PPCP Review

What are the risks that need to be reviewed during OTC counseling?

1.) misuse and overuse

2.) drug interactions

3.) Contraindications

4.) Underlying conditions

5.) Adverse reactions

misuse and overuse

• taking higher doses or using meds for longer than rec

• doubling up unknowingly on the same active ingredient

• equity angle: misuse risk is higher in low-literacy groups

drug interactions

OTC meds can interact with prescription drugs, supplements, or alcohol (i.e. NSAIDS + blood thinners)

contraindications in special populations

• pregnant/breastfeeding women

• children: age specific dosing is critical

• older adults: increased risk of side effects or confusion with multiple meds

underlying conditions

some OTC drugs can worsen chronic diseases

adverse reactions

including allergic rxns, GI upset, drowsiness, liver toxicity, etc

What are the five steps to the PPCP process?

1.) Collect

2.) Assess

3.) Plan

4.) Implement

5.) Follow-up

What is patient centered care?

the practice of providing care in ways that are respectful of and responsive to individual preferences, needs, and values + ensuring those receiving care or their advocates participate in the decision making

Describe Step 1: Collect

subjective/objective information (patient, caregiver vs. health records/observations)

Describe Step 2: Assess

review collected information to identify and prioritize patient needs; broken down in three areas:

• medication

• patient history and risk

• preventive care and wellness needs

Describe Step 3: Plan

develop an individualized patient-centered care plan in collaboration with patient that is evidence based and cost effective

Describe Step 4: Implement

putting the care plan in action with the patient/caregiver and care team; can include

• resoling medication therapy problems

• order/perform lab tests

• provide patient education

• appointments/referrals/community resources

Describe Step 5: Follow-up

• check progress toward patient goals and over health outcomes

• monitor and evaluate care plan results

• ensure ongoing optimization of medication

• continue the PPCP cycle

What are the SCHOLAR questions in SCHOLAR-MAC?

• Symptoms

• Characteristics

• History

• Onset

• Location

• Aggravating factors

• Remitting factors

What are the MAC questions in SCHOLAR-MAC?

• medication use

• allergice reactions

• coexisting conditions

What safety concerns exist for elderly patients using OTCs?

• age-related physiological changes (reduced hepatic and renal function/decreased metabolism and muscle mass/heightened medication sensitivity)

• pre-existing health conditions (multiple disease states and chronic medication use)

Which OTC medications are the key concerns for elderly patients?

• 1st gen antihistamines

• proton pump inhibitors (PPIs)

• non-steroidal anti-inflammatory (NSAIDs)

What are safety concerns with pediatric patients?

• more vulnerable organs so metabolizes drugs differently

• dosing errors

• lack of clinical evidence

• multiple-ingredient products

What are safety concerns with pregnant patients?

• prioritize non-drug measures

• use lowest effective dose for shortest duration

• always weigh maternal benefit vs. fetal risk

What drugs should pregnant patients avoid?

• NSAIDs

• aspirin

• pseudoephedrine/phenylephrine

• herbal supplements