隨著國人平均餘命的增長，健康相關議題逐漸受到重視，有關老年特殊族群之慢性病照護及其相關之用藥安全已成為維護病人安全的重要環節。老年人因生理機能退化，且易罹患多種慢性疾病，故屬於多重藥物使用族群。然而，多重藥物的使用亦容易引發藥物之間的交互作用，導致不良反應的發生。研究指出，當服用1 ~ 2 種藥物時，藥物不良反應的發生率為5.6 ~ 10.0%；一旦增加至9 種以上，則潛在用藥危險將高達41%，進而造成相關臥床、死亡率的上升，並增加不必要的醫療支出成本，故用藥安全實為老人預防醫學的重要課題。本文運用公共衛生疾病預防概念，針對國內老年人藥物使用現況、行為及認知態度進行相關文獻回顧，並介紹以民眾用藥安全為導向之三段五級預防策略，並針對用藥安全相關衛生教育及藥事照護在維護老人族群之用藥安全之初段及次段預防的目的及重要性進行說明。期許醫療院所、社區藥局及其他基層醫事執業處所之藥師於提供民眾及醫事人員藥事服務時，能夠以病人的福祉為中心，為民眾的用藥安全進行把關。
With the prolongation of life expectancy, interest in health-related issues has been gradually increasing. Chronic illness care for the elderly and related medication safety issues have become an important aspect in maintaining patient safety. Owing to the degeneration of the physiological function, the elderly tend to have multiple chronic diseases at the same time; therefore, polypharmacy is common among them. However, polypharmacy can easily cause drug-drug interactions, which can further cause adverse drug reactions
(ADRs). Studies have found that when taking 1 or 2 drugs, the rate of ADRs is 5.6–10.0%, whereas, when taking 9 or more, the rate would increase up to 41%, and also lead to being bed-ridden, increased mortality and unnecessary medical cost. Therefore, medication safety has become a big issue in the preventive medicine of the elderly. Using the concepts of public health and disease prevention, this article carried out literature review targeting research that discussed the present situation, behavior and cognitive attitude of drug use in the domestic elderly population. Furthermore, it also introduces the three levels and five stages of preventive medicine which focuses on public medication safety. In addition, medication safety related health education and pharmaceutical care are targeted to explain the objectives and importance of preliminary and secondary prevention in the maintenance of medication safety among the elderly. It is hoped that all pharmacists, whether in medical institutions, community pharmacies or other health care institutes, can focus on patient welfare and ensure the medication safety of the public when offering pharmaceutical services to both the public and medical professionals.
