Pharm-Med Education International © 2014
Enhancing Patient Lives Through Training Excellence
IMPORTANT NOTE:
1. Once you have completed the assignment, please
go to the portal, click on the “assessments”
button, select the “fill in the practical
competency authenticity statement and
checklist” option and fill in the statement of
authenticity and the Practical checklist.
2. Include the completed assignment in your
portfolio!
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Supplementary Course in Dispensing and Rational Prescribing
ISBN:0-620-33652-8
th
May 2013: 5 Edition
PHARMACY EDUCATION INTERNATIONAL© 2013: Enhancing Patient Lives through Training Excellence
Page 1
Pharm-Med Education International © 2014
Enhancing Patient Lives Through Training Excellence
Supplementary Course in
Dispensing and Rational Prescribing
PRACTICAL COMPETENCY ASSESSMENT
MODULE p01: PATIENT ASSIGNMENT 1
CONDUCT A CASE ANALYSIS
ON A PROBLEMATIC PATIENT CASE
This Assignment evaluates the practitioners Applied Competency. Applied competency is achieved when
a practitioner is able to demonstrate three distinct aspects of competency, namely
1) Practical Competency – the ability to perform a set of tasks and actions in an authentic context
2) Foundational Competency – demonstration of a well grounded knowledge and understanding of the
basic theory and principles of what they are applying and why they are applying it.
3) Reflexive Competency – the ability to integrate Practical and Foundational Competencies which
enables the learner to identify changed patient circumstances which lead to clinical problems and to
adapt to these changed circumstances by recognizing and recommending practical interventions
which they are able to implement and monitor with full awareness of the possible short, medium
and long term risks and benefits to the patient.
Supplementary Course in Dispensing and Rational Prescribing
ISBN:0-620-33652-8
th
May 2013: 5 Edition
PHARMACY EDUCATION INTERNATIONAL© 2013: Enhancing Patient Lives through Training Excellence
Page 2
Pharm-Med Education International © 2014
Enhancing Patient Lives Through Training Excellence
THIS PAGE MUST ACCOMPANY YOUR COMPLETED ASSIGNMENT
PORTFOLIO ASSIGNMENT: PATIENT INFORMATION DETAILS
LEARNER NAME: __________________________________ REG. NO: ________________
SIGNATURE: ________________________ DATE ASSIGNMENT COMPLETED:_________
NOTE: FOR AUTHENTICITY OF LEARNER PRACTICAL WORK
For the Patient whose case you select to conduct a Case Analysis on in completing this Assignment
you are required to record the PATIENT INFORMATION DETAILS and the patient folder/prescription
reference number in the Table below.
To stress this fact FULL Patient Name (First Name and Family name) and Folder/Prescription
Number must be indicated in the Table below. This information is required by PEI for (i) audit purpose
if necessary and (ii) as proof of authenticity that the prescription has been dispensed for an actual
patient. This page will be removed from your completed Portfolio and filed separately by PEI to
maintain patient confidentiality.
NOTE: FOR OBSERVATION OF PATIENT AND PRACTITIONER CONFIDENTIALITY
WHEREVER you refer, or are required to refer, to a Patients Name (e.g. on the first page of each
Assignment record; prescription or medicine label), include ONLY the patients Full First Name and
the First Letter Initial of the Family Name (e.g. if your patients name is Xolile Mguni, record his
name as Xolile M. on the Portfolio Record Sheet).
YOU MAY NOT, UNDER ANY CIRCUMSTANCE, identify ANY Health Practitioner(s) directly involved in
the patient’s management by recording their name. Simply refer to them as ‘the Doctor’, ‘the Nurse’,
‘the Pharmacist’ etc.
This procedure is to ensure that Patient and Practitioner confidentiality is maintained.
PATIENT ASSIGNMENT – CONDUCT A CASE ANALYSIS ON A PROBLEMATIC PATIENT CASE
No. Patient First Name
Patient Family Name
Folder / Rx Number
1)
Supplementary Course in Dispensing and Rational Prescribing
ISBN:0-620-33652-8
th
May 2013: 5 Edition
PHARMACY EDUCATION INTERNATIONAL© 2013: Enhancing Patient Lives through Training Excellence
Page 3
Pharm-Med Education International © 2014
Enhancing Patient Lives Through Training Excellence
THIS PAGE MUST ACCOMPANY YOUR COMPLETED ASSIGNMENT
PRACTITIONER DECLARATION OF AUTHENTICITY
This declaration must be completed and signed by the learner and countersigned by a
Verifier, Supervisor, Tutor or Assessor. This declaration covers the tasks undertaken in
this Assignment. The completed Assignment is submitted for moderation in order to
comply with the Short Course or Learning Module outcome(s) and subsequent
Certification.
