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完整後設資料紀錄
DC 欄位 | 值 | 語言 |
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dc.contributor.advisor | 賴美淑(Mei-Shu Lai) | |
dc.contributor.author | Tzu-Chiao Fang | en |
dc.contributor.author | 方姿喬 | zh_TW |
dc.date.accessioned | 2021-05-13T08:36:18Z | - |
dc.date.available | 2019-08-26 | |
dc.date.available | 2021-05-13T08:36:18Z | - |
dc.date.copyright | 2016-08-26 | |
dc.date.issued | 2016 | |
dc.date.submitted | 2016-08-15 | |
dc.identifier.citation | 1. 衛生福利部國民健康署, 民國102年癌症登記年報. 2016.
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dc.identifier.uri | http://tdr.lib.ntu.edu.tw/jspui/handle/123456789/3735 | - |
dc.description.abstract | 研究目的 此研究欲分析臺灣癌症病人生命末期之鴉片類藥物利用,包含是否開立鴉片類藥物、鴉片類藥物累積劑量,並分析族群特性與鴉片類藥物利用之相關性。
病人及研究方法 這是一篇橫斷性研究,使用臺灣健保資料庫2005年承保抽樣歸人檔中的四萬人,篩選出2005-2007年死亡之癌症病人,共152位癌症病人納入分析。分析全體癌症病人死亡前三個月之鴉片類藥物利用。針對腸胃道癌症病人,使用多元邏輯斯迴歸、多層次邏輯斯迴歸及廣義線性模型分析其鴉片類藥物利用之相關因子。 研究結果 本篇研究癌症病人於死亡前三個月鴉片類藥物開立率為78.4%,其鴉片類藥物累積劑量之中位數為670 mg OMEQ(oral morphine equivalent)(標準差, 3928)。在藥物種類分析中,morphine是最主要的鴉片類用藥(開立率: 69.2%、總累積劑量:156,000 mg OMEQ);而在弱效鴉片類用藥中,則以tramadol為主要用藥(開立率: 46.7%、總累積劑量:62,805 mg)。而腸胃道癌症病人鴉片類藥物利用分析中,經校正後,鴉片類藥物開立率以2007年最高(OR=8.28, 95%CI=1.03-66.37);共病症分數為2分者,鴉片類藥物累積劑量預估值較高(2,357, P=0.037)。 結論 臺灣的癌症病人多數於生命末期曾被處方鴉片類藥物。在鴉片類藥物中,主要用藥為morphine;而弱效鴉片類主要用藥為tramadol。鴉片類藥物利用較高之相關因子包含死亡年份為2007年及共病症分數為2分者。 | zh_TW |
dc.description.abstract | Purpose This study aimed to analyze opioid utilization of Taiwan cancer patients at the end of life. Opioid prescripation rate, accumulated opioid dose and factors associated with opioid utilization were determined.
