本研究以分析65歲以上老年人潛在性不適當用藥之型態與因素為目的，主要對象為患有高血壓、高血糖、高血脂、及其他身心疾病患者，藉社區健保藥局接受處方箋的調劑行為，評估慢性病連續處方箋對老年人用藥之適當性。本研究以橫斷性回溯方法，由社區健保藥局之健保申報資料檔中，選取65歲以上老年處方箋為研究樣本，進行用藥適當性之分析與探討。以AGS 2012 Beers criteria評估準則與2013 STOPP & START Toolkit為評估依據，進行老年人潛在性可能不適當用藥評估，並以Logistic多項式回歸分析法計算其相關危險因子。 本研究所採取的社區健保藥局之健保申報資料檔，由2012至2015年處方箋共11922份，醫令檔有藥品數37568筆，其中呈現65歲以上老年人處方箋有效張數有4889人次，男生佔2248人次(46%)，女生佔2641人次(54%)，以年齡區分65-74歲佔2339人次(47.8%)，75-84歲佔1968人次(40.3%)，85歲以上佔582人次(11.9%)。其中處方箋申報費用與病患就醫科別，對於處方箋可能不適當用藥探討，較無直接關連。 分析結果醫令檔中65歲以上老年人共佔17316筆醫令藥品數，具有可能不適當交互作用分析，以AGS 2012 Beers criteria評估，分析結果65歲以上可能潛在性不適當用藥共6979次，盛行率佔40.3%。以2013 STOPP & START Toolkit評估，分析結果65歲以上可能潛在性不適當用藥共6389次，盛行率佔36.9%。其中潛在性可能不適當用藥前面藥品有Acetylsalicylic Acid、Alprazolam、Atorvastatin 、Quetiapine、Rosuvastatin、Clonazepam。 研究結果顯示，慢性病處方箋需注意可能不適當用藥，65歲以上老年人需注意可能不適當用藥對身體可能副作用，藥師接受老年人處方箋調劑時，需注意相關危險因子，並提供可能遇到之用藥相關問題，並進行用藥諮詢指導與追蹤，以增加老年人用藥之安全，以提升藥師專業服務。 When the pharmacists in the health care community pharmacies accepted the prescription dispensing, elderly patients over 65 years were potentially prone to inappropriate medication. In order to understand the drugs risk factors and inappropriate of elderly chronic prescription, the study analyzed the community health care drug prescription dispensing behavior of hypertension, hyperglycemia, dyslipidemia patients with physical and mental illness. This research selected the Bureau of National Health Insurance drug claims data files of 65 year or older prescription as materials of this study and conducted the transected retrospective study to analyze and discuss. Based on the AGS 2012 Beers criteria and evaluation criteria for the 2013 STOPP & START Toolkit assessment, the research conducted Logistic regression analysis of polynomials to analyze the elderly potentially inappropriate medication assessment and the associated risk factors.Based on community health care Bureau of National Health Insurance drug claims data file, there are 11922 prescriptions and 37568 medical files between 2012 to 2015. The number of effectively rendered elderly sheets over the age of 65 prescription are 4889 people of which boys accounted 2248 people (46%) and girls accounted for 2641 people (54%). Based on the age, the 65-74 years old accounted for 2339 people (47.8%) and the 75-84 years old accounted for 1968 people (40.3%), and the higher than 85 years age 582 people (11.9%).The results of the analysis, potentially inappropriate prescriptions of 65 years or older accounted for 17316 numbers of drugs. Assessment by AGS 2012 Beers criteria, the results of 65 years of age or old were prone to potentially inappropriate medication for 6979 times accounted the ratio (40.3%). The potentially inappropriate medication were 6389 times which accounted the ratio (36.9%) by 2013 STOPP & START Toolkit. The medication may have these drugs : Acetylsalicylic Acid、Alprazolam、Atorvastatin、Quetiapine、Rosuvastatin and Clonazepam.The results show that in health care community pharmacies, pharmacists need to pay more attention to the relevant risk factors when receiving elderly patients prescription dispensing and provide the drug related problems people may encounter and the possible side effects of drugs, and conduct drug counseling and tracking to increase the safety of the patient medication to enhance pharmacists professional services.
