10 minute consultation: Using the NO TEARS tool for medication review
BMJ 2004; 329 doi: https://doi.org/10.1136/sbmj.0410362 (Published 01 October 2004) Cite this as: BMJ 2004;329:0410362
- Tessa Lewis, General Practitioner1
- 1Carreg Wen Surgery, Blaenavon, Torfaen NP4 9AF
What issues you should cover
At least a third of patients in Britain aged more than 75 years are taking four or more drugs. Adverse drug reactions are implicated in 5% to 17% of hospital admissions. Hence the dictum “first, do no harm” becomes prescient. Doctors need to be able to critically assess a patient's treatments. Waste is substantial: £19 000 worth of drugs were returned to pharmacies over an eight week period in Gwent.
Need - Does he know why he takes each drug? Does he still need them? Was long term treatment intended? Is the dose appropriate? Has the diagnosis been refuted? Would nonpharmacological treatments be better?
Open questions …
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