43卷5期

• Link 政策論壇 Policy Forum
• 台灣人民應該認識的大愛器官捐贈 What the people of Taiwan recognize the great love of organ donation
• 李伯璋
  Po-Chang Lee
• 大愛器官捐贈、器官移植
  organ donation, organ transplantation
• 臺灣許多需要心肝肺移植者最終仍未能等到機會，由醫院進行器官移植手術之病例統計也可發現臺灣器官捐贈的認知仍有提升的空間，故建議提升「腦死與器官捐贈」之宣傳並促進大愛腎臟移植手術之發展。
  Many patients in Taiwan who require heart, liver, or lung transplants ultimately do not receive the opportunity for surgery. Statistics on organ transplant cases performed by hospitals also reveal that there is still room to improve public awareness of organ donation in Taiwan. Therefore, it is recommended to enhance the promotion of organ donation and to promote the development of large-scale kidney transplant surgeries.
• 415-416
• 10.6288/TJPH.202410_43(5).PF05

• Link 公衛論壇 Public Health Forum
• 台灣青少年自殺防治之策略建言:校園模式Recommendations for adolescent suicide prevention strategies in Taiwan: a school-based model
• 李佳錡、吳佳儀、李明濱
  Chia-Chi Li, Chia-Yi Wu, Ming-Been Lee
• 青少年自殺防治
  adolescent suicide prevention
• 文章指出臺灣15-24歲族群之自殺死亡率自2015年起呈上升趨勢，而青少年心理健康與自殺問題同時是國際的重大公共衛生議題，作者群透過系統性分析十年內文獻，歸納出六大自殺防治策略，以及提出包含健康促進、自殺預防、防治措施、後續處置 (PPIP) 之校園自殺防治模式。
  The suicide mortality rate among the 15-24 age group in Taiwan has shown an upward trend since 2015. Adolescent mental health and suicide issues are also major public health concerns internationally. Through analysis of literature over the past decade systematically, the authors identified six key suicide prevention strategies and proposed a campus suicide prevention model that includes health promotion, suicide prevention, intervention measures, and postvention (PPIP).
• 417-426
• 10.6288/TJPH.202410_43(5).113001

• Link 綜論 Review Article
• 從公共衛生觀點重建台灣視力保健計劃的新藍圖 Reconstructing a new blueprint for Taiwan̓s visual healthcare plan from a public health perspective
• 張麗春、廖梨伶
  Li-Chun Chang, Li-Ling Liao
• 近視、學校計畫、公共衛生、國家政策
  myopia, school program, public health, nation policy
• 世界衛生組織報告推估2050年近視人口將達到49.49億，約佔總人口數50%。為避免早發性近視的不正常眼軸生長導致高度近視風險，近視兒童需要規律就醫與追蹤;再加上人口老化與3C產品盛行，將產生更多的眼科疾病，這些問題都將衝擊眼科醫療資源與量能。兒童近視已成為公共衛生的重要問題，亞洲國家，如：新加坡與中國，已應用公共衛生觀點，從預防、篩檢到近視矯治，建置較完整的國家近視防治計畫。台灣在教育部與國民健康署持續推動預防近視的策略外，部分縣市也針對幼兒與學童提供散瞳後屈光檢查，持續呈現防治成效。本文旨在借鏡亞洲國家近視政策，重新檢視台灣視力保健計畫內容，並以公共衛生觀點提出視力保健計劃新藍圖，建議教育單位能持續藉由推動健康促進學校輔導模式、透過強化教師融入視力保健教學知能，發展生活技能為導向的近視防治教育、強化眼科照護專業的合作、確保衛生單位為強力後盾、及落實視力監測調查與回饋等策略，來達到保護學童視力健康。
  The World Health Organization estimates that 50% of the global population will be affected by myopia by 2050, of which 10% will have high myopia. Regular medical check-ups and follow-ups are essential to prevent abnormal axial elongation, which leads to high myopia in children. Additionally, the prevalence of aging and widespread use of digital devices (3C products) are expected to exacerbate ocular diseases, impacting ophthalmic medical resources and capacity. Childhood myopia is a major public health concern. Asian countries, such as Singapore and China, have implemented more comprehensive national programs for myopia prevention and control, including prevention, screening, and treatment. In Taiwan, along with the national myopia prevention efforts, some municipalities have introduced cycloplegic refraction examinations for young children, which have shown sustained success in controlling myopia. This article re-evaluates Taiwan's vision care programs in light of myopia policies from other Asian countries and proposes a new blueprint for visual healthcare plans. The proposed plan recommends that educational institutions should encourage health promotion models in schools; develop knowledge-driven myopia prevention education; enhance collaboration with eye care professionals; ensure strong support from health authorities; and implement strategies for vision monitoring, surveying, and feedback to ensure the visual health of school children.
• 427-437
• 10.6288/TJPH.202410_43(5).113033

