高齡者門診用藥之藥物交互作用

Drug-Drug Interactions in Elder Patients Presenting to an Outpatient Clinic

10.6200/TCMJ.2014.11.2.03

楊瑛碧(Ying-Pi Yang)；鮑柏穎(Bo-Ying Bao)；鮑俊蓓(Jiunn-Bey Pao)

老人 ； 門診處方用藥 ； 潛在嚴重藥物交互作用 ； elderly ； outpatient prescriptions ； potentially serious drug interactions

北市醫學雜誌

11卷2期（2014 / 06 / 01）

135 - 145

繁體中文

目的：探討門診老年用藥常發生藥品交互作用之種類，以提高醫療人員開立藥品之警覺，共同保障病人用藥安全。方法：回溯性觀察收集2011年1-6月間至門診就醫65歲以上老人處方用藥資訊，並以院內資訊系統內建之藥品交互作用資料、Micromedex及MIMS交互作用查詢系統協助篩選發現一級或二級藥品交互作用。結果：研究發現65歲以上老人診斷多為慢性疾病。門診用藥一張處方平均藥品數為4.8種，最多開立14種藥品，仍有高達21.7%門診處方大於5種藥物使用。嚴重藥物交互作用佔3.7%，中等程度藥物交互作用佔55.6%，需謹慎使用藥物交互作用佔9.5%。結論：門診藥物交互作用系統，可以藉由資訊設定，協助提示開立處方醫師判斷，避免因嚴重藥物交互作用，發生藥物副作用及不良反應。

Objectives: To investigate the degree of drug-drug interaction among elderly outpatients in our hospital clinics. This should increase the vigilance of medical staffs when dispensing drugs for elderly outpatients and ensure safe drug use. Methods: We retrospectively collected prescription information from elderly outpatients during January to June 2011. Through the in-house drug-drug interaction information system, Micromedex, and MIMS drug interaction query system, we filtered out the records of primary and secondary drug interactions. Results: Elderly outpatients were frequently diagnosed with chronic diseases. The average number of drugs per outpatient prescription was 4.8, and up to 14 drugs in one prescription. A total of 21.7% of outpatients were prescribed more than 5 kinds of drugs. More importantly, 3.7% of the outpatient prescriptions had serious drug interactions. The rates of moderate and mild drug-drug interaction were 55.6% and 31.2%, and 9.5% of the prescriptions were marked use with caution. Conclusion: Outpatient drug-drug interaction information systems could provide prescribing suggestions for physicians to avoid inappropriate drug combinations and adverse reactions due to drug interactions for elderly patients.