目的：臺灣版潛在性不適當用藥 (PIM-Taiwan) 準則為一套省時又方便供醫療人員應用之準則。本研究目的在於將PIM-Taiwan 導入，建立本院的潛在性不適當用藥準則並臨床運用。一、探討本院老年病人使用PIMs 的情形。二、探討使用「電腦輔助開方警告系統」(computer assisted prescription alert system, CAPAS) 對於院內PIM 使用之影響，並推廣該系統的使用。

方法：一、參考臺灣版潛在性不適當用藥 (PIM-Taiwan) 準則，結合本院之藥物品項，以制定本院之PIM。二、向醫師進行教育訓練，以提升對PIM-Taiwan 之認知。三、評估教育訓練的介入對本院PIM 使用情形之影響。四、評估CAPAS 的介入對本院PIM 使用情形之影響。

結果：本院門診處方之PIM 比率較住院為高 (2.930% vs. 0.184%)，最常見為長期使用肌肉鬆弛劑 (0.799%) 以及長期使用長效鎮靜安眠藥品 (0.780%)。CAPAS導入後， 門診PIM 在antihistamine (H1 blocker) 及cimetidine (H2 blocker) 之下降較為顯著， 有統計上的意義 (H1 blocker 由總件數637 件降至357 件，p < 0.001；cimetidine 由總件數269 件降至185 件，p = 0.001)。

結論：教育訓練對於PIM 之成效有限。CAPAS 在有可直接替代品項者，醫師接受度則較為高；但對於只建議短期使用之藥品方面，則醫師之接受度較低。
 

Objectives: Potentially inappropriate medication-Taiwan, the time-efficient criteria for medical staff using. Our research aim is to develop our potentially inappropriate medication criteria and apply to our hospital. 1. to determine the population of PIM-Taiwan criteria among geriatric patients in our hospital. 2. to determine the effectiveness of the computer-assisted prescribing alert system” (CAPAS) on PIM prescriptions for older adults in regional hospitals and to promote the utilization of the CAPAS.

Method: 1. To develop PIM Criteria in our hospital. 2. To improve the knowledge of PIM-Taiwan Criteria by education to doctors. 3. Comparing the effectiveness of education on PIM incidence. 4. Comparing the effectiveness of the CAPAS on PIM incidence.

Results: In our research, the PIM incidence of outpatients is higher than inpatients (2.930% vs. 0.184%). The most common PIM incidence of outpatients is long-term using muscle relaxants (0.799%) and long-term using long acting benzodiazepines (0.780%).After CAPAS, number of antihistamine (H1 blocker) and cimetidine (H2 blocker) were significant decreased in outpatients (H1 blocker: 637 to 357, p < 0.001) (cimetidine:269 to 185, p = 0.001).

Conclusions: Education and training for the limited effectiveness of PIM. It is acceptable if we give the alternative drugs in CAPAS, but is difficult to change the long-term rescriptions.