藥物時程的服用時間彈性和劑量合併之機制

Abstract

非住院病人的藥物服用是現今醫療保健過程中最容易出錯的一環。多數的服藥錯誤發生在病人同時服用來自不同醫院、診所之處方用藥，和藥局購買的非處方用藥，卻沒有充分了解與遵守用藥指示，尤其年長病人及慢性病患者特別容易發生這種錯誤。本論文中，我們提出Wedjat，一個在行動手機上使用的藥物提醒與監控工具 (Medication Reminder and Monitor, MRM)以及我們設計的藥物時程劑量分群的機制，目的是減少病人的服藥次數，增加緊急的藥的服用機會，同時增加劑量服用時間的彈性，我們利用多維評估因素決策方法來決定最佳的分群組合。Wedjat有三個主要的特色: (1)遵守藥物指示與處方籤，計劃適當的服藥時程，同時避開潛在的藥物-藥物/藥物-食物交互作用；(2)控制服藥劑量，保持在適當的安全劑量範圍；(3)將時程接近的藥，合併在一起服用，減少繁複的提醒。Wedjat會維護使用者所有的用藥記錄，和家中主機的資料庫進行同步或上傳至遠端個人健康記錄伺服器(Personal Health Record Server, PHR)，做為往後醫療之用。

Out-patient medication administration has been the most error-prone process in contemporary health care. Most medication administration error was made when patients take various medicines from different sources at one time and with little or no directions, such as prescriptions from different doctors, over-the counter medicines from several drug stores and nutritional supplements. Especially, Elderly or chronic ailment patients are likely to make these mistakes. In this paper, we present Wedjat, a mobile phone based medication reminder and monitor to prevent these medication administration errors. We design a mechanism of dose grouping to decrease the number of in-take times and assign each in-take to a sufficiently long time slot and increase chances of taking emergency doses. Wedjat remind patient to take correct doses in right time and note down the in-take record for future medical care use. Three significant features of Wedjat are: (1) plan a proper intake schedule obey all intake medication directions and prescriptions and avoid all latent medicine-food/ medicine-medicine interactions; (2) control in-take dosage rate in safe range; (3) group in-take doses which in-take time are close to each others to prevent complicated remind. Wedjat maintains patient’s intake records and synchronize with local host database or upload to remote Personal Health Record Server.