• Link 原著 Original Article
• 探討慢性腎臟病患使用安寧療護的相關因素 Factors associated with in-home mortality among hospice home care patients: a population-wide study
• 曾鈺涵、謝明娟、湯淑貞、許庭瑜、陳楚杰
  Yu-Han Tseng, Ming-Chuan Hsieh, Shu-Chen Tang, Ting-Yu Hsu, Chu-Chieh Chen
• 慢性腎臟病、緩和醫療家庭諮詢會議、安寧療護
  chronic kidney disease, family palliative care consultation, palliative care
• 目標：探討台灣慢性腎臟病人使用安寧療護的相關因素。方法：本研究使用衛生福利部資料科學中心之全人口檔，以死因是慢性腎衰竭者14，490位為研究對象。使用描述性統計描述研究對象基本人口學變項及使用安寧緩和療護，再以多元邏輯斯迴歸分析研究對象使用安寧療護的相關因素。結果：1，354位(9.34%)研究對象使用緩和醫療家庭諮詢會議，有1，743位(12.03%)有使用安寧療護。政策實施中期及近期死亡、已婚及投保地區中度都市化程度的慢性腎臟病人使用緩和醫療家庭諮詢會議的機率較高。政策實施中期及近期、有使用緩和醫療家庭諮詢會議、女性、75歲(含)以上、投保地區中度都市化程度、投保金額40，001元（含）以上、查爾森合併症指標分數為1分（含）以上的慢性腎臟病人使用安寧療護的機率較高。結論：慢性腎臟病人使用緩和醫療家庭諮詢會議及安寧療護的比率有限，建議衛生主管機關應針對男性、75歲以下、鄉村地區及收入較少的民眾持續推廣安寧療護的相關知識。
  Objectives: To investigate the factors associated with in-home mortality among hospice home care patients in Taiwan. Methods: This population-based retrospective study employed data from the Health and Welfare Data Center's archives spanning from 2011 to 2020. Participants were hospice home care patients who died during the study period. Descriptive statistics were employed to analyze variable distributions, whereas logistic regression was used to explore the factors associated with in-home mortality. Results: A total of 2,775 patients were included in the analysis, of whom 57.91% died at home. In-home mortality rates exhibited a decreasing trend over time, with 621 of 1,016 (61.12%), 581 of 1,024 (56.74%), and 405 of 735 (55.10%) patients dying at home during 2011–2014, 2015–2017, and 2018–2020, respectively. The results of the multiple logistic regression analysis revealed that earlier years of death, older age, married status, higher urbanization levels, non–low-income households, absence of emergency room visits within 3 months prior to death, and fewer days of hospice home care were associated with an increased likelihood of in-home mortality. Conclusions: This study demonstrated a declining in-home mortality rate over time. Regardless of the hospice care model employed, health authorities should promote the option of home-based end-of-life care to enhance in-home mortality rates and overall care quality in Taiwan.
• 438-447
• 10.6288/TJPH.202410_43(5).113043

