Christopher Vu

PHAR 7733 Clinical Communications

IPPE Assignment #2: Drug Therapy Assessment

October 10, 2017

This assignment was completed at my community site (Sams Club #4761) on a Saturday
afternoon. At this site, medication therapy management is required for all pharmacists, including
follow-up phone calls and questions. After only one call, we uncovered a potential drug therapy
problem.
The patient was suffering from hypertension and was treating it with metoprolol.
However, his blood pressure goals were not being met, implying a problem of ineffectiveness of
therapy. After some questioning, we discovered the patient was also prescribed
hydrochlorothiazide, and had stopped taking it because he believed the metoprolol was
prescribed to replace the hydrochlorothiazide. The patient had also run out of
hydrochlorothiazide refills and had assumed he no longer needed to take it.
Uncovering this problem required communication with the patient, and calling the patient
to let them ask questions was effective. The pharmacist also asked what else the patient
remembered about his therapy. However, there may also have been miscommunication from the
prescribing doctor that may have also prevented this issue in the first place. It is also possible the
patient simply forgot, or the concept slipped his mind.
The issue was resolved quickly. We contacted the doctor to confirm that he had intended
for both metoprolol and hydrochlorothiazide to be taken concomitantly. Since it was a Saturday,
we were not expecting an answer until the work week. The patient was grateful, and we made
plans to follow up with him once we got a response from the doctor.
One surprising thing about drug therapy assessment is that patients may be aware of
problems but are not proactive in seeking help. Although the patient knew his blood pressure
was still high, he did not call the pharmacy or his doctor to ask why the medication had not been
helping. No matter how vigilant the health care team is, sometimes it is simply the patient who
needs to also know that the lines of communication exist to help them.