各層級醫療院所門診藥物交互作用分析 - 以全民健康保險學術研究資料庫為例

1. 各層級醫療院所門診藥物交互作用分析 - 以全民健康保險學術研究資料庫為例 • 中文摘要 • 藥物交互作用提高了對於民眾健康及生命的風險。然則台灣在這方面仍未有確實的統計數據足以佐證。本研究是利用全民健保研究資料庫的完整性，從全國門診處方明細檔中，分析全國各級醫療院所門診處方藥物交互作用的潛在發生情形。 • 研究目的是利用健保資料庫的完整性，從一年的門診就醫記錄中，針對不同等級醫療院所，進行一般門診案件的單一診次處方用藥藥物交互作用分析。 • 建置健保分析處理資料倉儲系統與藥物交互作用資料庫，利用資料處理的流程，以關連式資料庫與資料探勘的方法，從年約兩億多人次門診就醫處方中，做藥物交互作用分析，以瞭解不同等級醫院對於用藥安全之影響，進而探討不同就醫環境下用藥的差異。 • 研究結果發現，在一年195,770,950件處方簽 989,349,362項處方用藥下，經分析校正後，我們發現了潛在有31,313,542項的藥物交互作用發生，統計其發生率約為15.99%。而在台灣的四個醫療院所層級發生率，分別為醫學中心19.32%，區域醫院13.22% • ，地區醫院13.73%，基層診所16.83%。 • 研究分析結論是在台灣不同等級的醫療院所一般門診，單一處方中藥物交互作用發生率是有顯著差異的，而毛地黃（digoxin）則是分析結果中最常見發生藥物交互作用的主要成分。

2. Drug-drug interaction in multinomial ambulatory care Analyzing the National Health Insurance Research Database • 英文摘要 • Background: Adverse drug interactions increase morbidity and mortality. There is no exact statistical data till now in Taiwan. This study quantifies prescriptions with potential adverse drug interactions in ambulatory care over a year period in Taiwan. • Objectives: The purpose of this study was to explore the most common drug pairs of potential DDIs in a large claim database of ambulatory prescriptions in Taiwan. • Methods: All prescriptions administered in 2000 were analysed to identify potential interactions amongst drugs appearing on the same prescription sheet. The data was from the database of National Health Insurance. Potential DDIs were defined according to the drug pairs in the “Drug Interaction Facts， 2000ed”. Potential DDIs were analyzed in relational database integrated with data mining methods. • Results: There were 228,515,865 prescriptions including 989,349,362 medications during the study period. We found 63,798,362 potential DDIs. The prevalence rate of potential DDIs was 27.9%. The DDIs rates of 4 healthcare-classes in Taiwan were Medical Center， 44%， Metropolitan Hospital， 41%， Community Hospitals， 33%， Clinics， 23%。 • Conclusions: The prevalence of potential DDIs in Taiwan’s was different to hospitals of different size. Digoxin was the most common medication found in potential DDIs. The Grid computing structure is more efficent than centerized structure in this study.