• Link 原著 Original Article
• 面對疑似失智者遭財務濫用的風險評估與因應行動：金融業臨櫃行員的調查研究 Risk assessment and actions taken if faced with financial abuse among people suspected of having dementia: a survey of bank tellers
• 黃乙芹、廖翊涵、林軒竹、黃于玲、古鯉榕
  Yi-Chin Huang, Yi-Han Liao, Hsuan-Chu Lin, Yu-Lin Huang, Li-Jung Elizabeth Ku
• 失智症、銀行、財務濫用、情境
  dementia, bank, financial abuse, case scenarios
• 目標：台灣人口的快速老化使得失智症相關議題備受重視。本研究探討台灣金融業臨櫃行員面對疑似失智的客戶在櫃台可能出現的狀況，以及行員後續會採取的行動。方法：研究第一部分透過開放式問卷對兩家金融機構蒐集臨櫃行員面對疑似失智客戶的經驗，將其回答歸納為客戶遭財務濫用的不同情境的案例;第二部分則以結構式問卷對第三家銀行其32間分行的臨櫃行員進行調查。使用多元線性迴歸及多元邏輯斯迴歸分析行員對臨櫃情境的風險評估分數、行動決策及其相關影響因素。結果：第二部分的分析共納入163份有效問卷，在控制其他變項後，顯示當行員評估客戶在該情境遭遇財務濫用的風險越高，選擇拒絕受理業務的機會也越高(勝算比OR~=2)。結論：本研究為台灣第一個探討失智友善金融的先驅研究，發現行員對於疑似失智客戶的財務風險評估與其業務的行動決策具高度相關性，建議銀行未來舉行失智友善金融相關教育訓練，增進行員對疑似失智的客戶遭不同類型的財務濫用的風險的認識。
  Objectives: The rapid aging of Taiwan's population has brought attention to issues related to dementia. This study explores the situations that bank tellers may encounter with customers suspected of having dementia and the subsequent decisions made by the tellers. Methods: Bank tellers from two financial institutions who had interacted with customers suspected of having dementia were surveyed using an open-ended questionnaire. The experiences of the tellers were categorized into various case scenarios involving potential financial abuse. Next, bank tellers across 32 branches of a third financial institution were surveyed using a structured questionnaire. Multiple linear regression and logistic regression analyses were employed to evaluate the bank tellers' risk assessment scores, decision-making processes, and other related risk factors. Results: A total of 163 valid responses to the structured questionnaire were obtained and included in the analysis. The results indicated that the financial abuse risk score is positively correlated with the probability a bank teller choosing to decline services. Conclusions: This is the first study in Taiwan to investigate dementia-friendly banking. This study found a high correlation between bank tellers' assessment of the financial risk of customers suspected of having dementia and their decision-making. We recommend that banks provide educational training on dementia-related issues to increase bank tellers' awareness of the risk of financial abuse among customers suspected with dementia.
• 448-458
• 10.6288/TJPH.202410_43(5).113048

• Link 評論 Commentary
• 評論：面對疑似失智者遭財務濫用的風險評估與因應行動：金融業臨櫃行員的調查研究 Commentary: risk assessment and actions taken if faced with financial abuse among people suspected of having dementia: a survey of bank tellers
• 劉素芬
  Su-Fen Liu
• 無none
  無none
• 無none
  無none
• 459-459
• 10.6288/TJPH.202410_43(5).11304801

• Link 評論 Commentary
• 評論：面對疑似失智者遭財務濫用的風險評估與因應行動：金融業臨櫃行員的調查研究 Commentary: risk assessment and actions taken if faced with financial abuse among people suspected of having dementia: a survey of bank tellers
• 莊宜芳
  Yi-Fang Chuang
• 無none
  無none
• 無none
  無none
• 460-460
• 10.6288/TJPH.202410_43(5).11304802

• Link 作者回覆 Authors' response to commentary
• 作者回覆：面對疑似失智者遭財務濫用的風險評估與因應行動：金融業臨櫃行員的調查研究 Authorsʼ response to commentary: risk assessment and actions taken if faced with financial abuse among people suspected of having dementia: a survey of bank tellers
• 黃乙芹、廖翊涵、林軒竹、黃于玲、古鯉榕
  Yi-Chin Huang, Yi-Han Liao, Hsuan-Chu Lin, Yu-Lin Huang, Li-Jung Elizabeth Ku
• 無none
  無none
• 無none
  無none
• 461-462
• 10.6288/TJPH.202410_43(5).11304803

