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Polypharmacy reviews

Polypharmacy reviews. Francesca Aaen Care Homes Pharmacist NHS Lanarkshire. Polypharmacy guidance 2012 QOF. Polypharmacy review. Is there a valid and current indication? What is the patient experience? Consider drug effectiveness i.e. NNTs Is the dose appropriate?

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Polypharmacy reviews

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  1. Polypharmacy reviews Francesca Aaen Care Homes Pharmacist NHS Lanarkshire

  2. Polypharmacy guidance 2012 • QOF

  3. Polypharmacy review • Is there a valid and current indication? • What is the patient experience? • Consider drug effectiveness i.e. NNTs • Is the dose appropriate? • Dosing form and schedule appropriate? • Cost-effective prescribing

  4. Consent issues • Informed agreement of the patient / carer / welfare proxy • If no capacity consent must be from welfare attorney or guardian if in place • Otherwise there must be a valid AWI section 47 form completed

  5. Mrs W • 89 years old • Weight 47.2kg • HbA1c = 47 mmol (6.5%) • Alzheimer’s dementia (2006) • NIDDM (2000) • Poor mobility • Poor diet • Lives in a care home • BP 105/62 • eGFR = 47 ml/min • CVA • # NOF (2008) • Recurrent UTIs • Refusing medication

  6. Mrs W - Current medication • Cardioplen XL 5mg daily • Co-codamol 8/500mg x2 four times daily • Adcal D3 caplets x2 twice a day • Cefalexin 250mg at night (since 2011) • Perindopril 2mg daily • Risperidone 0.5mg at night (since 2009) • Aspirin 75mg daily • Simvastatin 40mg at night • Gliclazide 40mg BD • Furosemide 40mg daily

  7. Mr D • 70 years old • BP=125/75 • TC =2.8 • Osteoarthritis • Uncontrolled Angina • Angioplasty 2006 • Fit and well • Persistent dry cough • Lives at home with his wife • Pruritis • Hypertension • Golfs 3 times a week

  8. Mr D - current medication • Atorvastatin 40mg at night • Aspirin 75mg od • Clopidogrel 75mg daily • Diclofenac 50mg three times daily • Co-dydramol 20/500 x 2 four times a day • Bendroflumethiazide 2.5mg daily • Lisinopril 5mg daily • Amlodipine 5mg daily • Hydroxyzine 10mg three times daily • Omeprazole 40mg daily

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