目標：本研究旨在探討藥師運用多元策略介入門診多重用藥糖尿病病人服藥配合度，並評估此多元策略對門診多重用藥糖尿病病人之服藥配合度行為、自我效能與用藥知識的成效。方法：本研究設計為準實驗設計，研究執行期間為2022年9月1日至2023年12月31日。研究對象採立意取樣，選取臺北市某區域教學醫院新陳代謝門診中高齡糖尿病多重用藥病人，配對分派至實驗組與對照組，進行3個月課程及多元策略介入，分別進行前測包含研究者自編中高齡糖尿病病人服藥配合度評估問卷和生理數值量測，3個月後追蹤後測。結果：以廣義估計方程式進行分析。研究發現經為期3個月的多元介入策略後，當方程式控制了組別與時間之後，服藥配合度行為(B = 1.13， p = 0.006)、適當用藥的自我效能(B = 3.57， p = 0.006)、用藥知識(B = 3.27， p < 0.001)交互作用達顯著水準。另外在臨床生理指標中體重(B = -0.20， p < 0.001)及BMI(B = -0.07， p < 0.001)的交互作用達顯著水準，表示實驗組在提升中高齡糖尿病多重用藥病人服藥配合度行為、適當用藥的自我效能、用藥知識、體重及BMI顯著優於對照組。結論：經過藥師為期3個月的門診糖尿病多重用藥中高齡病人服藥配合度行為多元策略介入，能使實驗組相較對照組在服藥配合度行為、適當用藥的自我效能、用藥知識、體重及BMI有顯著成效。

Objectives: The purpose of this study was to explore the use of multifaceted pharmacist intervention in the medication compliance of outpatient polypharmacy diabetic patients, and to evaluate the effectiveness of this multiple strategy on the medication compliance behavior, self-efficacy and medication knowledge of outpatient polypharmacy diabetic patients. Methods: The research design was quasi-experimental, and the research execution period is from September 1, 2022 to December 31, 2023. The participants were purposefully sampled. Elderly diabetes patients with polypharmacy were selected from the metabolism clinic of a regional teaching hospital in Taipei City. Participants were paired and assigned to experimental and control groups. The experimental group was then subjected to multiple intervention strategies for three months. The researcher conducted pretests, including self-reported responses to a medication compliance assessment questionnaire and physiological value measurement for middle-aged and elderly patients with diabetes. A follow-up post-test was administered after the 3-month intervention period. Results: Analyzes were performed using generalized estimating equations. The study found that after a three-month multi-intervention strategy, when the equation controlled for group and time, medication compliance behavior (B = 1.13, p = 0.006) and self-efficacy for appropriate medication use (B = 3.57, p = 0.006) and medication knowledge (B = 3.27, p < 0.001), the interaction effect reached a significant level. In addition, among the clinical physiological indicators, the interaction between weight (B = -0.20, p < 0.001) and BMI (B = -0.07, p < 0.001) reached a significant level, indicating that the experimental group can improve the medication intake of middle-aged and elderly diabetic patients with multiple medications. Cooperation behavior, self-efficacy for appropriate medication, medication knowledge, weight and BMI were significantly better than those of the control group. Conclusions: The study revealed significant improvements in medication adherence, self-efficacy in appropriate medication use, and medication knowledge among middle-aged and elderly diabetic patients with polypharmacy following 3-month course using multifaceted intervention strategy.

藥師；糖尿病；服藥配合度；適當用藥的自我效能；衛生教育介入

pharmacists; diabetic patients; medication adherence; self-efficacy in appropriate medication use; educational intervention