| Summary: | 碩士 === 中國醫藥大學 === 醫務管理學研究所碩士班 === 97 === Objective：In recent years, drug safety has emerged to become one of the mainstream topics in the field of drug usages and medical practices. To maintain tight budget control, the Bureau of National Health Insurance (BNHI) started to eliminate bill coverage for controlled drugs. The Drug Alerting System, or DAS, then becomes one of the most effective tools to verify prescriptions for controlled drugs.
However, the DAS is not fully deployed in many small to mid-size hospitals in Taiwan, and many physicians also do not pay attention to the alerts provided by the DAS. Thus, the purposes of this research include 1) understanding the effectiveness of the DAS; and 2) researching factors that lead physicians to ignore alerts.
Method：This study first conducted a magnitude assessment on the level of warning message ignorance by physicians. Prescriptions from three local hospitals were collected as data for the assessment, and the collection period is from July 2008 to September 2008. Then, a factorial analysis was conducted with that sample population including only physicians whose prescriptions were collected for the assessment. Data analysis methods include descriptive analysis, t test, ANOVA test, and regression analysis.
Result：The analysis revealed that the overall significance for the DAS, on average, is 3.93, and satisfaction of usability, on average, is 3.40. Among all constructs, physicians perceive that easy to operate and message feedback are two of the most important dimensions, while simplified operating procedures is the worst dimension. The analysis further indicated that the factors leading physicians to ignore alerts include the educational level of physicians and the level of understanding that physicians have for prescribed drugs.
Conclusion and suggestion：Overall, respondents, or physicians surveyed in this study, approve the importance of the DAS, but they still perceive room for improvements for the DAS. Suggestions for the DAS deployments include 1) the DAS can incorporate patient health assessments in its decision algorithms; and 2) consensus about the measuring indexes should be established among physicians, and hence, physicians will be more willing to utilize the DAS. In the future, the study can be extended to include physicians from medical centers or regional hospitals as the sample population.
Keywords： drug alert system、effectiveness、influence factors、incorrect prescriptions、medication errors
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