Case scenario - Medication Review

Case study 1 (Cardio-metabolic) – Conduct a medication review in this patient

Mrs Y is a 55 year old, Asian lady who lives in East London with her extended family. She attends the surgery for a medication review with her daughter-in-law, as her English is poor.

She has a past medical history of Type 2 Diabetes, Hypertension, Hyperlipidaemia, Transient Ischaemic Attack, Thyroidectomy, Osteoarthritis and Depression.

She has a strong family history of Coronary Heart Disease. Her mother had a heart attack in her 50s and her father had a stroke in his 60s. She is a non-smoker and does not drink alcohol.

She recently attended a family wedding in Bangladesh and admits to overindulging in sweetmeats. Her daughter-in-law mentions she has been getting some “funny episodes” after taking her Gliclazide and has been reluctant to take it in the last few weeks.

Obs: BP 144/83, Pulse 77, height 5ft 2”, weight 52Kg, BMI 21 Kg/m2

Repeat Medication list:

· Citalopram 20mg od

· Levothyroxine 75mcg 1 od

· Metformin 500mg 2 bd

· Gliclazide 80mg bd

· Co-dydramol 10/500 2 qds prn

· Atorvastatin 40mg on 

· Ramipril 2.5mg od 

· Amlodipine 5mg od

· Aspirin 75mg od

· Arthrotec 1 tds

· Lansoprazole 30mg od

· Laxido 1 sachet prn

Allergies: NKDA

Blood results (data interpretation) - see below

Data interpretation Table for Medication Review Case GP3.docx

WEBINAR RECORDING DISCUSSING CASE WITH CLINICAL PHARMACIST (PLEASE WATCH AFTER WORKING ON THE CASE)

https://qmplus.qmul.ac.uk/course/view.php?id=3432

Step 1: (Aim) What matters to the patient

(Consider what is the patient’s agenda and is it the same as the doctor’s?)

Step 2: (Need) Identify essential drug therapy

Step 3: (Need) Does the patient take unnecessary drug therapy?

(Consider if diet and lifestyle changes can play a part in reducing drug therapy)

Step 4: (Effectiveness) Are therapeutic objectives being achieved?

(Consider HbA1c, Cholesterol, TFTs) (What changes would you make?)

Step 5: (Safety) Is the patient at risk of ADRs (Adverse Drug Reactions) or suffers actual ADRs?

(Consider possible cause of “funny episodes”)

Step 6: (Efficiency) Is drug therapy cost-effective?

Step 7: (Patient-Centred) Is the patient willing and able to take drug therapy as intended?

(What could be the barriers that would affect patient compliance)

Page updated

Google Sites

Report abuse