精神科長效針劑導入超寬頻技術，以提升精神科門診病人針劑即時注射完整率

Evaluation of the Effectiveness of Ultra-Wideband Technology in Improving the Real-Time Injection Rate of Long-Acting Injectable Antipsychotics in Patients with Schizophrenia

近年來，健保政策支持下，思覺失調症治療趨勢逐漸轉向第二代長效針劑，以減少病人因口服藥物順從性不佳而導致的疾病復發。本院2021年至2023年長效針劑使用量大幅增加86.98％，然而，約4.0％的病人未能按時接受注射，可能會影響治療效果。因此，本研究旨在導入「超寬頻（Ultra-Wideband, UWB）技術」於藥品調劑流程，並介入「未接觸即刻紀錄系統」於施打地點，以提升門診病人的即時注射率。本研究對象為門診施打第二代長效針劑的思覺失調症病人，收集方案導入前後6個月的病人性別、年齡及疾病診斷等基本資料，並採用GA-210 UWB定位基站，透過UWB標籤綁定病人訊息、用藥品項及施打時間，實現無接觸治療追蹤。主要指標為即時注射率，附加評估志工陪同病人前往注射地點的時間變化。結果顯示方案導人後共服務757名病人，總計3,373人次。病人基本特性在介人前後無統計學上的顯著差異（P>0.05），顯示該因素不影響研究結果。導入UWB技術後，即時注射率提升至100％，同時減少每日至少2名工作人力及130~325分鐘陪同時間。此外，每年可減少約180,000克碳排放量，具有節能減碳效益。本研究成功應用UWB智慧技術，提升思覺失調症病人長效針劑即時注射率至100％，並有效優化人力資源調配及環境永續發展。本院亦將UWB技術擴展至住院病人跨科就診的動向追蹤，以進一步提升醫療管理效率。

In recent years, with the support of National Health Insurance policies, the treatment of schizophrenia has increasingly shifted toward second-generation long-acting injectables (LAIs) to improve medication adherence and reduce the risk of relapse. From 2021 to 2023, the usage of LAIs at our hospital increased by 86.98%. However, approximately 4.0% of patients failed to receive their injections on time, potentially impacting treatment outcomes. Therefore, this study aimed to implement Ultra-Wideband (UWB) technology in the medication dispensing process and introduce a contactless instant recording system at the injection site to enhance the real-time injection rate among outpatient psychiatric patients. The study population consisted of outpatients receiving second generation LAIs for schizophrenia. We collected patient demographic and clinical data, including gender, age, and diagnosis, for six months before and after implementing the intervention. The study utilized the GA-210 UWB positioning system, which used UWB tags to bind patient information, medication details, and injection times, enabling a contactless tracking system. The primary outcome was the real-time injection rate, with an additional assessment of changes in the time required for volunteers to escort patients to the injection site. After implementing the intervention, the system served 757 patients, with a total of 3,373 injections. There was no statistically significant difference in patient characteristics before and after the intervention (P>0.05), indicating that these factors did not influence the study results. Following the adoption of UWB technology, the real-time injection rate increased to 100%. Additionally, the intervention reduced the daily requirement of at least two staff members and 130--325 minutes of escort time. Moreover, the system contributed to environmental sustainability by reducing paper usage, leading to an estimated annual reduction of 180,000 grams of carbon emissions. This study successfully applied UWB smart technology to achieve a 100% real-time injection rate for schizophrenia patients receiving LAIs, while also optimizing workforce allocation and promoting environmental sustainability. Our hospital has also extended the use of UWB technology to track the movement of hospitalized patients attending dental outpatient visits, further enhancing medical management efficiency.