| Summary: | 碩士 === 國立臺灣大學 === 預防醫學研究所 === 96 === BACKGROUND：
Because of multiple chronic diseases and co-morbidity, elderly people take more medications than younger people and might see different doctors at the same time. Besides, the inappropriate usage and management of medications will also increase the risks associated with medications such as adverse drug reactions and falls. Therefore, we will attach great importance to the appropriateness of medication in elderly people.
OBJECTIVE：
The aim of this study was to describe the prevalence of inappropriate medication and associative factors among community-dwelling elderly in Taipei City.
METHODS：
This is a cross-sectional study. Three hundred study populations were sampling from the elderly with chronic disease in Health Center of ZhongZheng District and 170 of them were interviewed between September, 2007 and December, 2007 (response rate=57%). Information of socio-demographic characteristics, health status, medication utilization and the characteristics of management of medication were collected with questionnaires designed by researcher ,a doctor ,a pharmacist , nurses and elderly. Finally, it examined the prevalence and associated risk factors of potentially inappropriate medication defined by updated Beers’ criteria among elderly in ZhongZheng District, Taipei city. The study has been approved by research ethics committee in college of public health, National Taiwan University.
RESULTS：
The average number of medication used by elderly among 170 respondents is 4.1. By using Beers’ Criteria, the prevalence of potentially inappropriate medication is 29.68% in 150 elderly in the analysis population. Most of them taking one inappropriate medication and 6 of 46 elderly with potentially inappropriate medication used potentially inappropriate medications related to specific medical conditions including Hyperplasia of prostate elderly patients, hypertension patients, Chronic obstructive pulmonary disease, gastric ulcers patients and Insomnia patients.The most commonly potentially inappropriate medication used by elderly were Dipyridamole、Doxazosin and Diazepam. According to the ATC classification system, blood & blood forming organs drugs, cardiovascular system drugs, muscle-skeletal drugs, nervous system drugs and respiratory system drugs are commonly used in elderly. Using univariate analysis , we investigated that (i) increased number of mediation use, living alone, increased number of self-reported disease, increased number of hospital visited, increased number of department visited and consumption of OTC drug users have higher risk of using potentially inappropriate medication. With multiple logistical regression model, we investigated the higher number of medication used by elderly is very important associated factor of potentially inappropriate medication.
CONCLUSION：
Elderly in community with potentially inappropriate medication was detected in one-third in this study. This study provides strong evidence that potentially inappropriate medication use for elderly is a substantial problem in community. Polypharmacy is independently associated with potentially inappropriate medication use. Therefore, improved pharmacological education of physicians, especially for drug adverse effects and teaching older adults how to self-manage medications are needed to improve the quality of medication in elderly population.
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