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Medication Review and Optimization
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Medication Review and Optimization

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Questions and Answers

What is the primary goal of medication review in the context of older persons?

  • To optimize the patient's medication using a patient-centered approach (correct)
  • To minimize the number of medications being taken
  • To focus solely on managing long-term conditions
  • To prioritize medication reconciliation over medication optimization

    • What is the main benefit of using the number-needed-to-treat (NNT) measure in medication review?

  • It identifies high-risk medications with a high anticholinergic burden
  • It provides a standardized measure of medication effectiveness (correct)
  • It helps estimate the risk of medication side effects
  • It determines the optimal dosage of a medication

    • What is a key consideration when deprescribing medications in patients with multi-morbidity?

  • Prioritizing the treatment of one condition over others
  • Minimizing the use of prioritization toolkits
  • Considering the cumulative effect of multiple medications (correct)
  • Focusing on medications with a high anticholinergic burden

    • What is the primary purpose of medication reconciliation in the context of medication review?

    <p>To ensure accurate and comprehensive medication lists</p> Signup and view all the answers

    What is a key benefit of using prioritization toolkits in medication review?

    <p>They support decision-making in complex medication review cases</p> Signup and view all the answers

    What is the main difference between medication optimization and deprescribing?

    <p>Medication optimization focuses on improving medication regimens, while deprescribing focuses on reducing medication burdens</p> Signup and view all the answers

    What is the primary focus of medication optimization, according to the NICE guidelines?

    <p>A person-centered approach to safe and effective medicines use</p> Signup and view all the answers

    What is the main difference between medication reconciliation and medication review, according to ISMP Canada?

    <p>Medication reconciliation is intended to prevent medication errors at transition points</p> Signup and view all the answers

    What is the primary goal of the WHO's Global Patient Safety Challenge: Medication Without Harm?

    <p>To prioritize three areas for strong commitment, early action and effective management</p> Signup and view all the answers

    What is a key factor contributing to high-risk situations, according to the report?

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

    What is the primary purpose of prioritization toolkits in medication review?

    <p>To predict clinical risk and assign pharmaceutical acuity</p> Signup and view all the answers

    What is a core element of prioritizing patients for medication review?

    <p>Identifying patients who are on high-risk medications</p> Signup and view all the answers

    What is the main benefit of using pharmacy prioritization tools in medication review?

    <p>To maximize patient outcomes and reduce costs</p> Signup and view all the answers

    What is the acronym used by the Australian Clinical Excellence Commission (CEC) to specify high-risk medications?

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

    What is the primary focus of medication safety in high-risk situations?

    <p>Medication errors and unsafe medication practices</p> Signup and view all the answers

    What is the primary goal of shared decision making in evidence-based medicine?

    <p>To use the best available evidence to guide decisions about patient care</p> Signup and view all the answers

    What is the primary focus of medication optimization in older persons?

    <p>Maximizing patient outcomes</p> Signup and view all the answers

    Which of the following is a key consideration in the medication review process?

    <p>Time constraints of the healthcare provider</p> Signup and view all the answers

    What is the primary goal of shared decision-making in medication optimization?

    <p>Promoting evidence-based medicine</p> Signup and view all the answers

    Which of the following is a key principle of medication optimization?

    <p>Patient-centered approach</p> Signup and view all the answers

    What type of medication is vincristine?

    <p>Chemotherapeutic agent</p> Signup and view all the answers

    What is the primary purpose of identifying high-risk medications in medication review?

    <p>To prioritize medication deprescribing</p> Signup and view all the answers

    Which of the following tools is commonly used in medication review to aid decision-making?

    <p>Prioritization toolkit</p> Signup and view all the answers

    Which of the following medications is NOT considered high-risk according to the South Tipperary Enablement Program for Older Persons?

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

    What is the primary benefit of using the number-needed-to-harm (NNH) measure in medication review?

