Summary: | 碩士 === 國防醫學院 === 公共衛生學研究所 === 104 === Objective : The prevalence of major depression and chronic insomnia in Taiwan is increasing with social changes and lifestyle modernization. Our study evaluated the frequency of duplicate hypnotic and antidepressant medication and the factors affecting it, by analyzing data extracted from outpatient department (OPD) of a medical center in northern Taiwan.
Methods : Data is extracted from the 2015 OPD records of a medical center in northern Taiwan. The National Health Insurance (NHI) Pharmaceutical Subsidy Anatomical Therapeutic Chemical (ATC) classification system was used to extract the pharmaceutical classification records. The cases included were then divided into 3 subgroups: patients taking antidepressants, patients taking hypnotics, and patients taking both antidepressants and hypnotics. In each subgroup we compare the demography, medical seeking behavior and clinical data between patients receive or do not receive duplicate medication. These data was analyzed by SPSS version 20.0 calculating percentage, average, standard deviation, chi-square test and independent-samples t test, to describe the epidemiologic characteristics. Logistic regression was applied to evaluate the factors affecting duplicate medication, and p value <0.05 was considered significant.
Result : Total case number was 28,389 and 28.91% of them have received duplicate medication. 59.20% are female, and most of them aged between 60 to 69 years old (23.19%), with second most aged between 50 to 59 years old (19.67%). The average number of OPD visit is 9.6. 92.83% of the patients received prescription for 28-day medication, and 16.62% have elevated serum creatinine concentration.
Conclusion : The common factor of duplicate medication in the three subgroups of our study is the increased number of OPD visit. Therefore we suggest establishing correct medical seeking behavior and medication safety recognition, decreasing the frequency of OPD visit to reduce the incidence of duplicate medication.
Key words : antidepressant, hypnotic, duplicate medication, inappropriate prescription
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