Chen Chang-Ming, Kuo Li-Na, Cheng Kuei-Ju, Shen Wan-Chen, Bai Kuan-Jen, Wang Chih-Chi, Chiang Yi-Chun, Chen Hsiang-Yin
Department of Clinical Pharmacy, School of Pharmacy, Taipei Medical University, Taipei, Taiwan; Department of Pharmacy, Taipei Medical University-Wan Fang Medical Center, Taipei, Taiwan.
Department of Internal Medicine, Wan Fang Hospital, Taipei Medical University, Taipei, Taiwan.
Comput Methods Programs Biomed. 2016 Oct;134:109-19. doi: 10.1016/j.cmpb.2016.07.008. Epub 2016 Jul 6.
This study evaluated a medication therapy management service using the Taiwan National Health Insurance Administration's PharmaCloud system in a medical center in Taiwan. The new PharmaCloud System, launched in 2013, links a complete list of prescribed and dispensed medication from different hospitals, clinics, and pharmacies for all insured patients.
The study included patients with polypharmacy (≥5 drugs) at a medication therapy management service from March 2013 to March 2014. A structured questionnaire was designed to collect patients' baseline data and record patients' knowledge, attitudes, and practice scores before and after the service intervention. Phone follow-ups for practice and adherence scores on medication use were performed after 3 months.
There were 152 patients recruited in the study. Scores for medication use attitudes and practice significantly increased after the service (attitudes: 40.06 ± 0.26 to 43.07 ± 0.19, p <0.001; practice: 33.42 ± 0.30 to 40.37 ± 0.30, p <0.001). The scores for medication adherence also increased from 3.02 ± 0.07 to 3.92 ± 0.02 (p <0.001).
The PharmaCloud system facilitates accurate and efficient medication reconciliation for pharmacists in the medication therapy management service. The model improved patients' attitudes and practice of the rational use of medications and adherence with medications. Further studies are warranted to evaluate human resources, executing costs, and the cost-benefit ratio of this medication therapy management service with the PharmaCloud system.
本研究在台湾的一家医疗中心评估了一项使用台湾国民健康保险署的药云系统的药物治疗管理服务。新的药云系统于2013年推出，它将所有参保患者在不同医院、诊所和药房开具和配发的完整药物清单连接起来。
该研究纳入了2013年3月至2014年3月在药物治疗管理服务中使用多种药物（≥5种药物）的患者。设计了一份结构化问卷来收集患者的基线数据，并记录服务干预前后患者的知识、态度和实践得分。在3个月后通过电话随访了解药物使用的实践和依从性得分。
该研究共招募了152名患者。服务后，药物使用态度和实践得分显著提高（态度：40.06±0.26至43.07±0.19，p<0.001；实践：33.42±0.30至40.37±0.30，p<0.001）。药物依从性得分也从3.02±0.07提高到3.92±0.02（p<0.001）。
药云系统有助于药物治疗管理服务中的药剂师进行准确、高效的药物核对。该模式改善了患者合理用药的态度和实践以及药物依从性。有必要进一步研究评估这项使用药云系统的药物治疗管理服务的人力资源、执行成本和成本效益比。