    <p>To estimate the potential harm of medications</p> Signup and view all the answers

    What is the primary purpose of a pharmacy prioritization toolkit?

    <p>To triage patients based on pharmaceutical acuity</p> Signup and view all the answers

    What is the goal of medication optimization?

    <p>To improve patient outcomes</p> Signup and view all the answers

    Which of the following is a key consideration when optimizing medications for patients with multi-morbidity?

    <p>Considering the complexity of medication regimens</p> Signup and view all the answers

    Which of the following is NOT a guiding principle for optimizing medicines suggested by the Royal Pharmaceutical Society?

    <p>Prescribe the most expensive medication</p> Signup and view all the answers

    What is the process of accurately listing a person's medications?

    <p>Medication reconciliation</p> Signup and view all the answers

    What type of medication is hydromorphone?

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

    What is the purpose of using tools like STOPP/START and Beers Criteria?

    <p>To identify potentially inappropriate medications</p> Signup and view all the answers

    Which of the following is a type of anti-infective?

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

    What is the purpose of medication review?

    <p>To evaluate the risks and benefits of each medication</p> Signup and view all the answers

    What is the reason for tapering off Duloxetine 60 mg daily?

    <p>As a result of low mood associated with family bereavement</p> Signup and view all the answers

    What is the basis for Tanya's new prescription of calcichew?

    <p>To ensure calcium and vitamin D levels are within range</p> Signup and view all the answers

    What is the primary indication for Tanya's prescription of denosumab?

    <p>To manage osteoporosis</p> Signup and view all the answers

    What is the reason for stopping Sertraline (Lustral) 100 mg daily?

    <p>Because the medication was prescribed in error</p> Signup and view all the answers

    What is the purpose of the FRAX (Fracture risk assessment) tool?

    <p>To evaluate the risk of osteoporosis</p> Signup and view all the answers

    Why was the dose of Bumetanide reduced from 2 mg to 1 mg?

    <p>The exact reason is not specified in the content</p> Signup and view all the answers

    What is the term for the process of tapering, stopping, discontinuing, or withdrawing drugs?

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

    What is the purpose of the DXA scan?

    <p>To evaluate the risk of osteoporosis</p> Signup and view all the answers

    What is the reason for stopping Ibuprofen?

    <p>Due to an adverse reaction to the medication</p> Signup and view all the answers

    What is the purpose of the number-needed-to-harm (NNH) measure?

    <p>To estimate the risks of a medication</p> Signup and view all the answers

    What is the primary reason why clinicians often have limited evidence to support the use of preventative medicines in the frail, multi-morbid, and cognitively impaired?

    <p>They are often excluded from clinical trials</p> Signup and view all the answers

    What is the primary goal of deprescribing in patients with multi-morbidity?

    <p>To reduce the risk of ADRs and improve adherence</p> Signup and view all the answers

    When is the ideal time to deprescribe in patients with multi-morbidity?

    <p>During a medication review, before a prescribing cascade or ADR occurs</p> Signup and view all the answers

    What is the primary benefit of using the NICE Multimorbidity guideline in patients with multi-morbidity?

    <p>It helps clinicians to identify when a patient needs management specifically for their multi-morbidity</p> Signup and view all the answers

    What is the primary consideration when adopting a patient-centered and shared decision-making approach to deprescribing?

    <p>To weigh up quality of life vs. quantity of medicines</p> Signup and view all the answers

    What is the primary purpose of using a prioritization toolkit in medication review?

    <p>To identify patients who need deprescribing</p> Signup and view all the answers

    What is the primary benefit of reducing the number of medications prescribed in patients with multi-morbidity?

    <p>It reduces the risk of ADRs</p> Signup and view all the answers

    What is the primary consideration when considering preventative medicines in patients with multi-morbidity?

    <p>To consider risk vs. benefit when prescribing</p> Signup and view all the answers

    What is the primary purpose of the number-needed-to-harm (NNH) measure?