You are required to sign this declaration of authenticity and it must accompany your
submission of this Assignment in your completed Portfolio. It confirms that the work
submitted in this Assignment is your own and that you have not copied it from someone
else or allowed another learner to copy it from you. It also confirms that you
acknowledge the penalty for false declaration may result in disqualification from the
Short Course or Learning Module outcomes and subsequent Certification.
Statement of Authenticity: Module p01 – Conduct a Case Analysis on a
Problem Patient Case
I confirm that the attached Assignment is entirely my own work and does not include any
work completed by anyone other than myself. I have completed the assignment / portfolio
in accordance with PEI’s instructions and have not allowed another learner to copy this work
from me. I furthermore acknowledge the penalty for false declaration may result in
disqualification from the Short Course or Learning Module outcomes and subsequent
Certification.
Signature: ____________________________ Date: __________________
Learner Name: ____________________________________________________
Statutory Body: ____________________ Prof. Reg. No: ___________________
(HPCSA; SANC; SAPC)
Verifier Statement of Authenticity
I confirm that, to the best of my knowledge, that the work contained in this Assignment, and
completed in accordance with the Assignment brief, is the individual work and effort of
______________________________(Learner Name)
Signed: ______________________________ Date: _______________
Name: ___________________________________________________
Capacity: ___________________________________________________
(VERIFIER / SUPERVISOR / TUTOR / FACILITATOR / ASSESSOR
Supplementary Course in Dispensing and Rational Prescribing
ISBN:0-620-33652-8
th
May 2013: 5 Edition
PHARMACY EDUCATION INTERNATIONAL© 2013: Enhancing Patient Lives through Training Excellence
Page 4
Pharm-Med Education International © 2014
Enhancing Patient Lives Through Training Excellence
Assignment Brief: Conduct a Clinical Audit on a Problematic Patient Case where
the therapeutic management has been unsuccessful because it has consistently
failed to achieve satisfactory Clinical Targets and Therapeutic Outcomes.
Before commencing this assignment you need to:1)
Review and be familiar with the content material in:
(i)
Module p01 of the Electronic Presentation Material of the Dispensing Course Material:
MEDICATION REVIEW – Assessment of the Prescription
(ii) Volume 1 Course Manual: Chapter 1: Basics Of Applied Therapeutics; Sections 3 to 7: pages 3
to 13 and Section 10: pages 20 - 30 (making effective use of the SAMF).
(iii) The case study of George M (Section 3 page 3) and its preliminary work up as laid out in the
above references as well as the model write-up for George M's case (see below)
(iv) The Formative Competency Assessment for the case study of Patient Xolile Mguni.
2)
Think carefully about the type patient case that is likely to fulfill the criteria for this assignment. The
most suitable patients to choose for these assignments are those with coexisting morbidities.
Therefore you are required to IDENTIFY A PATIENT WITH TWO OR MORE CHRONIC CONDITIONS
THAT HAVE NOT BEEN EFFECTIVELY CONTROLLED.
3)
Ensure that you select an appropriate case which enables you to systematically review the patient’s
medical and clinical history to establish how well the conditions have been controlled and whether
or not medical treatment of the conditions has been effective or ineffective. Therapeutic problems
that are lifestyle related and that present problems with patient education and adherence as well as
problems related to drug therapy (choice of inappropriate medications, incorrect doses or dose
intervals, adverse drug reactions and drug interactions) are common in patients with Chronic
Diseases of Lifestyle (Cardiovascular Disease, Diabetes, Respiratory – including HIV and TB;
Gastrointestinal etc) and other chronic conditions (especially Thyroid disorders, Epilepsy, Mood
disorder etc).
4)
As a template and a guide to what is expected in this assignment, refer to the Model Write Up that
you can download (from the Online component of Module 2 of the Dispensing Course: Assessment
of the Prescription) or which you have received for the Patient Case Analysis of George M. His case
is presented in the Volume 1 Course Manual: Chapter 1: Section 3 (p3 – 5)
5)
Make sure your case has sufficient clinical information and detail to fulfill the Assignment
requirements laid out below
To complete this assignment successfully the following criteria must be met:
In the process of undertaking this assignment, you will:
(A) Need to have official permission from the facility manager / responsible pharmacist to obtain the
folder of a patient who case fulfills the criteria of Points (1) and (2) above.
