Download Medication Use Systems Case 4: Principles of Medications

Medication Use Systems
Case 4: Principles of Medications Management
Objectives
1. To understand the operational necessities for a safe and effective medications use system.
2. To be able to determine which principle(s) might have been violated when a drug-therapy
problem occurs.
Instructions:
For each of the 14 exercises from Case 1:
(a) make sure you know what the problem is,
(b) write down which principle of medications management was likely to have been violated to
set the stage for a potential DTP or to initiate it. and
(c) briefly support your decision.
In many cases multiple principles may have been violated. Since all of the principles are related
at some level, try to choose the most immediate issue. Your explanation ( c) will be especially
important.
Example:
Consider the case of Sarah Bellum (Case 1, exercise 1)
(a) Her problem is that her asthma is poorly controlled by her over-use of Ventolin® and TheoDur® and her under-use of Asthmacort®.
(b) Does her DTP mainly involve . . .
i. a lack of response to signs and symptoms? Not her present problem, but maybe her
next problem will if you don’t respond!
ii. a lack of access to safe and cost-effective medications? Yes.
iii. a lack of follow-up? No. This could have been involved in the past but the case does
not say so.
iv. Poor cooperation with and among health professionals and herself? No. She is
probably trying to cooperate because she told the pharmacists how she uses her meds.
She is not cooperating correctly but there is no reason given to think that she is willfully
not cooperating.
v. Lack of a medications management system? No. If this type of problem kept recurring
in a patient because nobody did anything about it, it would suggest a breakdown in the
system of care. If a population had too many such cases then this would suggest that the
overall system has no way to detect and to resolve such breakdowns on the patient care
level.
NOTE: You do not need to write out every one like this, just your choice for the correct
answer to b with a brief explanation.
(c) She has physical and financial access to her medicines but does not know how to use
them correctly.