請用此 Handle URI 來引用此文件:
http://tdr.lib.ntu.edu.tw/jspui/handle/123456789/42554
完整後設資料紀錄
DC 欄位 | 值 | 語言 |
---|---|---|
dc.contributor.advisor | 賴美淑 | |
dc.contributor.author | Chia-Ping Su | en |
dc.contributor.author | 蘇家彬 | zh_TW |
dc.date.accessioned | 2021-06-15T01:16:09Z | - |
dc.date.available | 2016-10-03 | |
dc.date.copyright | 2011-10-03 | |
dc.date.issued | 2011 | |
dc.date.submitted | 2011-08-16 | |
dc.identifier.citation | 1. Dolin R. Influenza. In: Braunwald E, Fauci A, Kasper D, eds. Harrison's Principles of Internal Medicine. New York: McGraw Hill; 2001:1125.
2. Fiore AE, Fry A, Shay D, Gubareva L, Bresee JS, Uyeki TM. Antiviral agents for the treatment and chemoprophylaxis of influenza --- recommendations of the Advisory Committee on Immunization Practices (ACIP). MMWR Recomm Rep 2011;60:1-24. 3. Harper SA, Bradley JS, Englund JA, et al. Seasonal influenza in adults and children--diagnosis, treatment, chemoprophylaxis, and institutional outbreak management: clinical practice guidelines of the Infectious Diseases Society of America. Clin Infect Dis 2009;48:1003-32. 4. Glezen WP. Prevention and Treatment of Seasonal Influenza. New England Journal of Medicine 2008;359:2579-85. 5. World Health Organization. Pandemic influenza preparedness and response: a WHO guidance document. 2009. Available at http://www.who.int/entity/csr/disease/influenza/PIPGuidance09.pdf (Accessed June 19, 2011) 6. 行政院衛生署疾病管制局. 因應流感大流行執行策略計畫第二版. Available at http://flu.cdc.gov.tw/public/Attachment/8122918451168.doc (Accessed June 19, 2011) 7. 行政院衛生署疾病管制局. 流感抗病毒藥劑工作計畫第三版. Available at http:// flu.cdc.gov.tw/public/Attachment/9561539405.pdf (Accessed June 19, 2011) 8. Novel Swine-Origin Influenza A (H1N1) Virus Investigation Team. Emergence of a Novel Swine-Origin Influenza A (H1N1) Virus in Humans. New England Journal of Medicine 2009;360:2605-15. 9. World Health Organization. H1N1 in post-pandemic period. 2010. Available at http://www.who.int/mediacentre/news/statements/2010/h1n1_vpc_20100810/en/index.html (Accessed June 19, 2011) 10. Jhung MA, Swerdlow D, Olsen SJ, et al. Epidemiology of 2009 Pandemic Influenza A (H1N1) in the United States. Clinical Infectious Diseases 2011;52:S13-S26. 11. Brammer L, Blanton L, Epperson S, et al. Surveillance for Influenza during the 2009 Influenza A (H1N1) Pandemic–United States, April 2009–March 2010. Clinical Infectious Diseases 2011;52:S27-S35. 12. Shrestha SS, Swerdlow DL, Borse RH, et al. Estimating the Burden of 2009 Pandemic Influenza A (H1N1) in the United States (April 2009–April 2010). Clinical Infectious Diseases 2011;52:S75-S82. 13. Miller E, Hoschler K, Hardelid P, Stanford E, Andrews N, Zambon M. Incidence of 2009 pandemic influenza A H1N1 infection in England: a cross-sectional serological study. The Lancet 2010;375:1100-8. 14. Fisman DN, Savage R, Gubbay J, et al. Older Age and a Reduced Likelihood of 2009 H1N1 Virus Infection. New England Journal of Medicine 2009;361:2000-1. 15. Taiwan Centers for Disease Control. Taiwan Influenza Express week 13. 