Data collection:
(1) Get a complete medication list from the patient.
(2) Measure the patient's orthostatic pressure.
Evaluate Each Drug
Parameters to consider for each drug:
(1) indications (1 question)
(2) risks (4 questions)
(3) dosage (1 question)
Discontinue drug if:
(1) there is no specific indication for the drug OR if there are risks present, AND
(2) it is feasible to discontinue the drug.
Substitute a less toxic drug if:
(1) there is no specific indication for the drug OR if there are risks present, AND
(2) it is not feasible to discontinue the drug AND
(3) there is a less toxic or more appropriate drug available.
Adjust drug dosage to the least possible dose if:
(1) the dosage can be decreased, OR
(2a) there is no specific indication for the drug OR if there are risks present, AND
(2b) it is not feasible to discontinue the drug AND
(2c) there is no less toxic or more appropriate drug available.
Other Evaluations
Evaluate the entire drug regimen: 2 questions
If either is true, then make priorities and change drugs, dosages, schedules or preparations.
Evaluate compliance: 2 questions
If either is true, then
(1) educate
(2) write instructions
(3) suggest a medication dispenser
(4) recommend a home health evaluation.
