Polypharmacy

Cardiovascular System

You are a pharmacist working in the hospital. Please take an accurate medication history from Margerie Thomas, a 75-year-old female, who has just been admitted following a fall. You should gather relevant information from the patient and use their repeat prescription taken from their GP record to create an accurate up-to-date medication list.

To do:

1. Take an accurate medication history from the patient using the sources provided. Ascertain who you are speaking with. You are not stopping, starting, or changing any medications.

You DO NOT need to give any advice or information to the patient.

You have 10 minutes.
You have access to a BNF. 

Resources:

• Medication History Taking Form:
  • https://oscetoolbox.com/files/pdfs/medication-history-sheet-template.pdf
• The repeat prescription from the patient’s GP records can be found below

Assume today’s date is 19/07/2024

You are Margerie Thomas (Mar-jeh-ree Tom-as)

Opening statement: "I have been told you want to ask me about my medications."

 Patient information: 

To be given if the student asks.

• Name: Margerie Thomas
• Address: 50 Bread Crumb Drive
• Age: 75
• Allergies: None known
• Past medical history:
  • Admitted an hour ago because of a nasty fall.
  • High blood pressure
  • Diabetes

Medication History (State only when prompted):

• "I take Metformin, 2g tablets once a day every evening with tea."
• "I take 'Dap up gliflozin' or whatever it’s called once a day, but I don’t know the dose."
• "I take two blood pressure medications once a day with the rest of my medications, but I can’t remember the names."
• "I used antibiotic ear drops from the GP 6 months ago for an ear infection, but that's all cleared up now, and I finished the ear drops in a few days at the time."
• "I take one or two 200mg Ibuprofen tablets in the morning almost every day for headaches and general joint pain. I just got it from the supermarket."

If the Pharmacist Asks:

• If asked about Sertraline/antidepressants: "Oh yes, I was feeling quite down for a while, and I took a tablet for about 3 months. I felt better, so I have not taken it for the last two weeks. I’ve kept the tablets in case I need them in the future."
• If asked about a statin: "I tried it for a bit, but I don’t even remember what it was for, and it made my tummy feel off, so I stopped taking it."
• If asked about vaccines: “I am not vaccinated. should I get any I got some when I was a baby I think.”
• If the pharmacist asks for more details about your fall: “My memory is hazy, I don’t know.”

1. Holmes, J., (2022).OSCE Scenarios with Mark Schemes: A Practical Guide for Pharmacy Students. Paperback edition. 25 Dec. 2022.
2. OSCE Toolbox. (n.d.).Medicine Reconciliation Answer Sheet. [PDF] Available at: https://oscetoolbox.com/files/pdfs/medicine-reconciliation-1-answer-sheet.pdf [Accessed 20 Aug. 2024].