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Table 8 Verbatim examples of discharge health and medication issue outcomesa

From: Patient care activities by community pharmacists in a capitation funding model mental health and addictions program

  Health issue Action Outcome
Treatment optimization Anxiety & depression Has improved through talking as well as having better control over asthma. Still feels defeated and drained with anxiety more at night. But overall she is better. Improved
Sleep difficulty Melatonin and changed Effexor® [venlafaxine] schedule. Improved
Insomnia. Average sleep 3 h per night, multiple medications. Sleep therapy (CBTib), weaned off hypnotics. Resolved
Improve depression Initiation of Cipralex®[escitalopram], monitoring for effectiveness Improved
Did not feel comfortable taking venlafaxine Pharmacist contacted doctor to have patient switched to citalopram. Resolved
Depressive episodes related to menses Increased Paxil® [paroxetine], augmented with Abilify® [aripiprazole], controlled menses via depo [medroxy]progesterone. Improved
Anxiety + OCDc tendencies CBTd option identified and accessed Improved
Antidepressant ineffective Sent letter to doctor. He did not act/respond on it. Unchanged
Pain control Changed to long-acting Hydromorph Contin® [hydromorphone]. Improved
Anxiety Meditation, speaking with pharmacist during Bloom, speaking with doctor. Improved
Anxiety, anger, paranoia No changes in medications. [Patient] feels like this program has helped a lot. She has decreased anxiety coming into pharmacy, talking to me about her health/personal and mental health issues and feels comfortable if she needs help in the future. Still experiencing anger and paranoia - Has talked to doctor about referral to psychiatrist. Improved
Chronic pain Acupuncture, tried nortriptyline, massage, chiropractor, yoga Unchanged
Weight Controlled asthma better, therefore allowing her to exercise more and discontinue prednisone. Improved
PTSDe Sertraline 50 mg started Unchanged
Seasonal depression Light therapy suggested to be continued Improved
Adverse effects Medication side effects Met regularly to discuss medication side effects. Improved
Fatigue/insomnia Still unable to work full days. Tamoxifen may be causal but continuing × 2 years. Unchanged
Sertraline side effect management Zantac® [ranitidine] 150 mg once daily half hour before sertraline. Resolved
Decreased sex drive Switched oral contraceptive. Resolved
Non-adherence Not testing [blood glucose] regularly because of finances Now on 5 injections per day of insulin - > seeing clinic for supplies Improved
Not taking meds properly More organized - and knows what they are for, but now ++f financial issues Unchanged
Medication withdrawal Looking for a more natural approach/would like to stop all medications. We discussed current medication but did not think it was a good idea to stop everything abruptly. Unchanged
Inappropriate polypharmacy Domperidone + Ezetrol® [ezetimibe] not needed. Contacted doc for discontinuation. [Patient] felt fine without those. Resolved
Reduction in pill load. Change in meds. Improved
Unnecessary OTCg products Stopped Resolved
Other Finances, tax return. Had an accountant go through papers and get things straightened out. Resolved
Had not seen doctor for a long time Helped encourage visit to doctor’s office. Was able to get to doctor and to get blood work done. Resolved
Overlap in medications from 2 doctors Both doctors made aware - > patient now keeping them both informed on what she’s on Improved
  1. a Where medications were written verbatim as brand name or single source products, the generic name has been added in square brackets
  2. b CBTi: cognitive behavioural therapy for insomnia
  3. c OCD: obsessive compulsive disorder
  4. d CBT: cognitive behavioural therapy
  5. e PTSD: post traumatic stress disorder
  6. f ++: indicates increased or significant
  7. g OTC: over the counter