社團法人臺灣臨床藥學會

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【原著】老年人潛在性不當用藥準則STOPP Version 2 Criteria繁體中文版的發展與驗證
Development and Verification of Traditional Chinese Version of STOPP Version 2 Criteria
老年人、潛在性不當用藥、Screening Tool of Older People’s Prescriptions 準則、Elderly, Potentially Inappropriate Medications, Screening Tool of Older People’s Prescriptions Criteria
顏祥Hsiang Yen1 、黃輝慶Hui-Ching Huang黃輝慶1,2,* 、林俊宏Chun-Hung Lin3 、吳佩霖Pei-Lin Wu4 、羅惠珍Hui-Chen Lo4
1衛生福利部玉里醫院藥劑科 、2慈濟科技大學自然學科 、3法務部矯正署桃園監獄教化科 、4台南市立醫院(委託秀傳醫療社團法人經營)藥劑科
註: 經讀者來信指正,本篇文章附錄二(293 頁)E1 項內容之125 mcg 誤植為125 mg,故本版本將其更正為125 微克,同頁F4 項內容中之mg 則一併更改為毫克,特此勘正說明。

目的:人口老化是全球性的現象,臺灣已正式邁入高齡社會,如何為老年族群提供合適的醫療照護是最具挑戰的公衛議題之一。國內評估老年人用藥的相關研究均使用英文版本的準則工具,評估者很難避免因不同語言文化造成的誤解,導致研究或臨床評估結果的偏差,本研究主要目的是依據對跨文化研究工具所設計之翻譯流程發展screening tool of older people’s prescriptions (STOPP) version 2 繁體中文版,提供國內醫療人員在篩檢老年人潛在性不當用藥時的合適評估工具,進而提升老年人用藥的適當性與安全性。
方法:STOPP version 2 criteria 繁體中文版的發展過程包含翻譯與心理計量分析兩個階段。本研究分別於區域教學與精神專科教學醫院各收案門診老年患者200 名,以翻譯最終版本評估個案處方中的潛在性不當用藥。
結果:STOPP version 2 criteria 繁體中文版的內容效度優良 (S-CVI = 0.94),不同評估者間的信度良好 (κ = 0.8, p < 0.001)。在精神專科教學與區域教學醫院門診老年病患檢測到的潛在性不當用藥盛行率分別為83.0% 與31.5%。
結論:STOPP version 2 criteria 繁體中文版的適讀性高且具有良好的信效度,能應用於不同醫療機構老年病患處方中潛在性不當用藥的評估,本研究的成果除了提供國內臨床醫療工作者在評估老年病患潛在性不當用藥時的合適工具外,亦呈現國內不同醫療機構門診老年病患潛在性不當用藥之盛行率。

Objective: Aging populations are a global phenomenon, so appropriate medical care for the elderly is critical. Taiwan is already an aged society, so greater focus on improving medication appropriateness for the elderly is needed. Previous studies in Taiwan have utilized English assessment tools, thus misinterpretations due to variations in language and culture can be difficult to avoid. The purpose of this study is to develop a traditional Chinese version of the screening tool of older people’s prescriptions (STOPP) criteria, used for assessing potentially inappropriate medications (PIMs), for clinical usage to enhance the appropriateness of medications for elderly patients in Taiwan. 
Methods: A two-stage design of the translation and psychometric process was adopted to translate the 2015 STOPP version 2 criteria into traditional Chinese. To detect the prevalence of PIMs, 400 elderly outpatients were recruited from different institutions. The traditional Chinese version of the STOPP version 2 criteria was used to identify PIMs.
Results: The scale-level content validity index of the traditional Chinese version of the STOPP version 2 criteria was 0.94, and the inter-rater agreement was strong, κ = 0.8. Therefore, the created version is as reliable as the original English version. According to the traditional Chinese version, the prevalence of
PIMs tested in a metropolitan teaching hospital and a psychiatric teaching hospital was 31.5% and 83.0% respectively.
Conclusions: In addition to developing an instrument with satisfactory validity and reliability for PIMs assessment, this study’s results revealed the prevalence of PIMs among elderly outpatients in different institutions in Taiwan.
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