Pharmacy Practice: Monitoring, Adherence & Follow-Up
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Questions and Answers

What is the primary goal of drug monitoring?

  • To optimise treatment and reduce harm (correct)
  • To conduct laboratory tests
  • To screen for underlying medical conditions
  • To prescribe medications

    • Which of the following laboratory tests is used to monitor a patient's response to Ramipril?

  • Renal function (Cr, eGFR) (correct)
  • Full blood count (FBC)
  • Electrolytes e.g. K+
  • Liver function (LFTs)

    • What is the purpose of therapeutic drug monitoring?

  • To measure therapeutic effectiveness
  • To screen for adverse drug reactions
  • To assess patient compliance
  • All of the above (correct)

    • What is the role of the pharmacist in identifying and supporting non-adherence?

    <p>To identify and support non-adherent patients</p> Signup and view all the answers

    What is the difference between adherence, compliance, and concordance?

    <p>Adherence and compliance are interchangeable terms, and concordance is an agreement between patient and provider</p> Signup and view all the answers

    What is the purpose of conducting laboratory tests in drug monitoring?

    <p>To measure therapeutic effectiveness and screen for adverse drug reactions</p> Signup and view all the answers

    What is the volume of distribution of digoxin?

    <p>Large</p> Signup and view all the answers

    What is the half-life of digoxin in patients with normal renal function?

    <p>30-40 hours</p> Signup and view all the answers

    What is the therapeutic level of digoxin according to Clinical Pharmacy and Therapeutics?

    <p>0.8-2 micrograms/L</p> Signup and view all the answers

    What is the definition of adherence?

    <p>The extent to which the patient’s behaviour matches the prescriber’s recommendations</p> Signup and view all the answers

    What percentage of patients take their medicines as prescribed, experience no problems, and receive as much information as they need?

    <p>16%</p> Signup and view all the answers

    What is the difference between intentional and unintentional non-adherence?

    <p>Intentional non-adherence is when the patient decides not to take their medication, while unintentional non-adherence is when the patient forgets to take their medication</p> Signup and view all the answers

    What is the term for the process whereby the clinician and patient collaboratively design a treatment regimen?

    <p>Concordance</p> Signup and view all the answers

    What is the term for the extent to which the patient takes their medicines as prescribed?

    <p>Adherence</p> Signup and view all the answers

    What is the term for the extent to which the patient’s behaviour matches the prescriber’s recommendations?

    <p>Adherence</p> Signup and view all the answers

    How can you identify whether adherence is an issue?

    <p>By exploring the reason for non-adherence</p> Signup and view all the answers

    What is the primary goal of the Transfer of Care Around Medicines (TCAM) national initiative?

    <p>To connect hospitals with community pharmacies and reduce unintentional medication changes</p> Signup and view all the answers

    What is the primary purpose of the Discharge Medication Service (DMS)?

    <p>To reduce medication errors and avoidable harm at discharge</p> Signup and view all the answers

    Which platform is used to achieve the Transfer of Care Around Medicines (TCAM) initiative?

    <p>PharmOutcomes</p> Signup and view all the answers

    What is the recommended approach to recording patient discussions and advice given during a medication review?

    <p>Record in relevant places, including Patient Medication Records, hospital medical notes, and care plans</p> Signup and view all the answers

    What is the primary focus of the Specialist Pharmacy Service (SPS)?

    <p>Medication monitoring and advice</p> Signup and view all the answers

    What is the recommended approach to defining new medication in a medication review?

    <p>Define as 'acute' Rx</p> Signup and view all the answers

    What is the primary goal of a medication review?

    <p>To optimize the impact of treatment for an individual patient</p> Signup and view all the answers

    What type of medication review involves a holistic review of a patient's medicines?

    <p>Type 3 - Clinical medication review</p> Signup and view all the answers

    What is the purpose of a medication review in secondary care?

    <p>All of the above</p> Signup and view all the answers

    What should be assessed during a medication review?

    <p>All of the above</p> Signup and view all the answers

    What is the purpose of medication reconciliation during admission in secondary care?

    <p>To identify potential medication-related problems</p> Signup and view all the answers

    What is a common problem in clinical medication reviews?

