Table 8 Verbatim examples of discharge health and medication issue outcomesa
| Â | 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 3Â 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 50Â 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 |