| Outcome |
Pattern of care
|
| 1. Gastritis and/or upper GI bleed and anaemia |
NSAID (e.g. diclofenac, least one month ibuprofen, ketoprofen etc) use for at and/or GI perforation and/or GI ulcer No concurrent use of a cytoprotective agent (misoprostol) Haemoglobin/haematocrit/CBC not done at least every 3 months thereafter |
| 2. Acute renal failure and/or renal. insufficiency |
NSAID (e.g. diclofenac, ibuprofen, ketoprofen etc.) use for at least three months BUN/serum creatinine not done at least every three months |
| 3. ER visit/hospitalization due to depression and/or increase in dosage of antidepressant |
History/diagnosis of depression Use of long-acting benzodiazepine (e.g.; Librium, Valium, Centrax, Paxipam, Dalmane, Azaene/Tranxene etc.) |
| 4. Fall and/or hip fracture and/or other bone fracture and/or bone break |
Use of tricyclic antidepressant (e.g. amitriptyline, doxepin, imipramine etc.) |
| 5. ER visit/hospitalization due to worsening renal impairment and/or acute renal failure and/or renal insufficiency |
Diagnosis/history of moderate to severe renal impairment and/or history of kidney disease Use of tetracycline BUN/serum creatinine not done within 30 days of initiation of therapy and at least every 6 months |
| 6. ER visit/hospitalization due to hyperkalaemia |
Use of an ACE inhibitor (e.g. captopril, enalapril etc.) Electrolytes/CBC not done at least every 6 months Should be done at baseline, 10–14 days, then prn |
| 27. Blood dyscrasias and/or hyponatraemia and/or excessive water retention and/or syndrome of inappropriate antidiuretic hormone (SIADH) |
Use of carbamazepine Electrolytes/CBC not done before therapy initiated, at least weekly during the first month of therapy, at least monthly during the next five months of therapy, and at least every 6 months thereafter |
| 8. Acute renal failure and/or renal insufficiency |
Use of lithium. BUN/serum creatinine not done at least every three months |
| 9. Theophylline toxicity |
Use of theophylline Drug level not done at least every six months |
| 10. Bipolar exacerbation and/or ER visit/hospitalization due to bipolar disorder |
Diagnosis/history of bipolar disorder Use of lithium Drug level not done at least every three months |
| 11. Major and/or minor haemorrhagic event |
Use of IV heparin PTT not done at least every day |
| 12. Gastritis and/or upper GI bleeds and/or perforations and/or GI ulcers and anaemia |
History/diagnosis of ulcers and/or GI bleeding NSAID (e.g. diclofenac, ibuprofen, ketoprofen etc.) use for at least one month |
| 13. Gastritis and/or upper GI bleeds and/or GI perforations and/or GI ulcers and anaemia |
History/diagnosis of ulcers and/or gastrointestinal bleeding Use of an oral corticosteroid (e.g., prednisone) for at least 3 months |
| 14. ER visit/hospitalization due to depression and/or increase in dosage of antidepressant |
History/diagnosis of depression Use of a barbiturate (e.g. butalbital) |
| 15. ER visit/hospitalization due to depression and/or increase in dosage of antidepressant |
History/diagnosis of depression Use of a sympatholytic antihypertensive (e.g. resperine, methyldopa, clonidine etc.) |
| 16. ER visit/hospitalization due to congestive heart failure and/or heart block |
History/diagnosis of congestive heart failure with heart block or advanced bradycardia Use of digoxin |
| 17. Fall and/or hip fracture and/or other bone fracture and/or bone break |
Use of a long-half-life hypnotic-anxiolytic (e.g. flurazepam, diazepam, chlordiazepoxide etc.) |
| 18. Acute renal failure and/or renal insufficiency |
Use of an ACE inhibitor (e.g. captopril, enalapril etc.) BUN/serum creatinine not done at initiation of therapy and at least every three months thereafter |
| 219. Status epilepticus and/or ER visit/hospitalization due to seizure activity |
Use of an anticonvulsant requiring drug-level monitoring (e.g. phenytoin, carbamazepine, valproic acid) Drug level not done upon initiation of therapy and at least every six months thereafter |
| 20. Lithium toxicity |
Use of lithium Lithium level not done at least every month |
| 21. ER visit/hospitalization due to hyperglycaemia |
Use of an oral hypoglycaemic agent (e.g. chlorpropamide etc.) Haemoglobin A1c level not done at least every six months |
| 22. Major and/or minor haemorrhagic event |
Use of warfarin Prothrombin time not done before therapy starts and at least every month thereafter |
| 23. ER visit/hospitalization due to hyperthyroidism |
Use of a thyroid or antithyroid agent (e.g. levothyroxine, propylthiouracil etc.) T4/TSH not done within six weeks after initiation of therapy and at least every 12 months thereafter |
| 224. Secondary myocardial infarction |
History/diagnosis of myocardial infarction No use of ASA and/or a beta-blocker (e.g. metoprolol, etc.) |
| 25. Blood dyscrasias |
