2015-08-012024-05-13https://scholars.lib.ntu.edu.tw/handle/123456789/648201摘要：潛在不適當用藥(potentially inappropriate medications, PIM) 在所有臨床場所皆會發生，改善用藥安全已成為重要的議題，資訊科技產品可協助醫護人員預防不良藥物事件和PIM。本研究為三年期研究計畫，第一階段包括前瞻性量性研究和質性研究，以臺灣北部一家醫學中心的老年科病房為研究場所，透過結構性問卷，包括共病症指數、簡易心智狀況問卷、日常生活活動功能量表、服藥遵從行為量表和2012 AGS Bees 潛在不適當用藥準則，預計探討200 位老人出院後3 個月PIM 之型態與影響因素，同時也藉由半結構式訪談指引了解社區多重用藥老人和居家護理師對用藥安全資訊科技之內容與功能需求，預計訪談人數至資料收集飽和為止；第二階段為「雲端藥你安心E點通」應用程式(application,APP)設計開發，依據瀑布模式設計流程，並以2012 AGS Beers 潛在不適當用藥準則作為藍本，加上第一階段研究結果，設計符合護理人員使用的用藥衛教和PIM 評估工具；第三階段為描述性相關性研究測試APP 之穩定性，並以科技接受模式，以自擬的結構性問卷，包括認知有用性、認知易用性、使用態度、使用行為意向等量表，預計收集大臺北地區10 家獨立型居家護理所之60 位居家護理師檢視300位居家訪視老人用藥及PIM 狀況，驗證居家護理師對此APP 使用之看法和感受。所得量性資料以SPSS20.0 套裝軟體編碼和輸入資料，以描述性統計、獨立t 檢定、單因子變異數分析、皮爾森積差相關和羅吉斯迴歸等做統計分析，所得質性錄音資料撰寫成逐字稿後以內容分析法作資料分析。預期本研究結果可協助醫療人員了解老人出院後PIM 之類型與其影響因素，以及完成開發、測試和驗證「雲端藥你安心E 點通」APP，以利做為未來介入性研究的工具。<br> Abstract: Using potentially inappropriate medications (PIM) is common and improving medication safety hasbecome one of the major issues in all clinical settings. Information technology (IT) plays an important role toprevent adverse drug events (ADEs) and PIM. This 3-year research proposal will be conducted in threephases. The first phase is a combined prospective quantitative and qualitative research design. Structuredquestionnaires, including Charlson Comorbidity Index (CCI), Short Portable Mental Status Questionnaire(SPMSQ), Activities of Daily Living (ADLs) and Instrumental Activities of Daily Living (IADLs),Medication Adherence, and 2012 AGS Beers criteria for PIM will be used for exploring types anddeterminants of PIM in 200 older patients 3-month after hospitalization. Data will be collected in thegeriatrics ward of a medical center in northern Taiwan. Semi-structured in-depth interviews will be used tounderstand the needs and expectations for IT products in assisting medication safety in these older adults andhome care nurses. Number of participants recruited will be dependent on data analysis shows saturation forquality information. In the second phase, based on 2012 AGS Beers criteria for PIM and research findingsfrom the first phase, the medication safety application (APP) will be designed and developed throughWaterfall Model. In the third phase, testing the stability and validation of APP will be conducted bydescriptive and correlational study through Technology Acceptance Model (TAM). Based on TAM,structured questionnaire, including Perceived Usefulness, Perceived Ease of Use, Attitude toward Using andBehavioral Intention to Use, will be used for data collection after home care nurses have used the APP formedication review and recognition of PIM. Sixty home care nurses with 300 medication reviews by APP willbe recruited. All the quantitative data will be coded and entered to the computer system. Statistical analysiswill be carried out with SPSS 20.0 software package. Both descriptive and inferential, such as independent ttest, one-way ANOVA, Pearson product moment correlation and logistic regression, will be used to analyzethe data. All the interview data will be transcribed verbatim. Content analysis will be used to categorize theinformation. The results will help health care professionals understand the types and determinants of PIM inolder patients after discharge. The newly developed APP will be used as a useful tool in assisting nurses formedication review, and early recognition of PIM. The results of the study will be used to set up interventionprogram for PIM.老人潛在不適當用藥Beers 準則應用程式APP科技接受模式older adultspotentially inappropriate medicationsBeers criteriaapplication (APP)Technology Acceptance Model