Clinical Checking

Question 1

What do clinical checks involve?

Answer 1

Identifying potential pharmacotherapeutic problems by collating and evaluation all relevant information including patient characteristics, disease states, medication regimen and, where possible, lab results.

Question 2

What patient characteristics should be considered when performing a clinical check?

Give examples where applicable.

Answer 2

1) Patient Type
Establishing whether a patient falls into a group where a treatment is CI or cautioned, e.g.
- Children
- Women who are pregnant / breastfeeding
- Elderly
- Certain ethnic groups
- Gender

2) Co-morbidities
E.g. renal/hepatic impairment, HF etc.

3) Patient intolerances / preferences
Including known ADR’s/allergies, dietary intolerances, patient preferences, religious beliefs and knowledge/understanding of a medicine and why it’s being taken.

Question 3

What medication regimen factors should be considered when performing a clinical check?

Answer 3

1) Indication

2) Changes in regular treatment
Confirm that any changes are intentional.

3) Dose, frequency and strength
This should be considered according to the patient characteristics.

4) Dosing of the formulation
For the formulation prescribed, is the dose and frequency appropriate.

5) Drug compatibility
Regular and new treatments should be evaluated for interactions, duplications and antagonistic activity.

6) Monitoring requirements
For medicines requiring monitoring, ensure that the latest test results are available and determine if dose adjustments are required.

Question 4

What administration and monitoring factors should be considered when performing a clinical check?

Answer 4

1) Route of administration
Is the prescribed route suitable for the patient and whether a preparation is available for that route. Check for compatibility issues that may arise.

2) Aids to administration
Are any aids required to support administration, e.g. spacer devices, eye drop dispensers etc.

Question 5

Why is record keeping important?

Answer 5

• For continuity of care
• Evidence the benefit of pharmacy input
• Improving patient care

Question 6

Relating to clinical checks, what records should be kept?

Answer 6

Any significant clinical checks and interventions made; include details of discussions and agreed decisions with other HCP’s.