Patient's fear for potential side effects is the cause for them not taking a medication
What is "Concern for Potential Side Effects"?
100
The patient is unable to take the medication as prescribed because they have difficulty understanding instructions or have dementia or other cognitive deficiencies that are debilitating.
What is "Cognitive Challenges/Dementia"?
100
Provider order for a medication is unclear or incomplete and needs clarification.
What is "Order unclear or incomplete"?
100
Any condition or disease that renders a particular type of treatment improper or undesirable.
What is "Contraindication for therapy"?
100
Dose is considered to be too high or too low for a patient’s given medical condition.
What is "Opportunity for dose optimization"?
200
The medication is expired and can/should no longer be taken by the patient.
What is "Expired/Damaged" Med?
200
Medication instructions are not always easy to understand. Doctors, nurse and pharmacists may speak to patients in medical terminology or fail to take into consideration the health literacy of a patient. This results in instructions that are not understandable by the patient. The end result is the patient is non-adherent simply because they do not understand the instructions given.
What is "Low health literacy and/or complexity of therapy"?
200
Medication has been discontinued by a provider order or instructions but patient continues to take medication.
What is "Medication discontinued, patient taking"?
200
Use of multiple agents from the same chemical family or therapeutic class.
What is "Therapeutic duplication"?
200
Patient has a medical condition which does not appear to be treated.
What is "Untreated medical condition"?
300
Patient does not have any remianing refills on their prescription and will need additional refills in order to continued medicine
What is "Need Additional Refills"?
300
Patients who have dementia, forgetfulness or other cognitive issues often rely on family and friends to help them manage their medications appropriately. Often a family member may fill a pill box for the patient each week. Patients with the aforementioned cognitive issues but without the family/friend support system may not be able to adhere to their medication regimen.
What is "Insufficient support system "?
300
A medication was continued by the patient without documented orders. List discrepancy and/or medical history makes it unclear as to if this should still be an active order, patient is still taking.
What is "Unconfirmed Continuation"?
300
Patient is taking medications that could result in a severe drug interaction.
What is "Potential for severe drug interaction"?
300
Laboratory or physical monitoring may help prevent an adverse drug event.
What is "Monitoring needed to prevent ADE"?
400
Patient does not have medication on hand due to rejected claim, prior authorization, or pharmacy elected not to fill
What is "System Failure (i.e. rejected claim)"?
400
During the patient interview the interviewer may become aware that the patient is taking medications with improper frequency or timing. Improper frequency is when the patient takes the medication more often or less often than instructed.
What is "Frequency/timing "?
400
Medication name is different from another medication list.
What is "Medication name discrepancy"?
400
Patient is taking a medication and the medical condition being treated is unknown/not readily apparent.
What is "No indication for therapy"?
400
The patient’s insurance plan offers a preferred formulary alternative to the currently prescribed medication.
What is "Preferred formulary alternative available"?
500
The patient does not have the medication that was ordered by provider during paitnet interview. The patient may not have filled the medication or may not have the medication available because they have given to another person. This option is saved as last resort.
What is "Does Not Have/Did Not Have"?
500
Patient is taking more of the medication than prescribed.
What is "Patient potentially overusing meds"?
500
A previously prescribed medication no longer appears on a medication list. List discrepancy and/or medical history make it unclear if this medication was intentionally discontinued.
What is "Unconfirmed Discontinuation"?
500
Patient has an allergy to medication
What is "Drug Allergy"?
500
Polypharmacy includes but is not limited to many medications (6 or more), duplicate medications, inappropriate medications (i.e., lack of proven benefit, no indication for use, etc.).