本文為瞭解藥師對用藥錯誤的病患進行用藥指導之類別及其比率，以提供藥師臨床業務規劃執行及臨床工作者之參考。以某市立醫院新陳代謝科之門診糖尿病患為對象，於民國 96 年 4、5  月間曾列有藥師服務記錄，且有用藥問題者予以收案120 人，平均年齡63.9，平均糖化血紅素8.4%。病患用藥錯誤經藥師提供用藥指導共203件，其中依順性不佳佔94 件(46.3%)為最高，胰島素注射時間不符醫囑48 件(23.7%)次之，用藥錯誤經指導更正者過半數(109 件)。病人對藥師提供用藥指導之接受度高，對於病患用藥需要持續的追蹤。 

Diabetes mellitus is one of the most important chronic diseases worldwide.Intensive glycemic control may delay its progression,reduce the risk of complications and medical expenditure, as well as improve the quality of life. Pharmacists participated in the medical team of disease management. and patient drug counsel is very important. This study described Pharmacist services for the  diabetic  patients   with   the medicine using problem.

The pharmacist reviewed the records of diabetic outpatients in Taipei City Hospital between April and May, 2007. 120 patients with medicine used inappropriately were  included.
The average age is 63.9 years old and the average glycosylated hemoglobin value is 8.4% in investigated patients.Pharmacists provided total 203 items of drug counsel for medicine used inappropriately patients. The most common error is poor compliance 94 (46.3%), followed by insulin administrated at wrong time 48 (23.7%). More than half (109) of the medicine inappropriate usage were corrected. Continuous follow-up for the medicine used inappropriately patients is needed.