Home Medicines Review H 21.01
Home Medicines Review H 21.01
Patient details
Name: Robert Boyd Age: 54 years
Address: Adelaide Weight: 96 kg
Referring GP: Dr Lance Height: 173 cm
Patient information from HMR referral
Allergies or adverse reactions: Nil known
Smoking status: Ex-smoker; quit 20 years ago (15 pack year history)
Quitting stage: n/a
Alcohol consumption: 2-3 alcoholic drinks on weekends only
Reason for referral for HMR
Increasingly poor BSL control
Patient history (social/medical) from HMR referral
Medical history
Type 2 diabetes, hypertension, lower back pain, irritable bowel syndrome
Social history
Married, lives with wife
Delivery driver for a fresh seafood wholesaler
Current medications
Medication Dose (according to patient) Purpose/comments (according to patient)
Empagliflozin 10mg 1 tablet in the morning Diabetes (new medication)
Docusate and senna 50/8mg 2 tablets at night when required Most nights
Irbesartan 150mg/
Hydrochlorothiazide 12.5mg 1 tablet in the morning Blood pressure (new medication)
Metformin 1g 1 tablet in the morning
1 tablet at mid-day
1 tablet in the evening Diabetes
Paracetamol CR 665mg 2 tablets in the morning
2 tablets in the evening Pain
Rabeprazole 20mg 1 tablet in the morning Indigestion
Sitagliptin 100mg 1 tablet in the morning Diabetes
Tears Naturale Put 1 to 2 drops into each eye when required Dry eyes
TRUEbalance test strips Use weekly Does not like using
Relevant test results
2 weeks ago
Blood pressure 145/90 mmHg
HbA1c 77mmol/ mol (9.2%)
Total cholesterol 4.5 mmol/L
HDL 0.7 mmol/L
LDL 2.9 mmol/L
Triglycerides 2.0mmol/L
6 months ago
Sodium 139 mmol/L (135 - 145 mmol/L)
Potassium 4.2 mmol/L (3.4 - 5.5 mmol/L)
Urea 8.2 mmol/L (2.5 - 7.0 mmol/L)
Creatinine 142 micromol/L (60 - 120 micromol/L)
Information from patient interview
Whilst at the patients home the following information is obtained:
He does not want to start insulin, so his GP recently commenced empagliflozin after gliclazide was ceased. He has no idea what his blood glucose levels are as he does not measure his BSLs regularly.
At his recent visit 2 weeks ago, his GP told him that his blood pressure reading was too high, and he was commenced on medication for this too.
He has recently developed a burning sensation in his feet that he thinks is related to his back condition and sitting for prolonged periods. He frequently walks around on cold tiles during the night which makes his feet feel better.
Back pain is well controlled with the current analgesic regimen
He is regularly constipated unless he uses laxatives regularly
Questions
Consider the patient needs or concerns, medication-related problems, and medication management issues.
What further information would assist in making your assessment of this patient? Explain reasons for obtaining this information. Who/where would you obtain this information?
Based on the information provided, identify potential and actual medication-related and disease-related problems, and patient concerns. Suggest how these could be addressed and/or monitored.
Write a letter or report to the referring GP, outlining your key findings for this patient and your suggestions or recommendations.
Mandatory Format ofALL FOUR casestudy responses:
Please note the followingmandatoryformatting requirements for all case studies:
Your response must be a minimum of 11 pages in length, but must not exceed 22 pages (including references), as follows:
Question 1: not less than three pages, and not exceeding six pages in length including references
Question 2: not less than six pages, and not exceeding 12 pages in length including references
Question 3: not less than two pages, and not exceeding four pages in length including references
You must use one of the following fonts: Calibri, Arial or Times New Roman
Font size must be 11 or 12 and single line spacing and margins must be the default for Windows
Do not increase or decrease font size and margins (or forego paragraph and heading line breaks) to meet the minimum or maximum page length
Page numbers must be used
Do not use different colour fonts black only
Do not include a cover page or the case study scenario as an intro into your submission
