| Summary: | 碩士 === 長庚大學 === 醫務管理學系 === 99 === Adverse drug reactions cause higher medical consumptions and poor patient outcomes of which become a critical issue for health care systems. Moreover, repeated ADRs resulted in more adverse consequences are still scarcely reported. This study aims to explore factors associated with the occurrence of repeated ADRs. The investigation will provide valuable information for healthcare providers to construct a more safe system to improve care quality and medication safety.
A nested case-control design was adopted for repeated ADR cases and their matched controls including single-ADR cases and non-ADR cases during 2006-2010. Factors associated with repeated ADR were analyzed by conditional logistic regression. The predictive models for medical consumptions were analyzed by conditional linear regression.
Admitted department and number of drug prescriptions were two significant predictors while comparing between repeated-ADRs cases and single-ADRs cases. Number of secondary diagnoses, number of drug prescriptions, number of drug classes, and characteristics of attending physicians were significant factors while comparing repeated-ADRs cases with non-ADRs cases. Furthermore, medical consumptions were found increasing in the order of non-ADRs cases, single-ADRs cases, and repeated-ADRs cases.
The prevention of ADRs is a responsibility by all health care providers including physicians, nurses, pharmacists, administrators, and patients. The improvement of medication safety can be found through many pathways including on-job trainings, information technology assisted expert systems, and health educations. The problems of repeated-ADRs as demonstrated by the administrators in health care sectors.
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