By Kilburn, J.
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Extra info for Answer Plans for the MRCGP
Issues for the practice • • • • Use of clinical nurse for education and monitoring/lifestyle risk factors. Use of written material, videos etc. Practice formulary for prescribing. Prescribing costs. Information-sharing • • • • • Explanation of physiology. Risk-benefit assessment. Awareness of side-effects. Mutual agreement on different therapeutic approaches. Importance of the patient’s own unhurried choice. PRACTICE QUESTIONS 25 Evidence-based decision re principal effects Cardiac There may be a protective role in patients with significant risk factors or previous MI but clear evidence inconclusive.
Cultural or religious barriers. • Older, more vulnerable patients more likely to hoard medications. g. antihypertensive prevention strategies for heart disease and strokes undermined. • Unnecessary additional drugs prescribed. • Unexpected withdrawal effects. • Resources wasted. Ways of aiding compliance • Methods of checking compliance (questioning, counting tablets, measuring blood levels). • Communication issues: consider patient’s ideas, concerns and expectations. • Use simple language and repeat important messages.
Describe monitoring and recording. • Describe standards and targets. Dissemination • Guidelines are useless unless distributed effectively. • Period of discussion, debate and adaptation. Audit and update • Assess for improvement in delivery of patient care.
Answer Plans for the MRCGP by Kilburn, J.