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題名:使用社會網絡分析在老人用藥之應用
作者:黃立人
作者(外文):HUANG,LI-JEN
校院名稱:國立彰化師範大學
系所名稱:人力資源管理研究所
指導教授:許壹傑
學位類別:博士
出版日期:2022
主題關鍵詞:多重用藥老人不適用藥藥品交互作用社會網絡分析用藥安全polypharmaccypotenitially inappropriate medications in elderlydrug-drug interaction(DDI)social network analysis medication safety
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本研究引用分析與社會網絡分析的意涵及應用探討老人多重用藥產生不適用藥交互作用的用藥安全效能研究成果,本研究以某健保藥局其健保資料庫採回溯資料分析,依據老人不適用藥Stopp (screening Tool of older persons'prescriptions) 和Start (screening Tool to alert doctors to the right treatment)準則條文先建立比對資料庫,使用Spss、Ucinet統計分析找出產生老人不適用藥的科別部門與相關資料,發現1. 探討藥品數目越多不是藥品風險唯一條件,但藥品數量不宜作為老人進行藥事照護是否收案的條件,會產生遺落風險。2.老人用藥安全風險在多重,多科處方藥用藥方面則以內科對家醫科之科組最高。3.如果以藥品分類則以抗凝血劑為最高,其次則是新陳代謝疾病(糖尿病用藥)。4.在老人多重用藥之用藥安全管理,社區藥局藥師扮演非常重要的角色。因此本研究結果是使用社會網絡分析揭示了老人不適用藥的多科處方合併用藥的部門集群分佈,可在藥師進行藥事照護過程中需要未來監測,優先訴求及服務改善。
In this research, the implications and applications of analysis and social network analysis are used to explore medication safety efficacy on drug-drug interaction (DDI), caused by polypharmacy in the elderly. In this study, the retrospective data collected from the National Health Insurance Research Database was used for analyses. According to the inappropriate use of drugs for the elderly STOPP&START guidelines, a comparison database was first established, and SPSS as well as UCINET were used for statistical analysis to find out in clinical divisions with related data which produced inappropriate drugs for the elderly. The findings revealed that 1. The number of drugs used by the elderly do not reflect a higher risk of medication safety, but the number of drugs should not be used as a condition for the elderly to receive pharmaceutical care, which would lead to the risk of losing track of medication. 2. The highest safety risk of medication of multi-disciplinary prescription drugs for the elderly falls in department of medicine with division of family medicine. 3. Anticoagulants are the highest in the classification of drugs, followed by metabolic diseases (diabetic drugs). 4. Pharmacists in community pharmacies play a very important role in medication safety management of polypharmacy for the elderly. Therefore, the results of this study use social network analysis to reveal the distributed cluster in clinical divisions of multidisciplinary prescriptions combined with medication for the elderly who are unsuitable for medication, which may require future monitoring, prioritization of appeals and service improvement in the process of pharmacists' pharmaceutical care.
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