Description

The NO TEARS tool is intended to help prompt physicians to perform medication review. It can help reduce polypharmacy, drug costs and adverse drug reactions.


 

Goals:

(1) eliminate unnecessary drugs

(2) reduce drug dosings per day

(3) reduce adverse effects

(4) reduce errors in adherence

(5) switch to cheaper alternatives

 

N

Need and indication

O

Open questions

T

Tests and monitoring

E

Evidence and guidelines

A

Adverse events

R

Risk reduction and prevention

S

Simplification and switches

 

The questions for each sample can vary depending on the patient and the underlying conditions.

 

Need and indications: 4 questions

 

Open questions: 3 questions

 

Tests and monitoring: 3 questions

 

Evidence and guidelines: 3 questions

 

Adverse events: 6 questions

 

Risk reduction and prevention: 2 questions

 

Simplification and switches: 4 questions

 

Limitations:

• The tool is more a mnemonic than a standardized questionnaire. While this allows it to be highly adaptable it use is likely to be highly variable between practitioners.

• While mnemonics are fine, access to information technology means that more specific tools can be used.

 


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