Patient follow up
Click here to load reader
-
Upload
binaya-sapkota -
Category
Health & Medicine
-
view
56 -
download
0
Transcript of Patient follow up
PATIENT FOLLOW-UP
Dr. Binaya SapkotaBPharm, PharmD
1
• Once the initial adherence plan is implemented, F/U is imp. to judge how well the plan is working & whether changes are made.
• Pt. F/U is one of the vital elements of pt. care process that must be completed for individual pt.
• Continuity of care is essential to many pts (particularly those with chronic conditions).
2
• Pharmacist should track medications taken by such pts & regularly update pt’s medication history as long as the pt. is under his care.
• Whenever the pharmacist has any reason to believe that another “HC” provider would give better Rx to the pt., the pt. should be given a referral slip stating his condition & medication.
• Pharmacist’s name & pharmacy contact no. should be stated on the referral slip to facilitate any further inquiries by the other “HC” provider.
3
• F/U may be accomplished during subsequent visits of pt. or through telephone callbacks for which the pt’s consent may be obtained.
• Pharmacist must personally make F/U calls or meetings & enquire about:
i. Pt’s general condition & response to therapyii. General problems, adverse events encountered by the pt.iii. Dose & frequency at which medicines have been taken by the pt.iv. Missed doses
4
• Possible causes of non-compliance by the pt. should be evaluated & the pts counseled accordingly.
• Pharmacist should keep the prescribers updated about all adverse events reported by or elicited from pt. & the stated or probable reasons for pt. not complying with the prescription/therapy.
5
Diagrammatic interpretation of Pt. care process
6
Purposes/needs of F/U evaluations
• To determine actual outcomes achieved by pharm. care plan.
• To assess the extent to which the plan has achieved desired outcomes.
• To determine if there are new or changing medication therapy problems that must be addressed.
• To determine if anything has occurred that increases pt.’s risk for developing new medication therapy problems.
7
• Pt.’s progress is documented accurately in pharmacy record & communicated effectively to pt. & other HPs.
• Status of each medical condition described a/c following categories:– Resolved: Therapeutic goals achieved & therapy
completed.– Stable: Goals achieved but continue the same therapy
(CST).– Improved: Progress being made towards achievement of
goals. So, “CST”.– Partial Improvement: Progress being made but minor
adjustments in therapy required.
8
Status of each medical condition
– Unimproved: No measurable progress yet but “CST”.
– Worsened: Decline in health condition. So, revise therapy accordingly.
– Failure: Goals not achievable with the present therapy. So, initiate new therapy.
– Expired: Pt. died while receiving medication therapy.
9
Status of each medical condition
• If changes in the plan reqd. to maintain or improve its efficacy, safety or economy, clinician coordinates these changes & communicates them to the pt. & other “HC” providers.
10
Plan for Regular F/U
• Pharmacist plans to interact with pt. at regular, brief intervals to reinforce adherence plan.
• Brief appointments scheduled when pt. visit the pharmacy for prescription refills.
• Plan adapted to pt.’s lifestyle & re-evaluated from time to time to adjust for life changes such as ageing or change in work or school schedules.
11
F/U counseling sessions
• Identification of following factors should be considered while conducting F/U counseling by pharmacist:
i. Pt. problems with medication (S/S, complex drug regimen, medication therapy interfering with lifestyle)
ii. Deterioration in health status requiring pharmacotherapy review
iii. Medication errorsiv. Medication mgmt.
12