Concurrent use of trimethoprim/ sulfamethoxazole (Bactrim, Septra) and methotrexate WBC/platelets/CBC not done at least every four weeks |
| 26. ER visit/hospitalization due to a major/minor haemorrhagic event |
Warfarin use NSAID (e.g. diclofenac, ibuprofen, ketoprofen, etc.) use PT not done within 10 days |
| 27. ER visit/hospitalization due to hypothyroidism |
Lithium use for at least six months TSH not done at least every six months |
| 28. ER visit/hospitalization due to a major/minor haemorrhagic event |
Warfarin use Antibiotic use (Bactrim etc.) PT not done within five days |
| 29. Gastritis and/or upper GI bleed and/or GI perforation and/or GI ulcer and anemia |
Use of two or more NSAIDs concurrently for at least 2 weeks. |
| 30. Blood dyscrasias/ thrombocytopenia |
Use of Ticlopidine (Ticlid) CBC/platelets not done at baseline, within two weeks of start of therapy and within two months |
| 31. Rebound congestion |
Use of a long-acting nasal spray (e.g. oxymetazoline) for more than three days |
| 32. Acute urinary retention |
Diagnosis/ history of bladder atony due to diabetes Use of imipramine |
| 33. Acute respiratory failure |
History/diagnosis of severe COPD Use of a medium- to long-acting benzodiazepine |
| 34. Acute urinary retention |
History/diagnosis of benign prostatic hypertrophy (BPH) Use of an anticholinergic agent |
| 35. ER visit/hospitalization due to liver toxicity |
Use of troglitazone (Rezulin) Liver function tests not done at baseline and at least monthly for the first eight months of therapy and at least every two months for the remainder of the first year |
| 36. ER visit/ hospitalization due to congestive heart failure and/or fluid overload |
History/diagnosis of high blood pressure (over 140/90 mmHg and/or congestive heart failure NSAID (e.g. diclofenac, indomethacin, ketoprofen, etc.) use for at least three months |
| 37. ER visit/hospitalization due to extreme hypoglycaemia |
History/diagnosis of diabetes Use of a beta-adrenergic blocking agent (e.g.; propranolol, nadolol etc.) |
| 38. ER visit/hospitalization due to depression and/or increase in dosage of antidepressant |
History/diagnosis of depression Use of a moderate to high lipophilic beta-adrenergic blocking agent (e.g. propranolol, pindolol etc.) |
| 39. ER visit/hospitalization for hypokalaemia |
Use of a potassium-wasting diuretic (e.g. hydrochlorothiazide etc.) No concurrent use of potassium chloride supplement Electrolytes not checked at least every two months |
| 240. Anticonvulsant drug toxicity |
Use of an anticonvulsant requiring drug level monitoring (e.g.; phenytoin, carbamazepine, valproic acid) Drug level not done at least every six months |
| 41. ER visit/hospitalization due to systolic heart failure |
History/diagnosis of systolic heart failure Use of a beta-adrenergic blocking agent (e.g. propranolol, nadolol etc.) |
| 42. ER visit/hospitalization due to congestive heart failure |
History/diagnosis of congestive heart failure Use of an antiarrhythmic agent (e.g. disopyramide, procainamide etc.) |
| 43. Fall and/or hip fracture and/or other bone fracture and/or bone break |
Use of an antipsychotic (e.g. thioridazine, haloperidol, chlorpromazine etc.) |
| 44. Asthma exacerbation and/or status asthmaticus and/or ER visit/hospitalization due to asthma |
Diagnosis of asthma Use of a bronchodilator No use of a maintenance corticosteroid (e.g. beclomethasone etc.) |
| 45. Hospitalization/ER visit due to worsening renal impairment and/or acute renal failure and/or renal insufficiency |
Diagnosis/history of moderate to severe renal impairment/history of kidney disease Use of a select urinary antiinfective agent (nalidixic acid, nitrofurantoin, or methenamine complexes) BUN/serum creatinine not done within 30 days of initiation of therapy and at least every six months |
| 46. ER visit/hospitalization due to congestive heart failure |
Diagnosis/history of congestive heart failure Not on an ACE inhibitor (e.g. captopril, enalapril etc.) |
| 47. Aminoglycoside toxicity (acute renal failure and/or renal insufficiency and/or vestibular damage and/or auditory damage) |
Use of an aminoglycoside Serum creatinine not done before and after therapy (and if therapy longer than seven days, not done at least every seven days). At least one drug level not done |
| 48. ER visit/hospitalization due to congestive heart failure |
History/diagnosis of congestive heart failure Use of a calcium channel blocker (e.g. diltiazem etc.) |
| 49. COPD exacerbation and/or visit/hospitalization due to COPD |
Diagnosis/history of COPD. Use of a beta-blocker (e.g. propranolol, etc.). |
| 50. ER visit/hospitalization due to hypoglycemia or hyperglycemia |
Use of insulin. Hemoglobin Alc level not done at least every 6 months. |
| 51. Fall and/or hip fracture and/or other bone fracture and/or bone break |
Use of an anticholinergic agent |
