居家醫療藥物整合之經驗分享與實務困境：個案報告

Experience and Difficulty with Medication Reconciliation in Home-Based Medical Care: A Case Report

居家醫療提供長照病患持續性及周全性的醫療照顧，透過醫療團隊持續關懷追蹤個案，減少居家照護期間引發的合併症及降低再入院率。居家醫療藥物整合是透過醫師定期到宅診視個案，根據病患病況進行藥物評估及指導，進而執行藥物整合。透過藥物整合可避免多重用藥及不適當用藥、減少藥物副作用及交互作用，更可減少個案就醫次數、減輕家屬負擔及避免醫療資源浪費。本院居家護理所已累計執行超過數百位居家醫療個案之藥物整合經驗。目前居家醫療藥物整合業務仍面臨諸多難題。本文透過一位臨床個案實務經驗，探討居家整合用藥之現況及困境，並分享居家醫療藥物整合步驟及不同情境之處理經驗，以提供相關單位參考。

Home-based medical care provides persistent and comprehensive medical care for patients who require long-term care. Through continuous care and follow-up provided by the home care team, the complications during home care can be reduced, and the readmission rate can also be decreased. Home-based medical medication reconciliation is carried out through the regular visits by physicians to the patients’home to conduct drug evaluations and education based on the patient’s condition. Medication reconciliation acts to avoid the use of multiple and inappropriate drugs, reduce drug side effects and interactions, decrease the number of doctor visits, and prevent the burden on family members and the waste of medical resources. The home care center of our hospital has accumulated experience in medication reconciliation with hundreds of home care cases. However, medication reconciliation for home-based medical care patients continues to encounter numerous challenges. This article discusses the current situation and dilemmas of medication reconciliation for home-based medical care patients through the practical experience of a clinical case. The shared steps and experiences in different situations provide a insight for relevant units.