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Scenarios

Medicine Information 6

By Jack Holmes . September 27, 2024 . Last reviewed: 24/09/24 .

Summary

In this scenario, the student is expected to counsel a patient who is about to start a new medicine for their condition. Their role is to provide information to the student and check for patient understanding.

Please ensure that this scenario and mark scheme aligns with the most up-to-date guidelines from the UK NICE and the BNF when using it for your OSCE assessment.

You will need a student pharmacist and an actor for this OSCE Scenario.

Revision Topics

Be aware, this may reveal any answers!

Eye Infections

Student Instructions

You are the pharmacist. You have been asked to counsel a patient who has recently been initiated on a new medication. You are expected to answer any questions appropriately and provide relevant advice.

The medicine has been dispensed, checked and is ready to be given out. You will be handing out the medication. You may wish to verify who you are speaking with.

To do

Take a brief medical history from the patient by asking the relevant questions.
Provide the patient with detailed information about their medication, addressing any questions, concerns and queries they may have regarding their treatment plan and condition.

You have 8 minutes.
You have access to the Patient Information Leaflet.

Link to the Patient Information Leaflet (EMC, 2024):
https://www.medicines.org.uk/emc/product/427/smpc

The Prescription:

Actor Instructions

You are the patient.

Opening Statement: “Hello, this medication is new for me. I was wondering if you could tell me about it in detail.”

Patient Details:

Name: Oliver Swordsman (Ol-iv-er, Swords-man)

DOB: 06/07/62

Address: 12 Foster Green

Medical History:
- “I have high blood pressure.”
- “I have conjunctivitis too now.”
Medication History:
- “Amlodipine 10mg Tablets – I take one in the morning.”
- “Bisoprolol 2.5mg Tablets – I take one in the morning.”
Allergies:
- “None.”

Details for the Actor:

The pharmacist may check your understanding of what is being said throughout. Make sure to state what they have said or ask them to clarify any information you deem relevant. You should nod and agree with their points throughout to prompt them to continue to speak.

Mark Scheme

Introduction

0 / 4

Introduce yourself professionally.

+1

Verify patient's identity (e.g. address)

+1

Ask preferred addressing manner.

+1

State intent for medication counsel.

+1

Medical History

0 / 2

Confirms medication history including dose, frequency, indication, including any over-the-counter products and herbal remedies.

+1

Ask about allergies for safety.

+1

Management and Advice

0 / 6

Clarify medication's purpose.

+1

This is an antibiotic eye drop which kills bacteria and is commonly used to treat eye infections .

Detail correct dose, frequency.

+1

You prescriber has stated to use the eye drops as directed. The patient information leaflet states - The recommended dose is two drops applied to the affected eye(s) every three hours. Use during waking hours only. Continue treatment at least 48 hours after the eye appears normal, or as directed by your doctor.

Any special usage instructions.

+1

Store in a refrigerator at a temperature between 2-8 degrees celsius. Discard the bottle 28 days after opening even if there is solution remaining.

Explain common side effects.

+1

Some people may find their eyes sting or their sight is blurred immediately after use. These should wear off after a short period of time.

Explain overdose steps.

+1

If you accidently apply too much drops, you should wash your eye with plenty of water, if any painful symptoms continue after this, you should tell your doctor immediately.

Outline missed dose action.

+1

Apply the drops as soon as you remember. However, if it is almost time for your next dose, do not double your dose and carry on with the normal schedule dose.

Following up with a patient

0 / 3

Confirm patient understanding.

+1

Do you understand everything I have said to you, or do you have any other queries

Stress when to go A&E or GP

+1

Allow discretionary mark if suitable referral criteria given. For more information on this see our referral criteria below!

Conclude session suitably.

+1

Thank you for your time!.

Professionalism and Competencies

0 / 5

Display professionalism and respect.

+1

Utilize Patient Information Leaflet (PIL).

+1

Share relevant info succinctly.

+1

Explain relevant drug interactions.

+1

Patient safety was not compromised.

+1

This includes but is not limited to, providing incorrect information or medication, misdiagnosing conditions, neglecting to inquire about allergies, making incorrect referrals, or failing to act on red-flag symptoms.

Time Management

0 / 1

Completed the scenario in time and achieved 70% of marks

+1

Red Flags missed: 0

Total Score
0/

Skills

communication 0/9

professionalism 0/3

patient safety 0/6

patient-centred care 0/4

information gathering 0/2

patient education 0/5

knowledge 0/5

time management 0/1

diagnostic reasoning 0/1

Time Management 0/1

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Referral Criteria

Referral Criteria for Eye Infection

Advise an urgent GP or Optometrist Appointment if:

Patient wears contact lenses and has conjunctivitis symptoms along with spots on the eyelids: may indicate an allergy to the lenses.
Conjunctivitis symptoms have not resolved within 7 days: persistent symptoms may require further evaluation.
Pain in the eyes: could suggest a more serious issue like cellulitis.
Sensitive to light: may indicate a deeper issue needing urgent care.
Changes in vision, such as wavy lines or flashing: could be signs of a more severe eye condition.
Very red eyes in one or both eyes: could indicate a more significant problem.
A baby under 30 days old has red, sticky eyes: requires immediate evaluation to exclude serious conditions.
A baby under 2 years old has red, sticky eyes: conjunctivitis needs assessment, especially if under 30 days old; chloramphenicol OTC licensing is for children over 2 years.

References

NHS (National Health Service), 2023. Conjunctivitis. [online] Available at: https://www.nhs.uk/conditions/conjunctivitis/ [Accessed 27 September 2024].

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Comments

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Management and Advice

8

Clarify medication's purpose. [1]

{This is an antibiotic eye drop which kills bacteria and is commonly used to treat eye infections .}

Patient Education, Knowledge

9

Detail correct dose, frequency. [1]

{You prescriber has stated to use the eye drops as directed. The patient information leaflet states - The recommended dose is two drops applied to the affected eye(s) every three hours. Use during waking hours only. Continue treatment at least 48 hours after the eye appears normal, or as directed by your doctor.}

10

Any special usage instructions. [1]

{Store in a refrigerator at a temperature between 2-8 degrees celsius. Discard the bottle 28 days after opening even if there is solution remaining.}

Patient Education, Knowledge

11

Explain common side effects. [1]

{Some people may find their eyes sting or their sight is blurred immediately after use. These should wear off after a short period of time.}

Patient Education, Knowledge

13

Explain overdose steps. [1]

{If you accidently apply too much drops, you should wash your eye with plenty of water, if any painful symptoms continue after this, you should tell your doctor immediately.}

Patient Safety, Patient Education

14

Outline missed dose action. [1]

{Apply the drops as soon as you remember. However, if it is almost time for your next dose, do not double your dose and carry on with the normal schedule dose.}

Patient Safety, Patient Education

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