How do I monitor patients who have been started on new medication?

Introduction
To improve the accuracy of patient monitoring for new or changed medications, we’re updating how the system identifies when monitoring is needed. This article explains the changes and how the system will prompt you when medication adjustments require follow-up.

What’s Changing?

Previously, the system identified the need for monitoring based on when a patient was first put on repeat medication. Now, monitoring prompts will be triggered by the system recognising changes to a patient’s medication. This includes scenarios like:

• Starting new medication.
• Changing the dose of an existing medication (e.g., increasing Ramipril)

This approach ensures that monitoring is tailored to changes in treatment, rather than simply the start of a repeat prescription.

How the New Monitoring Prompts Work

1. Pop-Up Trigger:
   If a medication that hasn’t been issued in the last 6 months is issued again, or if there’s a change in dosage, you’ll see a pop-up notification. For example, if you started a patient on Ramipril, the system will recognise that and display the following prompt:

   
   

2. Adding Monitoring:

   • When the pop-up appears, you can choose to add monitoring for the medication.
   • If you select to add monitoring, the protocol will allow you to send the patient an invite for any necessary tests or follow-up appointments.
   • If the required monitoring is not immediate (e.g., needed in a few months), the system will track this and ensure the patient is included in reports for future monitoring invites.

3. Opting Out of Monitoring:

   • If you click “No”, the system will not invite the patient for monitoring.
   • If you click "NOT Indicated" it will prevent the pop-up appearing for a few weeks. This is to aid situations where a clinician may add the medication to repeats but not issue the medication, then admin staff issue the medication at a later date.

Benefits of the New Approach

• More Accurate Monitoring: The system now identifies when medication changes trigger the need for monitoring, rather than relying on when the medication was first prescribed.
• Improved Control: You can decide on a case-by-case basis whether monitoring is needed for each patient, allowing for a more tailored approach to patient care.
• Future-Proofing: This new method provides a more robust system for tracking medication monitoring and will replace the older method based on repeat prescriptions over time.

Phasing Out the Old Method

As we roll out this new approach, we will gradually phase out the older method that triggers monitoring based on when patients are placed on repeat medication. This transition ensures that all patient monitoring will be aligned with the new system, reducing redundant alerts and improving efficiency.

Medication Currently Covered

• Allopurinol / Feboxustat
• Anti-Diabetic medication for those with a Diabetes diagnosis or latest HbA1c>=48
  • DD4Pis
  • GLP1s
  • Insulin
  • Metformin
  • SUs
• Anti-Hypertensives
  • ACE/ARBs
  • Calcium Channel Blockers
  • Doxazosin / Prazosin
  • Potassium Sparing Diuretics (e.g. Eplerenone / Spironolactone)
  • Thiazides
• Lipid Regulating Agents (e.g. Statins/Ezetimibe)
• Levothyroxine
• Testosterone
• Vitamin D

We are planning to add more in time.  

What if I don't see a pop-up?

If you don't see a pop-up when you start or amend medication, it means you need to manually configure it. The protocols can't pick up everything, e.g. if medication is changed by amending the instructions to take two daily instead of one. In our "Request One-Off Tests" template there is a page where you can manually launch the relevant protocol, or you may need to request the bloods individually.

Conclusion

The new monitoring system ensures that patients receive the right follow-up care when their medication is changed or new treatments are started. By allowing you to add monitoring directly from a pop-up prompt, the system offers more control and accuracy in managing patient care.

For further assistance or questions, please contact the helpdesk!