• Link 原著 Original Article
• 評估COVID-19三級警戒對新診斷癌症人數之影響 Assessing the effects of the COVID-19 lockdown on new cancer diagnoses
• 孔常喜、梁立霖
  Chang-Xi Kung Li-Lin Liang
• 新冠肺炎、疫情、癌症、斷點迴歸分析、中斷時間序列分析
  COVID-19, pandemic, cancer, regression discontinuity design, interrupted time series analysis
• 目標：COVID-19疫情對醫療體系造成衝擊，對癌症患者的診斷及預後造成影響。本研究旨在評估三級警戒對於台灣癌症新診斷人數的影響，並分析對不同癌症次族群是否造成不同程度的影響。方法：自癌症登記檔收集2018至2021年各縣市每週癌症新發人數。採用斷點迴歸設計，估計三級警戒造成的新診斷癌症人數的影響。以中斷時間序列分析評估三級警戒對不同臨床期別、年齡以及性別的立即影響與干預後趨勢。結果：三級警戒期間，平均每個縣市每週減少66.1(p<0.001)個新診斷癌症患者。干預後的立即效果，以臨床期別第0期減少75.1%最多，第4期減少45.0%最少;女性下降69.2%相較男性52.1%減少的比例更大。干預後各次族群均出現回復趨勢，其中第0期每周每十萬人回復0.020(p<0.001)最慢;第4期0.121(p<0.001)最快。結論：三級警戒使癌症新診斷人數銳減。中晚期癌症患者可能延誤治療造成過早的死亡，早期癌症患者可能增加癌症併發症造成較差的預後，需儘快找出延遲診斷的癌症患者。本研究結果有助於未來防疫政策與癌症臨床照護決策參考。
  Objectives: The COVID-19 pandemic adversely affected healthcare systems, including the availability of cancer diagnosis and monitoring services. This study evaluated the effects of the COVID-19 lockdown on newly diagnosed cancer cases in Taiwan. Methods: Weekly data on new cancer diagnoses from 2018 to 2021 were collected from Taiwan's National Health Insurance Research Database. A regression discontinuity design was used to estimate the impact of the lockdown on the number of new cancer diagnoses, using city/county-level data. An interrupted time series analysis was conducted to evaluate the immediate impact and post-intervention trends of the lockdown on new cancer diagnoses by clinical stage, age, and sex. Results: The lockdown resulted in an average weekly reduction of 66.1 new cancer diagnoses per city or county (p < 0.001). This decrease was largest for stage 0 cancer (75.1%), smallest for stage 4 cancer (45.0%), and larger among women (69.2%) than men (52.1%). After the lockdown, the rates of diagnoses for all cancer stages increased. This recovery was slowest for stage 0 cancer (0.020 per week per 100,000 people, p < 0.001) and fastest for stage 4 cancer (0.121 per week per 100,000 people, p < 0.001). Conclusions: The COVID-19 lockdown caused a sharp drop in new cancer diagnoses. Delays in diagnosis may lead to postponed treatment, resulting in premature death for advanced-stage cancers and increased complications with worse prognoses for early-stage cancers. Prompt identification of patients affected by these delays is crucial. These findings can inform future pandemic policies and cancer care decisions.
• 463-476
• 10.6288/TJPH.202410_43(5).113061

• Link 原著 Original Article
• COVID-19疫情對剖腹產的影響 Impact of COVID-19 on cesarean section rates
• 廖鈺欣、林青青
  Yu-Hsin Liao, Ching-Ching Claire Lin
• 剖腹產、催生或引產、COVID-19、高風險孕產婦
  C-section, induction, COVID-19, high-risk pregnancy
• 目標：本研究旨在比較COVID-19疫情對於生產行為與產科介入的改變，並分析疫情前後不同風險的孕產婦之間的差距變化，探討疫情本身是否會加劇台灣持續上升的剖腹產率與催生或引產利用的影響。方法：本研究使用衛生福利部資料科學中心的健保申報資料進行分析，分別以2019年與2021年有分娩事實之孕產婦做為主要研究對象，並根據孕齡或有任一孕期間危險因子來判定是否為高風險族群。研究共納入246，660位產婦，利用差異中的差異分析方法，以多元線性機率模型分析疫情是否會影響不同風險族群間使用剖腹產和催生或引產。結果：不論疫情前後，高風險產婦的剖腹產機率較高(邊際效果=0.077，p<0.001)，但催生或引產的機率較低(邊際效果=-0.009，p<0.001)。疫情提高剖腹產的機率，但模型加入控制變項後此效果不顯著(邊際效果=0.003，p=0.138);疫情也提高催生或引產的機率(邊際效果=0.061， p<0.001)，且疫情期間，催生或引產的使用在非高風險族群的使用有較大幅度的增加，使不同風險族群間使用催生或引產的差距擴大(邊際效果=-0.010，p<0.001)。結論：台灣醫療體系面對疫情壓力，雖然疫情前後整體生產模式保持穩定，但額外的產科介入是疫情的代價之一。
  Objectives: This study aimed to assess whether the COVID-19 pandemic has contributed to an increase in cesarean section (C-section) rates and how it has influenced the utilization of induction among pregnant women with different risk levels. Methods: We used Taiwan National Health Insurance Claims Data linked to the Birth Registry to analyze 246,660 cases of delivery hospitalizations of women in 2019 or 2021. High-risk pregnancies were identified on the basis of maternal age or the presence of medical risk factors during pregnancy. A difference-in-difference approach was adopted, wherein linear probability models were used to assess the impact of the pandemic on C-section and induction rates among different risk groups. Results: Multivariable analysis revealed significant positive associations between pregnancy risk levels and outcomes. High-risk pregnancies were associated with a higher C-section rate (marginal effect = 0.077, p < .001) and a lower induction rate (marginal effect = −0.009, p < .001). Although the pandemic was associated with an increase in C-section rates, this association was not significant (marginal effect = 0.003, p = .138). However, the pandemic had a significant effect on induction rates (marginal effect = 0.061, p < .001), with a significant larger difference between high- and low-risk groups during the pandemic (marginal effect = −0.010, p < .001). Conclusions: Although the overall mode of delivery remained stable during the pandemic, the increase in obstetric interventions reflects both the adaptations made by maternity units and the broader impact of pandemic-related stress on healthcare systems. These findings underscore the need to evaluate the long-term effects of such external pressures on obstetric care.
• 477-487
• 10.6288/TJPH.202410_43(5).113062