2010. Available at http://flu.cdc.gov.tw/public/Data/04614183971.pdf (Accessed June 19, 2011) 16. United States Centers for Disease Control and Prevention. Updated interim recommendations for the use of antiviral medications in the treatment and prevention of influenza for the 2009-2010 season. 2009. Available at http://www.cdc.gov/h1n1flu/recommendations.htm (Accessed June 19, 2011) 17. Uyeki T. Antiviral Treatment for Patients Hospitalized with 2009 Pandemic Influenza A (H1N1). New England Journal of Medicine 2009;361. 18. Hersh AL, Stafford RS. Antiviral Prescribing by Office-Based Physicians During the 2009 H1N1 Pandemic. Ann Intern Med 2011;154:74-6. 19. Kuehn BM. Antiviral Drugs Underused in US Patients for 2009 Influenza A(H1N1) Pandemic. JAMA: The Journal of the American Medical Association 2011;305:1080-3. 20. Nguyen-Van-Tam JS, Nicholson KG. Neuraminidase inhibitors were widely used in the UK during the 2009 influenza A(H1N1) pandemic. J Clin Virol 2011;50:183-. 21. Hernández JM, López-Rodas V, Costas E. Antiviral agents: To treat or not to treat? An old dilemma revisited in light of new data from the 2009 influenza A(H1N1) pandemic. J Clin Virol 2010;49:145-6. 22. World Health Organization. Update on oseltamivir-resistant pandemic A (H1N1) 2009 influenza virus: January 2010. Wkly Epidemiol Rec 2009;85:37-40. 23. Su CP, Chen JH, Tsai HY, Chi YC, Chen CS. Analysis of Strategies of the Use of Antiviral Medication in Patients with H1N1 2009 Influenza in Taiwan. Taiwan Epidemiol Bull 2010;26:275-83. 24. Jones M, Del Mar C. Safety of neuraminidase inhibitors for influenza. Expert Opinion on Drug Safety 2006;5:603-8. 25. Nicholson KG, Aoki FY, Osterhaus A, et al. Efficacy and safety of oseltamivir in treatment of acute influenza: a randomised controlled trial. The Lancet 2000;355:1845-50. 26. Jefferson T, Jones M, Doshi P, Del Mar C. Neuraminidase inhibitors for preventing and treating influenza in healthy adults: systematic review and meta-analysis. BMJ 2009;339. 27. Jefferson T, Jones M, Doshi P, Del Mar C. Possible harms of oseltamivir--a call for urgent action. The Lancet 2009;374:1312-3. 28. Kitching A, Roche A, Balasegaram S, Heathcock R, Maguire H. Oseltamivir adherence and side effects among children in three London schools affected by influenza A(H1N1)v, May 2009 - an internet-based cross-sectional survey. Euro Surveill 2009;14:19287. 29. Chung S, Joung YS. Oseltamivir (tamiflu) induced depressive episode in a female adolescent. Psychiatry Investig 2010;7:302-4. 30. Ho LNL, Chung JPY, Choy KLW. Oseltamivir-Induced Mania in a Patient With H1N1. Am J Psychiatry 2010;167:350-. 31. Kruker AT, Krause M. ['Oseltamivir-induced delirium']. Ther Umsch 2010;67:613-5. 32. Nakamura K, Schwartz Brian S, Lindegårdh N, Keh C, Guglielmo BJ. Possible Neuropsychiatric Reaction to High‐Dose Oseltamivir during Acute 2009 H1N1 Influenza A Infection. Clinical Infectious Diseases 2010;50:e47-e9. 33. Strong M, Burrows J, Stedman E, Redgrave P. Adverse drug effects following oseltamivir mass treatment and prophylaxis in a school outbreak of 2009 pandemic influenza A(H1N1) in June 2009, Sheffield, United Kingdom. Euro Surveill 2010;15. 