2019-01-142024-05-14https://scholars.lib.ntu.edu.tw/handle/123456789/656986摘要：我國歷年管制藥品處方使用資料屢發現有醫療不當處方鎮靜安眠劑之狀況，其中將易被不當使用的藥物如Zolpidem等6項鎮靜安眠藥列入關懷名單，持續提醒醫師需謹慎評估後方可開立處方，然而我國鎮靜安眠類管制藥品的使用量仍有持續增加之態，期藉由本研究之執行，研析醫師處方行為及態樣、進行各項鎮靜安眠類管制藥品之濫用風險比較，預先採取相關防制策略，防杜管制藥品處方藥之濫用及流用。本計畫期望能了解我國鎮靜安眠類管制藥品使用現況，研析國內外處方BZD及Z-drug兩類藥品間之消長趨勢，及各層級醫療院所之執業醫師使用鎮靜安眠類管制藥品之處方行為及用藥態度，評估濫用風險及管道，並了解醫師是否對病人施予衛教、用藥教育，使病人能充分了解鎮靜安眠類管制藥品之副作用、危險性及正確的使用觀念。期本研究計畫探討醫師處方使用鎮靜安眠類管制藥品之各種相關因素，並透過辦理醫師教育宣導活動，增進醫師正當、合理使用成鎮靜安眠類管制藥品知能，以避免因醫師不當處方而導致病人濫用藥物成癮。預期完成工作項目包含以下: (1)蒐集103-107年我國與歐美等國家(至少包括美國ヽ英國ヽ中國大陸及日本等4個國家)醫師處方BZD及Z-drug等鎮靜安眠類管制藥品認知態度之相關文獻，並研析國內外處方BZD及Z-drug二類藥品中之代表性品項10項之間的消長趨勢。 (2)分析99-106年健保資料庫:(1)研析我國具濫用潛力之鎮靜安眠類管制藥品，評估其濫用風險，並研擬相關防制策略。(2)研析開立鎮靜安眠類管制藥品處方醫師之專科醫師類別及醫療院所類別間之關聯性。 (3)針對開立鎮靜安眠類管制藥品處方之劑量較一般使用量高之前三名專科醫師類別進行問卷調查，研析其對鎮靜安眠劑之用藥態度、處方行為及是否對病人進行衛教等，有效問卷數需達1,000份以上，並提出改善醫師對鎮靜安眠劑處方行為之具體建議。 (4)以醫師為對象，於台灣北區、中區及南區各辦理至少一場，總共五場正當合理處方使用鎮靜安眠類管制藥品之宣導活動，總計參加人數為500人次以上，且其中診所執業醫師(基層醫師)所有場次參加總人數至少為100人次。 (5)將成果撰寫成一篇文稿，並投稿至國內外期刊，發表本計畫之成果。<br> Abstract: From the existing records of controlled drug presciptions, it has been repeatedly found that there are medical improper prescriptions on sedatives and hypnotics. Some drugs, such as Zopidem and 5 others, with inappropriate prescription potentials have been placed on the list for close moniterings to remind physicians need to carefully evaluate the cases before prescriptions. However, the uses of sedative and hypnotic control drugs still continuously increase. By the implementation of this study, we will analyze the prescription behaviors and patterns of physicians, the risks associated with abuse of sedatives and hypnotics, and propose to take relevant prevention strategies to prevent controlled drugs being abused or flowed. This study will also understand the status of the use of sedation and sleep control drugs, to analyze the trend of the growth and decline of prescriptions BZDs and Z-drugs, and to assess the risk of abuse and the use of drugs by practicing physicians at all levels of medical institutions. Through questionnaires, it will be understood whether the physicians provide the patients medication relavent education and knowledge, so that the patient can fully understand the side effects, risks and correct uses of sedative and sleep controlled drugs. This research plan explores the various factors related to the use of sedation and sleep control drugs prescribed by physicians, and promotes the proper and rational use of medical knowledge by physicians in order to avoid the abuse of drug addiction caused by improper prescription of doctors.This research plan explores the various factors related to the use of sedatives and hypnotics prescribed by physicians, and promotes the proper and rational use of sedatives and hypnotics in order to avoid the abuse and addiction of hypnotics drug caused by improper prescriptions of physicians.The expected work items contain the following: (1)Collect literature about physicians’ prescription BZDs and Z-drugs from year 2014 to 2018 including Taiwan and other countires such as the United States, UK, China and Japan. To analyze the physicians prescription attidue and behavior toward sedative and sleep control drug. It will also be analyzed the trend between the uses of at least 10 representative items of the prescription BZD and Z-drugs.(2)To analysis of the year 2000 to 2017 Health Insurance Database: (1) research and analysis the abuse potential of sedatives and hypnotics, assess the risk of abuse, and develop relevant control strategies. (2) To explore the relationship between the categories of specialist physicians and various medical institutions the prescription patterns and differences for sedative and hypnotic control drugs. (3)According to the questionnaire survey of three specialist categories before the prescribed dosage of sedation and sleep controlled drugs was higher than that of general use, this paper investigates the attitude of drug use, prescription behavior and whether or not to carry out health education to patients. The number of valid questionnaires should be carried out more than 1,000. Suggestions on improving the prescription behaviors of sedative sleep agent by physicians. We will propose some principles related to sedatives and hypnotics. (4)Taking physicians as the target audiences, in the north, central and southern districts of Taiwan, provide at least five educational speeches to physicians who can advance their professional competencies on prescribing hepnotics and sedatives. It is expected to include at least 500 physicians (in whom at least one-third or 100 ones being LMD, or local medical doctors). (5)Write a manuscript to disseminate the results and submit it to domestic or international journals to publish the results of this study.鎮靜安眠藥物處方行為BZD及Z藥物鎮靜安眠藥物濫物sedativs and hypnoticsprescription behaviorsBZD& z-drugssleep pills abuse