• Link 原著 Original Article
• 疫情時，誰來值班？我國新冠肺炎期間醫院志工持續服務影響因素研究 Factors influencing the sustained service of hospital volunteers in Taiwan during the COVID-19 pandemic
• 劉秋伶、謝文中
  Chiu-Ling Liu, Wen-Chung Hsieh
• 醫院志工、志工管理、公民志願主義觀點、順序邏輯迴歸、新冠肺炎
  hospital volunteers, volunteer management, civic voluntarism model, ordinal logistic regression, COVID-19
• 目標：醫院志工是醫院重要輔助人力，但新冠肺炎下投入服務情形卻少有實證探究。本研究以志工持續服務「意願、能力、機會」觀點調查新冠肺炎期間醫院志工持續服務情形，分析影響醫院志工持續服務相關因素。方法：分層隨機台灣北、中、南、東區域，再依醫院層級分地區醫院、區域醫院與(準)醫學中心醫院志工為抽樣對象。以紙本問卷及SurveyCake©雲端問卷蒐集資料，得有效樣本625份。結果：87.4%醫院志工在三級警戒前有服務，41.9%在三級警戒間有服務，及97.6%在三級警戒後有服務。順序邏輯迴歸分析顯示：意願層面中使命感越高、家庭照顧負荷越低、醫院志工管理支持越好;能力層面中退休/現任軍公教、擔任志工幹部、疫情前服務時數越高、有災難/疫災志工經驗者;以及機會層面中服務醫院層級越高之醫院志工，在新冠肺炎期間持續服務情形越高。結論：呈現醫院志工新冠疫情變化下投入服務情形，分析意願、能力與機會層面等影響因素，提出傳染性疫病下醫院志工管理應變建議。
  Objectives: This study investigated the sustained service of hospital volunteers during the COVID-19 period from the perspectives of ""willingness, ability, and opportunity,"" analysing the factors influencing the sustained service of hospital volunteers during the pandemic. Methods: Stratified random sampling was conducted across northern, central, southern, and eastern regions of Taiwan. Volunteers from district hospitals, regional hospitals, and (quasi-) medical center hospitals were selected as the sampling population. Data were collected using both paper questionnaires and the SurveyCake© online survey platform, resulting in 625 valid samples. Results: Of the samples, 87.4% of hospital volunteers were serving before the Level 3 alert, 41.9% continued to serve during the Level 3 alert, and 97.6% resumed service after the Level 3 alert. Ordinal logistic regression analysis indicated that Higher sense of mission, lower family caregiving burden, and better support from hospital volunteer management were associated with higher willingness to continue the service. Retired or active military officers, civil servants and teachers, volunteer leaders, higher service hours before the pandemic, and experience in disaster/epidemic volunteer activities contributed to the ability to carry out sustained service. Volunteers serving in higher-tier hospitals showed higher opportunity for sustained service during the COVID-19 pandemic. Conclusions: This study clarified the service patterns of hospital volunteers during the COVID-19 pandemic and analysed the factors influencing their willingness, ability, and opportunity to continue serving. Recommendations are offered for managing hospital volunteers during infectious disease outbreaks.
• 488-500
• 10.6288/TJPH.202410_43(5).113051

• Link 原著 Original Article
• 藥師多元策略介入門診多重用藥糖尿病病人之成效研究 The efficacy of multifaceted pharmacist intervention in outpatient diabetic patients with polypharmacy
• 鮑俊蓓、黃煒翔、吳淑娟、劉潔心
  Jiunn-Bey Pao, Wei-Hsiang Huang, Shu-Chuan Wu, Chieh-Hsing Liu
• 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
• 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.
• 501-512
• 10.6288/TJPH.202410_43(5).113045