34. Enger C, Nordstrom BL, Thakrar B, Sacks S, Rothman KJ. Health outcomes among patients receiving oseltamivir. Pharmacoepidemiol Drug Saf 2004;13:227-37. 35. Blumentals WA, Song X. The safety of oseltamivir in patients with influenza: analysis of healthcare claims data from six influenza seasons. MedGenMed 2007;9:23. 36. Smith JR, Sacks S. Incidence of neuropsychiatric adverse events in influenza patients treated with oseltamivir or no antiviral treatment. International Journal of Clinical Practice 2009;63:596-605. 37. Casscells SW, Granger E, Kress AM, Linton A. The association between oseltamivir use and adverse neuropsychiatric outcomes among TRICARE beneficiaries, ages 1 through 21 years diagnosed with influenza. Int J Adolesc Med Health 2009;21:79-89. 38. Okamoto E. Is oseltamivir (Tamiflu®) safe? Re-examining the Tamiflu ‘ado’ from Japan. Expert Review of Pharmacoeconomics & Outcomes Research 2010;10:17-24. 39. Graitcer SB, Gubareva L, Kamimoto L, et al. Characteristics of patients with oseltamivir-resistant pandemic (H1N1) 2009, United States. Emerg Infect Dis 2011;17:255-7. 40. Hurt AC, Deng YM, Ernest J, et al. Oseltamivir-resistant influenza viruses circulating during the first year of the influenza A(H1N1) 2009 pandemic in the Asia-Pacific region, March 2009 to March 2010. Euro Surveill 2011;16. 41. Lai S-K, Chang H-L, Wu H-S, Chuang J-H. Multiple Disease Surveillance Systems against Pandemic (H1N1) Influenza in Taiwan. Taiwan Epidemiol Bull 2010;26:251-61. 42. Sloan C, Moore ML, Hartert T. Impact of Pollution, Climate, and Sociodemographic Factors on Spatiotemporal Dynamics of Seasonal Respiratory Viruses. Clinical and Translational Science 2011;4:48-54. 43. Kuo T-W, Chuang J-H. Cost Analysis of the Use of Rapid Influenza Diagnostic Test during H1N1 2009 Influenza Pandemic Taiwan Epidemiol Bull 2009;25:762-72. | |
dc.identifier.uri | http://tdr.lib.ntu.edu.tw/jspui/handle/123456789/42554 | - |
dc.description.abstract | 2009年3月起,H1N1新型流感病毒從墨西哥與美國開始,散播至全世界造成流感大流行。流感抗病毒藥物被建議使用在所有疑似或確診為流感的病人,特別是容易產生併發症之高危險族群。其中以oseltamivir最廣為被使用。台灣全民健康保險於此波大流行期間給付流感抗原快速篩檢以及oseltamivir藥物。oseltamivir藥物利用,尤其在不同年齡層與地區的差異是重要的議題。此外關於大量使用oseltamivir之效果,藥物安全與抗藥性病毒的問題也引起大眾關注。
本研究利用2009年台灣全民健保資料庫,擷取其中所有開立oseltamivir或流感抗原快速篩檢之處方箋,分析2009 H1N1新型流感流行期間之oseltamivir藥品利用情形,初步分別檢視不同地區,年齡群及醫院別之藥物利用情形,並進一步探討藥物使用與流感病毒快速篩檢陽性率之關係。另針對使用oseltamivir個案,作短期結果(outcome)的初探。 在2009年間,健保資料庫共有1,559,233次流感抗原快篩的處方以及516,772次的oseltamivir處方。大於99.9%的處方是於八月之後開立。Oseltamivir處方量於第48週達到最高,處方量趨勢與流感病毒活動的趨勢相當。就學年齡之兒童開立oseltamivir之比率為最高,其次是青少年以及學齡前兒童。台北區開立oseltamivir的高峰約在第44週,此趨勢早於台灣其他地區。南部地區開立oseltamivir比率則低於北部地區。六成左右的oseltamivir處方是從診所開出。隨著流感病毒陽性率升高,快篩陽性率也隨之升高,最高時達40%。藥物處方量也隨之增高。而隨著流感疫情之下降,快篩處方之次數與其陽性率亦大幅下降。門診處方使用oseltamivir者約有2%之後有住院的紀錄。 整體來說,台灣開立oseltamivir之比率較其他國家為高,分離出oseltamivir抗藥性病毒之比率與其他國家相當,而整體流感死亡率則較低。罹患新型流感而接受oseltamivir治療者絕大多數為18歲以下族群。Oseltamivir開立趨勢與流感病毒活動趨勢大致相符。 | zh_TW |
dc.description.abstract | Background
