失眠問題是許多病患就診的主訴之一。長期睡眠不足除了影響患者的身心健康，還嚴重影響其日常生活及工作表現。根據台灣最新的調查顯示，國人15歲以上人口失眠的盛行率高達28％，為亞太地區之冠軍。用於失眠治療的安眠鎮靜劑，成為台灣最常被處方的精神治療藥品。由於安眠鎮靜劑的使用可能衍生依賴性、耐藥性、反彈性失眠及戒斷症狀，衛生署建議不宜連續使用超過4星期。
　　本研究分成兩部分。第一部分以回溯性方式，利用電腦資料庫分析成大醫院門診於2001年9月至2003年2月安眠鎮靜劑之處方型態，觀察安眠鎮靜劑延長使用與連續使用之比例，並分析長期服藥的病患特質。在3650個安眠鎮靜劑的新使用者，醫師在4星期之內停止安眠鎮靜劑處方的比例為47.67％，7.81％的病患被處方超過一年，69.3％的病患於就診期間連續使用鎮靜安眠劑。服藥超過一年的病患年齡較大，男性比例多於女性，病患前五名的診斷依序為消化系統疾病（10.17％）、高血壓及其併發症（9.64％）、睡眠障礙（7.27％）、生殖泌尿道系統疾病（6.92%）及骨骼系統及結締組織疾病（5.96%）。精神科與非精神科病患服藥超過一年的比例沒有差別。
　　第二部分以前瞻性方式，觀察臨床藥師於診間即時介入是否能增加病患對失眠及其治療藥品的認識。本研究研發15個問題的「失眠及安眠鎮靜藥物相關知識測驗問卷」，比較病患在衛教前後的答對題數來評估藥師衛教成效。共收入65位病患進行第一次問卷測驗及病患衛教，其中37位病患完成兩次問卷測驗。完成兩次測驗的病患，衛教前後之問卷平均答對題數分別為10±3題及13±2題（p＜0.001），顯示病患接受衛教後，失眠及安眠鎮靜藥物相關知識有明顯的進步。

　　Insomnia is a popular complaint of patients in general medical practice. Chronic insomnia not only impact patients’ overall health, but also their daily activities and occupational performance. According to the latest survey in Taiwan, the prevalence of insomnia in people aged 15 or older is 28%, which is highest among all countries in Asia. Hypnotics and sedatives for the treatment of insomnia have become the most frequently used psychotropic drugs in Taiwan. Due to the side effects of hypnotics and sedatives including tolerance, dependence, rebound insomnia and withdrawal symptoms, the Department of Health in Taiwan has recommended that they should not be used regularly for longer than four weeks.
　　This study was divided into two parts. In the first part, the prescribing patterns (especially the proportions of prolonged use and regular use cases) were investigated retrospectively using the outpatient database of National Cheng-Kung University Hospital form September 1, 2001 to February 28, 2003. We also identified the characteristics of patients with prolonged use of hypnotics and sedatives. Among the 3,650 initial users, 47.67% discontinued use of hypnotics and sedatives within four weeks, 7.81% continued the use for longer than one year, and 69.3% used their hypnotics and sedatives regularly. Prolonged use (longer than one year) was likely associated with elderly patients and male patients. The top five diagnoses of initial users with prolonged use were gastrointestinal disorders (10.17%), hypertension and its complications (9.64%), sleep disorders (7.27%), genitourinary disorders (6.92%), and musculoskeletal disorders (5.96%). The ratios of prolonged use were not significantly different between psychiatric and nonpsychiatric users.
　　In the second part of this study, we examined whether the patient would know more about insomnia and its treatment drugs if the pharmacist had explained it to the patient immediately after the diagnosis. In the study, we developed a 15-question questionnaire named “Knowledge about insomnia: hypnotics and sedatives” to assess the efficacy of the patient education program by comparing the number of correct answers before and after the patient was counseled by the pharmacist. 65 patients answered the questionnaire once and received patient education, and 37 of them completed the questionnaire twice. Among patients who completed the questionnaire twice, the average number of correct answers were 10±3 and 13±2, before and after patient education, respectively (p＜0.001). The results of our study revealed that the patients became more knowledgeable about insomnia, hypnotics and sedatives after the education program.

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