依據台灣長期照護專業協會於民國九十一年訂定的護理之家作業規範內容，藥師應每個月對護理之家住民進行“藥物治療評估”。藥師運用專業知識，有系統地評量住民的藥物治療，確保住民的藥物治療能符合適應症、有效、安全且服藥配合度高。在國外已有許多藥師在護理之家提供藥物治療評估服務，且成效也在許多文獻中被討論及記載，但是目前國內仍缺少相關之研究。
本研究為前瞻性研究，目的在建立藥師於護理之家提供“藥物治療評估”服務的模式；並經由此研究深入了解目前護理之家住民之基本特性及相關用藥問題，確認藥師在護理之家的專業介入空間；也期望經由直接提供專業知識及判斷服務，給醫護人員作參考，改善住民的療效結果。
研究由兩位藥師執行，在五個月中完成台灣省北區五所護理之家220位住民的藥物治療評估。結果顯示：住民平均年齡為77.7歲，有99.5%住民接受藥物治療，平均患有4.5種疾病，平均使用6.2種藥物，且有39.1%的住民其用藥至少存在一項藥物交互作用，而對健康影響較大的一、二級交互作用佔了45.2%。將資料經進一步分析後發現：平均每位住民有2.2種“發生藥物治療問題的潛在危險因子”，住民中有25.0%接受至少一種不適合老年人的藥物治療。藥師提出的建議中有43.8%被醫師接受，其中常見的藥物治療問題為「藥物選擇不適當」及「有不良反應」；藥師被接受的建議中，有77.1%對住民療效結果具正面影響。
本研究結果證實“藥物治療評估”服務是一項可執行並值得推廣的專業服務模式；護理之家住民的藥物治療中，確實存在藥師專業介入的服務空間且藥師的介入可改善住民的療效結果。

According to the “Nursing Home Practice Guideline” published by the Taiwan Long Term Care Professional Association in 2002, the pharmacist should provide “Drug Regimen Review” to the residents of nursing home at least once every month. In order to provide the resident with appropriate, safe, and effective drug therapy, pharmacists should evaluate the residents’ drug therapy with professional knowledge. Pharmacists in the other countries of the world have been offering drug regimen review in nursing homes for some times already, and those services have been documented and generally discussed in many literatures. However, similar published research and practice is lack of evidence in Taiwan society.
The purpose of this pilot study are (1)to establish the practice model of pharmacists providing “Drug Regimen Review” in nursing homes; (2)to find out the disease characteristics of residents in nursing home and their drug-related problems, and to identify the roles of pharmacist practice in nursing homes; and (3)to improve the residents’ outcomes of drug therapy by providing professional cognitive services from pharmacists. 
Two pharmacists conducted the study for a duration of five months. The drug therapy of 220 residents from 5 nursing homes in north Taiwan were reviewed. Residents in average was 77.7 years old, 99.5% were receiving drug therapy, there were 4.5 diseases/resident and taking average 6.2 medications. Thirty-nine percent of residents suffered at least one drug-drug interaction and 45.2% of which were 1st and 2nd degree significance. Further analysis indicated that each resident had 2.2 “potential risk factors of drug-related problem”, 25.0% of residents were receiving at least one inappropriate drug for elderly. There were 43.8% of suggestions provided by pharmacists accepted by physicians, the most frequent drug-therapy problems were “inappropriate drug selection” and “adverse drug effect”. There were 77.1% of accepted suggestions have positive impact on the residents’ therapeutic outcomes.
The results of the study demonstrated that the model of “Drug Regimen Review” is performable and should be encouraged. The nursing home needs pharmacist service. Pharmacist can have significant benefit to the outcome of residents’ drug therapy.