The Study of Factors Associated with Prescription of Sedatives and Hypnotics by Physicans

• Main Authors: Shu Wen Cheng, 鄭淑文
• Other Authors: K. H. Hsu
• Format: Others
• Published: 2009
• Online Access: http://ndltd.ncl.edu.tw/handle/54357208131093740863

碩士 === 長庚大學 === 醫務管理學研究所 === 97 === According to Statistics, Benzodiazepines, a Sedatives and Hypnotics drug, was constantly ranked as the top third commonly prescribed drugs in psychiatric health care settings in Taiwan. Researches have shown that the dosage of Sedatives and Hypnotics was rising worldwide during the past few years. The Bureau of National Health Insurance has reported that the prescription of Zolpidem, a short-acting hypnotics, has hit the record high in the amount in 2007 with a 2.17 folds higher average dosage than that of 2003. The unusually high consumptions of such medication drugs in Taiwan directed research issues in the causes and distributions of the alterations. This study aims to analyze the prescription of Sedatives and Hypnotics in a psychiatric care setting from the perspectives of doctor-related factors, prescription patterns, and patient-related variables. This study has found that the prescription of Sedatives and Hypnotics was counted as 53.03 percent among all prescribed drugs. The mean age of the study subjects was counted as 44.31 years old with a range from 41 to 64 years old. Patients prescribed with such drug medictions were found majorly as women, emergency admision, and suffering from neurosis. The characteristics of physicians prescribing the drugs were shown as aged above 51 years old, having 11 to 15 years of practice, and certified by professional accreditation at least 16 years. There were 8.94 percent of multiple prescriptions among all the prescribed Sedatives and Hypnotics drugs, which occured frequently among female patients aged from 19 to 40 years old, national health insurance holder, and suffering from neurosis. The physician factors were found as male residents, aged above 51 years old, having 11 to 15 years of practice, and certified by professional accreditation at least 16 years. Overdose prescriptions were accounted for 27.89 percent among all the prescribed Sedatives and Hypnotics drugs, which were frequently found in male patients aged from 41 to 64 years old, suffering from catastrophic illness and sleep disorder. The physicians frequently prescribing such drugs were found as male residents aged 51 and above, having at least 16 years of practice, and with professional accreditation of 11 to 15 years. Over amount prescriptions were counted as 47.69 percent of all the prescribed Sedatives and Hypnotics drugs, which frequently occured among male patients, aged above 65 years old, suffering from catastrophic illness and sleep disorder. The physicians frequently prescribing such drugs were male residents, aged from 21 to 30 years old, having practice for 6 to 10 years, and obtaining professional accreditation for 11 to 15 years. This study thus concludes that the high risk group of incorrect prescriptions can be monitored by data dragging from computer systems. A feedback system can be adopted from the results of this study. In clinical practices, specific clinical guidelines can be made from this analysis. This study offers suggestions to issues in patient safety and health care policies, which can be improved by well designed systems and on-job trainings.