Medication review template (PDF 58 kB)
Medication review template (PDF 58 kB)
Medication review template (PDF 58 kB)
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<strong>Medication</strong> Review<br />
• Review all medications regularly to ensure they are achieving the desired results<br />
• When conducting a medication <strong>review</strong>, consider the following:<br />
1. Disclose all medications being used<br />
• Instruct the patient to collect and bring in all medicines (including OTC, herbal remedies, vitamins etc) when they<br />
next visit you<br />
• During the office visit, ask the patient to describe:<br />
⇒ Their understanding of the indication for each medication<br />
⇒ Their method of administration<br />
⇒ Dose and time of taking medication<br />
⇒ Any side effects experienced<br />
2. Identify medications by generic name and drug class<br />
• Reduce drug name confusion by emphasising generic identification<br />
• Drugs of the same class may have a similar profile of side effects, and the requirements for monitoring may be similar<br />
3. Identify the clinical indication of each medication<br />
• Prescriptions may be renewed by reflex, leading to chronic therapy when an acute treatment was intended<br />
4. Know the side effect profile of each medication<br />
• In order to recognise an adverse drug reaction, become familiar with the common side effects of each agent on a<br />
patient’s medication list. This is most easily achieved by identifying the side effects common to the drug class<br />
5. Identify risk factors for an adverse drug reaction<br />
• Elderly people are at greater risk of polypharmacy due to increased likelihood of multiple diseases, and an increased<br />
sensitivity to adverse effects and drug interactions<br />
• Some medications are poorly suited for use in the elderly and should be avoided except under unusual circumstances<br />
e.g. long –acting benzodiazepines, central-acting antihypertensives<br />
• Patients often hoard drugs from previous treatment regimens and use them “as needed”<br />
6. Eliminate medications with no demonstrable therapeutic benefit and no clinical indication<br />
• Therapeutic benefit can be determined by questioning the patient (e.g. Has this medication helped you?), or<br />
performing a physical exam or diagnostic test for more objective information<br />
• Patients receiving medications for no clinical indication are at risk of side effects with a very limited chance for<br />
therapeutic benefit.<br />
7. Substitute a safer medication<br />
• To expose an adverse drug reaction, compare the patient’s <strong>review</strong> of symptoms with the side effect profile of their<br />
medications. If these symptoms are significantly distressing or reflect potential serious sequelae, consider eliminating<br />
agents that may be unnecessary or consider making drug substitutions<br />
8. Avoid treating an adverse drug reaction with a drug<br />
• Treating an adverse drug reaction with another medication may occur as a consequence of an unrecognised adverse<br />
drug reaction and can lead to a vicious cycle of one new medication after another being added simply to address a<br />
cascade of side effects<br />
• Any adverse reaction that necessitates the addition of another drug should be a ‘red flag’, warning you to discontinue<br />
the therapy or find an alternative<br />
9. Use a single drug with an infrequent dosing schedule, if possible<br />
• Patient non-compliance is directly related to the total number of medications and the daily dose frequency of each<br />
medication<br />
Reference: Carlson, J.E. 1996, Perils of polypharmacy: 10 steps to prudent prescribing, Geriatrics 51(7): 26–35.<br />
You may wish to use the <strong>template</strong> overleaf for the <strong>Medication</strong> Review, and file the completed form in your patients’ medical notes.
<strong>Medication</strong> Review<br />
Patient Name: ___________________________________<br />
File number: ____________________________________<br />
Date of <strong>review</strong>: __________________________________<br />
<strong>Medication</strong><br />
(including strength &<br />
frequency prescribed)<br />
Actual<br />
dose/frequency<br />
taken by patient<br />
Indication<br />
<strong>Medication</strong> issue<br />
(e.g.none, duplication,<br />
compliance, adverse<br />
event etc)<br />
Action Taken<br />
(e.g. reduce/increase<br />
dose, cease medication,<br />
counsel patient etc)<br />
1<br />
2<br />
3<br />
4<br />
5<br />
6<br />
7<br />
8<br />
9<br />
10<br />
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