Monitoring , Adherence and Follow-up

What is drug monitoring ?

• The managements of a patients drug regimen by assessing laboratory and physical tests

What is a medication review?

• A structured, critical examination of a patients medicines

Identify the 3 types of medication review

• prescription review

• Concordance and compliance review

• Clinical medication review

What is clinical medication review ?

• Holistic review

• Involves patients , medical notes and lab results

Give an example of clinical medication review

• pharmacist medication review

List the 4 contents of medication review

• the medication is appropriate for the patients needs

• The medication is effective

• The medication is cost effective

• Appropriate monitoring has been done

What does the abbreviation NO TEARS stand for in terms of medication reviews?

• Need and indication

• Open questions

• Test and monitoring

• Evidence and guidelines

• Adverse events

• Risk reduction or prevention

• Simplification and switches

What is the STOPP/START tool ?

• The tool is used in medication reviews to help optimise prescribing especially in older adults

What does the abbreviation STOPP stand for?

• Screening Tool of Older Persons’ Prescriptions

What is the purpose of STOPP?

• identifies potential inappropriate medications that should be stopped

What does the abbreviation of START stand for?

• Screening tool to alert to right treatment

What is adherence?

• the extent to which the patients behaviour matches agreed recommendations from the prescriber

What is compliance?

• The extent to which a patients follows the prescribed treatment plan

What is concordance ?

• a collaborative approach where the patient and healthcare provider agree on the treatment plan with the patent actively involved in decisions

What are 2 categories non-adherence ?

• Intentional

• Unintentional

How can we improve medication adherence ?

• suggest practical support

• Ask patient about concerns

• Don’t make assumptions

• Provide support and information

• Involve patients in decision about their care

List 2 initiates to better transfer care

• Discharge Medication Service

• Transfer of Care Around Medicines (TCAM)