠山區精神病人服藥遵從率。

The aim of this patient- and family-centered project was to improve the drug compliance rate among our hospital's psychiatric patients who lived in remote mountainous areas of Taiwan. From January 1, 2010 to December 31, 2010, our hospital collected drug compliance data on 60 psychiatric patients residing in remote mountainous areas in central Taiwan and found a drug compliance rate of 13.33%. Barriers to drug compliance were patient cognitive deficiency for diseases and drugs, lack of family participation, a lack of adequate communication mechanisms and platforms for medical teams leading to unreliable consultation with patients and their families. Medication side effects also presented a barrier. The project to improve drug compliance was implemented from 2011 January, 2011 to December 31, 2011. Proposed program measures included providing health education and guidance, designing disease and drug evaluation forms, executing behavior convention, offering health education courses and seminars for the patients and their families, encouraging the patients to keep a drug monitoring diary, providing 24-hour phone consultation, and increasing the number of telephone care phone calls. After implementation, drug compliance rate increased from 13.33% to 66.67%, suggesting that our project goals had been achieved. We concluded that this project effectively improved medication compliance among our psychiatric patients residing in remote mountainous areas.