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Zo Payne

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Zo Payne

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    2. Adherence Key factor in relapse (Robinson , 2002) Adverse side effects have impact on adherence (Tacchi and Scott, 2005) Good concordance = reduce risk of relapse Adverse side effects cites as reason for non adherence (Patel and David, 2007)

    3. Glasgow assessment of Side effects Scale (GASS) Developed as a self rating scale to measure frequency of side effects Authors examined 9 other tools that rated side effects. Only two other scales self rated: one of which rated attitudes, other was 51 questions long. Examined other scales, BNF and identified medical significance/consequence of side effects. Focus groups of patients identified and rated acceptability of side effects.

    4. ‘GASS’ 21 item schedule. Patients self complete the scale. Frequency rating: never, once, a few times, everyday (scored 0-3). 0 or 3 for final two yes/no questions. 13-26 = moderate, 26+ =severe Written in simple language that is easy to understand. Also has a distress rating component (non scoring)

    5. GASS ratings categories Sedation/CNS (sleepy/zombie) Cardiovascular side effects (dizzy/ fainted/ fast heart rate) EPSE-Extra-Pyramidal Side Effects (jerky muscles/ shaky arms/ slow movements/ restless legs/ drooling/ uncontrollable movements) Anti-cholinergic side effects (blurry vision/ dry mouth/difficulty passing urine) Gastro-intestinal side effects (felt like being sick/vomited) Genito-urinary side effects (wet the bed) Screening for diabetes (very thirsty/passing urine frequently) Prolactinaemia side effects (sore and swollen around nipples/fluid coming form nipples)/problems enjoying sex/changes to periods) Weight gain (have been gaining weight)

    6. What if a person has a high score?

    7. What if a person has a high score?

    8. Use in primary care setting Short self rating scale so can be completed on arrival by patient in waiting area, so less onerous for clinician Allows a structured and collaborative discussion about medication and side effects. Opens up discussion about non visible side effects such as sexual dysfunction/nigh-time incontinence that might otherwise go unreported. Can always telephone sector consultant for advice if unsure

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