(B) Learn how to apply the process we referred to SPIPA (Structured Procedure In Pharmacotherapy
Assessment: Volume 1 Course Manual: Chapter 1: Sections 5(i) and (ii); pages 9 and 10). In this
process you will learn how to ‘tease out' a patient case by following exactly the same principles
embodied in the example given in George M's case and in Xolile Mguni's case
Supplementary Course in Dispensing and Rational Prescribing
ISBN:0-620-33652-8
th
May 2013: 5 Edition
PHARMACY EDUCATION INTERNATIONAL© 2013: Enhancing Patient Lives through Training Excellence
Page 5
Pharm-Med Education International © 2014
Enhancing Patient Lives Through Training Excellence
(C) Adhere to the following procedure in completing your Clinical Audit Assignment report:
1) Record the Folder number and Demographic data of the patient concerned (Section 4 (i) p 6)
2) Summarize the patient’s Personal details, Family history details Social History and Lifestyle
details (choose a patient where this information is available) Section (Section 4 (i) p 6)
3) Record the patients Medical Condition History – give a short summary (2 – 3 lines) for each of the
diagnosed or reported conditions you identify (Section 4 (i) p 7)
4) Make sure you record the patient’s RELEVANT clinical and medication history data clearly and
systematically on your Assignment form, by GROUPING SIMILAR READINGS TOGETHER IN A
SEQUENTIAL AND CHRONOLOGICAL ORDER. For example systematically group your patients
Body Mass records together, blood glucose values together, BP readings together etc so that it is
easy to follow the trends of how these clinical parameters vary. Record data for the following:
(i)
Systematically record the patients Clinical Measurements (Body Mass; BMI; BP; ECG
results; Peak Flow etc) (Section 4 (i) p 7)
(ii)
Systematically record the patients Laboratory data (HGT; Serum Creatinine; TSH; Uric
Acid; K+; CD4 count and Viral Load etc.) (Section 4 (i) p 7)
(iii) Systematically record the patients Medication History (Section 4 (i) p 8)
5) Because of the volume of clinical data in that is often present in patient cases of this nature – it is
important to be selective in the data you include in your case write-up. Do not include data that
have no bearing on the problems being addressed.
6) Compile a patient Problem List and arrange these problems in your order of priority (Section 4 (ii)
p 8). NOTE: Each of the patients Chronic Conditions become part of your Problem List
7) APPLY the SPIPA process (Sections 5(i) and (ii)) and follow it as applied in Xolile Mguni's case.
Supplementary Course in Dispensing and Rational Prescribing
ISBN:0-620-33652-8
th
May 2013: 5 Edition
PHARMACY EDUCATION INTERNATIONAL© 2013: Enhancing Patient Lives through Training Excellence
Page 6
Pharm-Med Education International © 2014
Enhancing Patient Lives Through Training Excellence
8) Systematically analyse the patients REGIMEN HISTORY and assess the APPROPRIATENESS of the
MEDICATIONS PRESCRIBED for EACH of the patient’s MORBIDITIES.
9) Compile a S O A P NOTE for EACH OF THE PATIENTS CHRONIC CONDITIONS and discuss the
problems you identify (Section 6 page 11).
10) Your discussion of Medication Appropriateness should be:
o in terms of your own understanding of what you consider to be the advantages or
disadvantages of each prescribed medication and why they have, or have not, been
effective.
o Where you feel that interventions, in terms of changes in therapy or treatment options,
would benefit the patient – have no reservations to discuss these.
o Always consider Polypharmacy and whether, in your opinion, it is possible to decrease the
number of medications prescribed.
o Be aware that the prescription of more medications, at higher doses, is often the
consequence of unsuspected or undetected Non-adherence.
o NOTE THAT YOU WILL BE REWARDED FOR SHOWING CRITICAL THINKING SKILLS IN THESE
ASPECTS. YOU WILL NOT BE PENALISED FOR ERRORS OF JUDGEMENT DUE TO LACK OF
EXPERIENCE IN THESE ASPECTS.