A global pandemic of novel influenza A/H1N1 emerged from Mexico and US in March 2009. Antiviral medications are recommended to treat suspected or confirmed influenza patients, especially in those with high risk for morbidity and mortality. Influenza rapid test and oseltamivir were paid by National Health Insurance (NHI) and widely used during the influenza pandemic in Taiwan. The trends of prescription in specific age group and geographic difference are of particular interest. Material and Method The study collected all influenza rapid test and oseltamivir prescription from NHI claims database in 2009. Rates of oseltamivir prescription in different age groups and regions are calculated using population data from Taiwan Statistical Yearbook of Interior. The trend of prescription was compared with measures of influenza virus activity from Taiwan Centers for Disease Control. Results There were 1,559,233 influenza rapid test conducted and 516,772 courses of oseltamivir prescriptions from NHI claims database in 2009. Less than 0.1% of oseltamivir were prescribed before August. Both peaks of oseltamivir and rapid test prescriptions were seen in week 48, which were compatible with the trend of influenza virus activity. School-aged children had the highest oseltamivir prescription rate, followed by adolescents and pre-school-aged children. The prescription rate in Taipei region peaked in week 44, which is earlier than other regions. Generally, oseltamivir prescription rate is low in southern Taiwan. Conclusions The trends of influenza rapid test and oseltamivir prescription were closely realted to the level of influenza virus activity. Oseltamivir prescription rate is high among persons aged under 18 years, who are at high risk of 2009 H1N1 influenza infection. | en |
dc.description.provenance | Made available in DSpace on 2021-06-15T01:16:09Z (GMT). No. of bitstreams: 1 ntu-100-R98846009-1.pdf: 956129 bytes, checksum: 229d671dd0ffab6e7a27321522ebe339 (MD5) Previous issue date: 2011 | en |
dc.description.tableofcontents | 口試委員會審定書
致謝 i 中文摘要 ii ABSTRACT iii 目錄 v 圖目錄 vii 表目錄 viii 第一章 前言 1 第二章 文獻探討 4 第一節 2009 H1N1新型流感之流行病學文獻回顧 4 第二節 2009 H1N1新型流感流行期間使用Oseltamivir之文獻回顧 7 第三節 Oseltamivir藥物安全文獻回顧 9 第四節 流感大流行期間Oseltamivir抗藥性病毒文獻回顧 12 第三章 研究目的 14 第四章 研究材料與方法 15 第一節 Oseltamivir藥物處方箋相關分析 15 1. 研究對象 15 2. 變項定義 15 3. 建立處方箋研究資料庫流程 17 第二節 藥物使用者層級分析 17 1. 研究對象 17 2. 變項定義 17 3. 建立開立藥物病人研究資料庫流程 18 第五章 研究結果 19 第一節 Oseltamivir藥品處方箋描述性分析 19 第二節 Oseltamivir藥物使用者分析 28 第六章 討論 30 參考文獻 34 | |
dc.language.iso | zh-TW | |
dc.title | 2009年台灣H1N1新型流感流行期間之oseltamivir藥物利用研究 | zh_TW |
dc.title | Oseltamivir utilization during the 2009 H1N1 influenza pandemic, Taiwan | en |
dc.type | Thesis | |
dc.date.schoolyear | 99-2 | |
dc.description.degree | 碩士 | |
dc.contributor.oralexamcommittee | 張家勳,邵文逸,方啟泰,莊人祥 | |
dc.subject.keyword | oseltamivir,H1N1新型流感,藥品利用,健保資料庫, | zh_TW |
dc.subject.keyword | 2009 H1N1 influenza pandemic,oseltamivir,drug utilization,neuropsychiatric adverse events, | en |
dc.relation.page | 38 | |
dc.rights.note | 有償授權 | |
dc.date.accepted | 2011-08-16 | |
dc.contributor.author-college | 公共衛生學院 | zh_TW |
dc.contributor.author-dept | 流行病學與預防醫學研究所 | zh_TW |
顯示於系所單位: | 流行病學與預防醫學研究所 |
文件中的檔案:
檔案 | 大小 | 格式 | |
---|---|---|---|
ntu-100-1.pdf 目前未授權公開取用 | 933.72 kB | Adobe PDF |
系統中的文件,除了特別指名其著作權條款之外,均受到著作權保護,並且保留所有的權利。