Patients and Methods We conducted a cross-sectional study based on Longitudinal Health Insurance Database 2005 from National Health Insurance Research Database in Taiwan. All cancer patients who died during 2005-2007 were identified (N=152) and opioid utilization during the last three months of life were analyzed. Among patients with gastrointestinal cancer (N=78), factors associated with opioid utilization were analyzed by logistic regression, multilevel logistic regression, and generalized linear model. Results The opioid prescription rate was 78.4%.The median accumulated opioid dose was 670 mg oral morphine equivalent(OMEQ)(Standard Deviation: 3,928). Morphine was the mainly prescribed opioid (prescription rate: 69.2%, OMEQ: 156,000 mg), while tramadol was the mainly prescribed weak opioid (prescription rate: 46.7%, OMEQ: 62,805 mg).For patients with gastrointestinal cancer, opioid prescription rate was higher if patients died in 2007(OR:8.28, 95%CI=1.03-66.37) and the estimated opioid dosage was higher for patients with Charlson comorbidity index=2(estimate:2,357, P=0.037) after adjustment. Conclusion Most cancer patients in Taiwan were prescribed with opioids at the end of life. The mostly prescribed opioids was morphine, and the mostly prescribed weak opioids was tramadol. Factors associated with higher opioid utilization were patients died in 2007 and with Charlson comorbidity index=2. | en |
dc.description.provenance | Made available in DSpace on 2021-05-13T08:36:18Z (GMT). No. of bitstreams: 1 ntu-105-R02847024-1.pdf: 1240956 bytes, checksum: c3f15af07f33bd9d2601ed10f7a8b16d (MD5) Previous issue date: 2016 | en |
dc.description.tableofcontents | 論文口試委員審定書 I
致謝 II 中文摘要 III 英文摘要 IV 第一章 導論 1 第一節 實習單位特色與簡介 1 第二節 研究背景及動機 1 第二章 文獻探討 2 第一節 癌症疼痛的流行病學、治療準則及控制現況 2 第二節 鴉片類藥物利用測量單位 4 第三節 鴉片類藥物利用分析 5 一、國際間鴉片類藥物消耗量比較 5 二、單一國家鴉片類藥物利用分析 7 三、癌症病人鴉片類藥物利用分析 9 四、安寧照護病人鴉片類藥物利用分析 10 第四節 影響鴉片類藥物利用之相關因子 14 第五節 癌症病人生命末期研究設計 16 第三章 研究方法 18 第一節 研究目的 18 第二節 研究架構 18 第三節 資料來源 19 第四節 研究族群 20 第五節 研究變項之定義 21 第六節 資料處理及分析 27 第四章 研究結果 29 第一節 研究族群描述性分析 29 第二節 鴉片類藥物利用分析 35 一、平均每人鴉片類藥物累積劑量 35 二、藥物種類分析 36 三、強弱效分析 39 四、使用途徑分析 40 第三節 腸胃道癌症病人鴉片類藥物利用相關因子分析 40 一、腸胃道癌症病人鴉片類藥物利用分析 41 二、腸胃道癌症病人是否使用鴉片類藥物之迴歸模型 45 三、腸胃道癌症病人鴉片類藥物累積劑量之廣義線性分析 47 第五章 討論與建議 49 第一節 研究討論 49 一、鴉片類藥物開立率 49 二、平均每人鴉片類藥物累積劑量 50 三、藥物種類分析 50 四、強弱效鴉片類藥物利用 51 五、途徑別鴉片類藥物利用 52 六、腸胃道癌症病人鴉片類藥物利用相關因子 52 第二節 研究限制 53 第三節 建議 54 一、對實務實習單位之回饋 54 二、未來研究方向 54 第六章 結論 55 參考文獻 56 附錄 61 | |
dc.language.iso | zh-TW | |
dc.title | 癌症病人生命末期鴉片類藥物利用 | zh_TW |
dc.title | Utilization of Opioids in Cancer Patients at the End of Life | en |
dc.type | Thesis | |
dc.date.schoolyear | 104-2 | |
dc.description.degree | 碩士 | |
dc.contributor.coadvisor | 施玲娜(Ling-Na Shih) | |
dc.contributor.oralexamcommittee | 季瑋珠 | |
dc.subject.keyword | 癌症病人,生命末期,鴉片類藥物,健保資料庫,藥物利用分析, | zh_TW |
dc.subject.keyword | cancer patient,end of life,opioids,NHIRD,drug utilization study, | en |
dc.relation.page | 62 | |
dc.identifier.doi | 10.6342/NTU201602782 | |
dc.rights.note | 同意授權(全球公開) | |
dc.date.accepted | 2016-08-16 | |
dc.contributor.author-college | 公共衛生學院 | zh_TW |
dc.contributor.author-dept | 公共衛生碩士學位學程 | zh_TW |
顯示於系所單位: | 公共衛生碩士學位學程 |
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