慢性病連續處方箋衛教宣導在知識與行為的短期成效

The Short Term Effects on Knowledge and Practice after an Educational Lecture about Refilling Prescriptions for Chronic Diseases

目的：地方衛生單位進行慢性病連續處方箋（簡稱｢慢箋｣）衛教宣導多年，多數沒有進行成效評估或只進行立即成效評估。本研究調查慢箋知識、持慢箋至社區藥局領藥行為，及評估衛教宣導後的短期成效。方法：對參與桃園活力站民眾在衛教宣導前發問卷，2009年4月及8月的衛教宣導分別為慢箋及用藥安全。（一）採橫斷研究，分析兩梯次未重複者的資料。（二）採單組前後測介入，分析兩梯次重複者的資料。結果：（一）橫斷研究：1,348位慢性病者中使用慢箋有830位（61.6%）。持慢箋者只到就診醫院或診所領藥佔61.8%，只到社區藥局領藥佔30.8%，兩者都有佔2.9%。慢箋知識平均答對比例為64.1%。（二）單組前後測介入：138人出席兩次活動，慢箋知識上升9.9%，達統計顯著差異（p =0.0004），但慢箋使用行為無顯著改變（p =0.6301）。結論：持慢箋者到社區藥局領藥的民眾不到1/3，衛教的短期成效只增加知識，未改變行為。

Purposes: Local public health offices have given educational lectures about refilling prescriptions for chronic diseases (RPCD) for many years, but they seldom assessed results other than the immediate effects of RPCD. This study surveyed the knowledge about and practice of RPCD and examined the short-term (four months) effects of an educational lecture about RPCD. Methods: Patieints who participated in the activities of the Vital Health Station in Taoyuan were asked to fill out a questionnaire before they attended an educational lecture. A lecture about RPCD was given in April, 2009 (T1), and a lecture about medication safety was given in August, 2009 (T2). (1) A cross-sectional study was used to analyze the knowledge about and practice of RPCD for those who participated in the first lecture. (2) A single group pretest and posttest was used to examine the change in knowledge about and practice of RPCD after four months for those who attended both lectures. Results: (1) For the cross-sectional study, 1,348 patients had chronic diseases, and 830 (61.6%) had used RPCD. Among those who used RPCD, 61.8% obtained their medications only from hospitals or clinics, 30.8% only from community pharmacies, and 2.9% from both places. The proportion with correct knowledge about RPCD was 64.1%. (2) For the single group pretest and posttest trial, 138 people participated both lectures and their knowledge at posttest increased by 9.9% and reached statistical significance (p=0.0004). RPCD practice, however, did not change (p=0.6301). Conclusions: Only one-third of the patients used RPCD to obtain their medication from community pharmacies. There was a short term effect from the educational lecture in terms of increased knowledge about RPCD, but not in practice.