    <p>To measure the number of people who need to be exposed to a risk factor to cause harm to an average of one person</p> Signup and view all the answers

    What is the primary challenge in deprescribing in patients with multi-morbidity?

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

    Study Notes

    Medication Review and Optimization

    • Medication review is crucial to ensure patients take their medicines as intended, supporting the management of long-term conditions, multimorbidity, and polypharmacy.
    • The review process can incorporate medication optimization and deprescribing, with varying levels depending on factors like professional knowledge, time constraints, and objectives.

    Principles of Medication Review

    • The goal of medication review is to optimize the patient's medication using a patient-centered approach, aiming to achieve the best possible outcomes from their medicines.

    Learning Outcomes

    • Outline the principles of medication reconciliation and optimization.
    • Identify high-risk medication, including those with a high anticholinergic burden.
    • Leverage appropriate tools to aid decision-making in the medication review process.
    • Explain the value of the number-needed-to-treat (NNT) measure and the number-needed-to-harm (NNH) measure.
    • Explain the role of prioritization toolkits in practice.
    • Identify deprescribing opportunities in patient care.
    • Consider the role of multi-morbidity in the deprescribing process.

    Medication Optimization and Review

    • Medication review is a structured evaluation of a patient's medicines, which can incorporate medication reconciliation, medication optimization, and/or deprescribing.
    • The goal of medication optimization is to achieve the best possible outcomes from the individual patient's medicines.
    • The Royal Pharmaceutical Society suggests four guiding principles for optimizing medicines:
      • Aim to understand the patient's experience
      • Make choices based on evidence
      • Make optimization routine in practice
      • Ensure medicines are as safe as possible

    Medication Reconciliation and Review

    • Medication reconciliation is the process of accurately listing a person's medications.
    • Medication review is a person-centered approach to safe and effective use of medicines.
    • The World Health Organization (WHO) has identified three areas for strong commitment to protect patients from harm while maximizing the benefit from medication:
      • Medication safety in transitions of care
      • Medication safety in polypharmacy
      • Medication safety in high-risk situations

    Pharmacy Prioritization Tools

    • Pharmacy prioritization tools are used to identify patients who are at a higher risk of adverse drug events or increased risk of medication-related safety issues.
    • These tools can help predict clinical risk and target patients who would benefit most from a medication review.
    • Examples of high-risk medications include:
      • Anti-infectives
      • Potassium and other electrolytes
      • Insulin
      • Narcotics (opioids) and other sedatives
      • Chemotherapeutic agents
      • Heparin and anticoagulants

    Deprescribing

    • Deprescribing is the process of tapering, stopping, discontinuing, or withdrawing drugs, with the goal of managing polypharmacy and improving outcomes.
    • The ideal time to deprescribe is during a medication review, before a prescribing cascade or ADR occurs.
    • Challenges in deprescribing include:
      • Fear of adverse withdrawals
      • Lack of knowledge around identification of opportunities to deprescribe
      • Lack of available resources
      • Time constraints

    Statistical Measures

    • The number-needed-to-treat (NNT) is a measure that indicates how many people need to be treated to result in a beneficial outcome in one person.
    • The number-needed-to-harm (NNH) is a measure that indicates how many people need to be exposed to a risk factor over a specific period to cause harm to an average of one person.

    Polypharmacy and Multimorbidity

    • The NICE Multimorbidity guideline (2016) enables clinicians to stop stringently adhering to all the single disease guidelines that preceded its issuance.
    • The guideline aims to help identify when a patient needs management specifically for their multi-morbidity, where broad functional outcomes are usually the major therapeutic goal.
    • Single disease guidelines may not apply to the complex needs of an individual patient, especially those who are frail, multi-morbid, and cognitively impaired.

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    Description

    Medication review is crucial to ensure patients take their medicines as intended, supporting the management of long-term conditions. This quiz covers the principles and processes of medication review and optimization.

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