o REMEMBER THIS IS A LEARNING PROCESS
11)Compile a Case Summary and set realistic Therapy Targets to suit the particular circumstances of
your patient’s case. These include Lifestyle, Adherence and Pharmacotherapy Targets (Section 7
page 12)
Supplementary Course in Dispensing and Rational Prescribing
ISBN:0-620-33652-8
th
May 2013: 5 Edition
PHARMACY EDUCATION INTERNATIONAL© 2013: Enhancing Patient Lives through Training Excellence
Page 7
Pharm-Med Education International © 2014
Enhancing Patient Lives Through Training Excellence
PATIENT ASSIGNMENT # 1
PATIENT CASE REPORT
PRACTITIONER NAME ____________________________
PROF. REG NO ________________ DATE ________________
PRACTITIONER SIGNATURE ______________________
PRACTITIONER CONTACT ADDRESS_________________________________________________
COMMUNITY HEALTH CENTER _____________________________________________________
TELEPHONE _________________
RESPONSIBLE OFFICER (Print) _____________________________ DATE ________________
SIGNATURE_____________________________ TELEPHONE _________________
(Senior Medical Officer / Matron)
Patient Demographic data
Family Name
First Name
Folder No
Patient Chronic Conditions
# Condition
1
2
3
4
5
Patient General Information
Marital Status
Married
Single
Sex
M
F
Date of Birth
Mass (Kg)
Height
BMI(m/h2)
Waist (cm)
Hip (cm)
Waist:Hip
Date Dx
# Condition
6
7
8
Other Dx
Date Dx
SUMMARY PATIENT SOCIAL HISTORY
Tobacco
Exercise
Alcohol
Diet
Caffeine
Allergies
Other
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SUMMARY HISTORY OF DIAGNOSED CONDITIONS
CLINICAL & LAB DATA RELEVANT TO THERAPY PROBLEMS (e.g. Patient Mass, BMI,
BP, HGT / HbA1c; Lipids; PEFR, TSH/T4; Hb; ECG; CD4 / Viral Load; Sputum;
Liver and other Enzyme tests; Sr. Creatinine; Electrolytes
OBSERVATIONS
TEST
DATE
RESULT
(include TARGET / NORMAL RANGE for data)
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Enhancing Patient Lives Through Training Excellence
RELEVANT PHYSICAL MEASUREMENTS / LABORATORY TESTS (Continued)
OBSERVATIONS
TEST
DATE
RESULT
(include TARGET / NORMAL RANGE for data)
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Pharm-Med Education International © 2014
Enhancing Patient Lives Through Training Excellence
RELEVANT PHYSICAL MEASUREMENTS / LABORATORY TESTS (Continued)
OBSERVATIONS
TEST
DATE
RESULT
(include TARGET / NORMAL RANGE for data)
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Pharm-Med Education International © 2014
Enhancing Patient Lives Through Training Excellence
MEDICATIONS ISSUED ON THE PATIENTS LATEST
CHRONIC PRESCRIPTION
(i.e. The LAST Prescription before you started your
review of the Patient Case)
Condition Med Rx for
Date Rx
Dispensed
Active ingredient (INN name), Dosage
Form and Strength
D | D || M M || Y Y Y Y
Dose & Dose Interval
Prescribed
HISTORICAL RECORD OF MEDICATION REGIMEN CHANGES
Condition Rx for
Active ingredient & Dosage Strength
Dose /
Frequency
Date Start
Date Stop
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HISTORICAL RECORD OF MEDICATION REGIMEN CHANGES (Continued)
Condition Rx for
Active ingredient & Trade name
Dose /
Frequency
Date Start
Date Stop
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Pharm-Med Education International © 2014
Enhancing Patient Lives Through Training Excellence
HISTORICAL RECORD OF MEDICATION REGIMEN CHANGES (Continued)
Condition Rx for
Active ingredient & Trade name
Dose /
Frequency
Date Start
Date Stop
PATIENT PROBLEM LIST
Priority #
Problem
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PROBLEM #
Subjective Data
Objective Data
Assessment of Problem
Plan to manage Problem
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PROBLEM #
Subjective Data
Objective Data
Assessment of Problem
Plan to manage Problem
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Enhancing Patient Lives Through Training Excellence
PROBLEM #
Subjective Data
Objective Data
Assessment of Problem
Plan to manage Problem
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Enhancing Patient Lives Through Training Excellence
PROBLEM #
Subjective Data
Objective Data
Assessment of Problem
Plan to manage Problem
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SUMMARY PRACTITIONERS’ COMMENTS AND RECOMMENDATIONS
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PRACTITIONER NAME ____________________________
PRACTITIONER SIGNATURE __________________________
DATE ________________
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