    <p>All of the above</p> Signup and view all the answers

    What is the purpose of a medication review in primary care?

    <p>To optimize the impact of treatment for an individual patient</p> Signup and view all the answers

    What is the role of a GP/Pharmacist/Advanced nurse practitioner in a medication review?

    <p>To undertake a structured, critical examination of a patient's medicines</p> Signup and view all the answers

    What is the definition of a medication review according to NICE (NG5), 2015?

    <p>A critical examination of a patient's medicines with the objective of reaching an agreement with the patient about treatment</p> Signup and view all the answers

    What is the purpose of a medication review tool?

    <p>To provide a structured approach to medication review</p> Signup and view all the answers

    Study Notes

    Drug Monitoring

    • Primary Goal: Optimize drug therapy to achieve desired therapeutic outcomes while minimizing adverse effects.
    • Therapeutic drug monitoring: Ensures medications are at the optimal level in the body.
    • Laboratory tests:
      • Ramipril: Monitor the patient's response to Ramipril by checking blood pressure and serum potassium levels.
    • Purpose of conducting laboratory tests:
      • Determine the efficacy and safety of drugs
      • Identify potential drug interactions
      • Monitor drug levels in the body
    • Digoxin:
      • Volume of distribution: Approx. 7 L
      • Half-life: 36 hours in patients with normal renal function
      • Therapeutic level: 0.8 to 2.0 ng/mL (Clinical Pharmacy and Therapeutics)

    Adherence, Compliance, and Concordance

    • Adherence: The extent to which the patient takes their medicines as prescribed.
    • Compliance: The extent to which the patient’s behaviour matches the prescriber’s recommendations.
    • Concordance: Collaboration between the clinician and patient in designing a treatment regime.
    • Identify non-adherence:
      • Observe directly or through medication refill records.
      • Ask the patient about their medication use.

    Medication Management

    • Transfer of Care Around Medicines (TCAM): Aims to improve the safety and effectiveness of medication use at transitions of care.
    • Discharge Medication Service (DMS): Assists patients in transitioning to home care.
    • Platform for achieving TCAM: Digital platforms like Medication Management system.
    • Specialist Pharmacy Service (SPS): Focuses on supporting patients with complex medication needs.
    • Medication review: A comprehensive assessment of a patient's medications.
    • Types of medication reviews:
      • Holistic medication review: Considers all aspects of a patient's medicine use.
    • Purpose of medication review:
      • Identify and address potential medication-related problems
    • Medication review in secondary care:
      • Purpose: Ensure appropriate prescribing and minimize adverse drug reactions.
      • Assessment during review:
        • Current medicines
        • Patient's health
        • Any potential problems
    • Medication reconciliation during admission: Ensure continuity of care by reviewing the patient's medications and making necessary adjustments.
    • Common problem in clinical medication reviews: Incomplete medication history.
    • Medication review in primary care: To identify and address potential medication-related problems in the community.
    • Role of healthcare professionals in medication review:
      • GP/Pharmacist/Advanced nurse practitioner: Lead medication reviews, provide advice and support to patients.
    • Definition of medication review according to NICE: A structured process of considering a patient's medication needs where the patient's medication use is reviewed and adjustments are made based on a consideration of their individual needs.
    • Purpose of medication review tools: To guide healthcare professionals in performing comprehensive reviews.
    • Percentage of patients who take their medicines as prescribed, experience no problems, and receive as much information as they need: 50%.
    • Intentional non-adherence: The patient chooses to take their medications differently than prescribed (e.g., due to cost, side effects, or disbelief in its effectiveness).
    • Unintentional non-adherence: The patient forgets to take their medication or has difficulty understanding and following their medical instructions.
    • Recording patient discussions and advice: Use clear and concise language that captures key details about medications, including any changes, concerns, and advice provided.
    • Defining new medication: Include the name, dosage, frequency, and any special instructions for administration.

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    Description

    Test your knowledge of drug monitoring, adherence, and follow-up methods in primary and secondary care, including the role of pharmacists in identifying and supporting non-adherence. Explore different transfer of care methods and understand the importance of structured medication reviews.

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