Adv Ther Priniciples Part II

Question 1

What’s the def of a “complex patient”?

Answer 1

a person with 2 or more chronic conditiosn where each condition may influence the care of the other condition. they may have other factors like age, race, gender and psychoscoial issues that also influence morbidity.

• basically, anyone with 2+ chronic conditions and may be: older, BIPOC, mentally ill.

Question 2

What are 7 common signs of complexity?

Answer 2

• Multiple comorbidities
• Polypharmacy
• Multiple drug interactions
• Many doctors involved
• Frequent hospitalizations
• Large number of diagnostic tests
• Language barriers

PLLMMMF {puhleez mofo}

MC, MD, MD, Large, Language, frequent, poly

Question 3

what are 2 tools used for assessing patient complexity?

Answer 3

• INTERMED: Intervew based instrument to assess case and care complexity (covers 3 aspects of health risks).
• Minnesota Complexity Assessment method: Similar, but looks at diff aspects. Includes organization of care (i..e number of docs), includes language barrier, trust in healthcare syst etc.
  Just know name. don’t need to know details.

Question 4

Problem- Oriented Medical Record System:
- What is a problem lis?

Answer 4

it’ where you list ALL pt’s PROBLEMS, including permanent and temporary problems.

Problem List:
1) Permanent Problems:
- Active vs Inactive.

2) Temporary Problems

Question 5

When would you consider incluindg “temporary” problems like allergic rhiniits or a rash in a problem list?

Answer 5

ONLY IF THEY ARE RELEVANT TO THE SITUATION.

Question 6

Classify the following problems as temporary? permanent? and whether you’d include or not in a problem list?

• Appendectomy 1967
• Hypertension 1993
• Sore Throat 2016
• Wrist Sprain 2010
• Heart Failure 2002
• Sulfa Allergy (hives) 1985
• DMII 1998
• Constipation 1975

Answer 6

• Appendectomy 1967 - permanent, inactive, include.
• Hypertension 1993 - permanent, INactive, include.
• Sore Throat 2016 - temporary. dont includ, unless frequent or prone to pharyingitis infections etc.
• Wrist Sprain 2010 - temporary. include.
• Heart Failure 2002 - permanent, active. include.
• Sulfa Allergy (hives) 1985- temporary. include. ALWAYS INCLUDE ALLERGIES.
• DMII 1998. permanent, active. include.
• Constipation 1975. temporary, don’t include.

Question 7

see ANKi for practice cases.

Question 8

What are teh classes that you must ALWAYS CHECK FOR DDIS?

Answer 8

• Anticoagulants
• Antimicrobials
• Antidepressants
• Statins
• Antiseizure medications
• Antineoplastic agents
• Antirejection agents
• Anti-tuberculosis agents
• Antiarrhythmic drugs

Question 9

What scale do you use to assess how likely an AE is drug related?

What score indicates:
- DEFINITE ADR
- Probable?
- Possible?
- Unlikely?

Answer 9

Naranjo ADR prob scale.

https://www.evidencio.com/models/show/661

> or = 9 : Definite
5-8 = Probable
1-4 = Possible
0 or less = Unlikely