Called to complete review. LMOM. Called for CMR verbal offer. Delivered CMR offer. SOAP PP1 PP2 Called to complete review. Unavailable. Called to complete review. NA. Unable to leave a message. 1 Warfarin WARFARIN: Denies s/s of excessive bleeding. Reviewed s/s and referred to MD if any occur. Discussed recommended INR monitoring frequency. Monitoring for bleeding with WARFARIN. This is an important medicine to help prevent blood clots, but it can put you at an increased risk for bleeding. When you are on a medicine like this it is important to watch for signs of bleeding. Continue to take WARFARIN as directed. Watch for SIGNS OF BLEEDING. Call your provider if you experience prolonged nosebleeds, bruises that will not heal, get bigger or appear for no reason, bleeding gums, dark or tar-colored stools, or vomit that looks like coffee grounds. Go to the emergency room if you have blood in your urine, bright red blood in your stool, or if you are coughing up bright red blood. Make sure to keep all appointments for blood work to determine you are receiving the best dose of this medicine. Called to complete review. Patient unable to complete review at this time. Received transfer, completed call as CMR. 1 DOAC ELIQUIS: Denies s/s of excessive bleeding. Reviewed s/s and referred to MD if any occur. Monitoring for bleeding with ELIQUIS. This is an important medicine to help prevent blood clots, but it can put you at an increased risk for bleeding. When you are on a medicine like this it is important to watch for signs of bleeding. Continue to take ELIQUIS as directed. Watch for SIGNS OF BLEEDING. Call your provider if you experience prolonged nosebleeds, bruises that will not heal, get bigger or appear for no reason, bleeding gums, dark or tar-colored stools, or vomit that looks like coffee grounds. Go to the emergency room if you have blood in your urine, bright red blood in your stool, or if you are coughing up bright red blood. ____: Denies s/s of excessive bleeding. Reviewed s/s and referred to MD if any occur. Monitoring for bleeding with ____. This is an important medicine to help prevent blood clots, but it can put you at an increased risk for bleeding. When you are on a medicine like this it is important to watch for signs of bleeding. Continue to take ____ as directed. Watch for SIGNS OF BLEEDING. Call your provider if you experience prolonged nosebleeds, bruises that will not heal, get bigger or appear for no reason, bleeding gums, dark or tar-colored stools, or vomit that looks like coffee grounds. Go to the emergency room if you have blood in your urine, bright red blood in your stool, or if you are coughing up bright red blood. Called to complete review, verified HIPAA, updated allergies, reconciled medication list and OTCs, re ran rules, received consent to complete call as CMR. Received incoming call, verified HIPAA, updated allergies, reconciled medication list and OTCs, re ran rules, received consent to complete call as CMR. 2 HF Discussed HF management. Monitoring your heart failure. It is important for you to manage and report any changes in your symptoms to your provider. This will help reduce the chances of ending up in the hospital from heart failure. Keep an eye out for swelling in your feet and legs or any shortness of breath when lying down. Talk to your provider about weighing yourself daily. Report any changes in your daily weights, such as a 2 pound weight gain in one day OR a 5 pound weight gain in one week. If you do not already have a home plan for fluid management, talk to your provider. Catching these things before they get worse can keep you out of the hospital. 3 DM Discussed DM management. Controlling your diabetes. Diabetes can affect any part of your body, including your heart health, vision, and kidney health. Complications from diabetes can be prevented by making sure your blood sugar levels are controlled. Ask your provider what your diabetes goals are and if you are meeting them. To help prevent long-term complications from diabetes, make sure to see an eye provider every 1-2 years, have your feet examined at least yearly. Make sure to keep all appointments for blood work so that your provider can monitor your kidney function. Refer to the directions on the label or use as instructed by your provider as needed or directed by your provider 3 DM hypo Discussed DM, emphasizing s/s of hypoglycemia and how to manage. Managing LOW BLOOD SUGARS. People with diabetes get low blood sugar when their bodies don't have enough sugar to use as fuel. It can happen for several reasons, including diet, some medications and conditions, and exercise. Signs and symptoms of low blood sugar include shakiness, dizziness, sweating, confusion, lightheadedness, racing heart, hunger, and/or fatigue. Watch for symptoms of LOW BLOOD SUGAR. Talk to your provider about any low blood sugars at your next visit. Treat blood sugars under 70 with 15 to 20 grams of carbohydrates, including: glucose tablets (refer to package instructions), a half-cup of juice or non-diet soda, 1 cup skim milk, or a tablespoon of sugar or honey. After you consume the carbohydrate, recheck your blood sugar levels in 15 minutes. If your levels are still under 70, repeat this process every 15 minutes until your blood sugar levels come back up. If your blood sugar level does not go up after treatment, call 911. Once your levels are within a normal range, make sure to eat a meal to prevent your blood sugar levels from dropping too low again. Take 1 by mouth every day as needed or directed by your provider Take ___ by mouth ___ times every day as needed or directed by your provider 4 COPD Pt confirms COPD, denies asthma. Denies increase in fast-acting inhaler use. Breathing has not worsened. Denies exacerbations or hospitalizations. Breathing is controlled. Controlling your breathing problem. It sounds like your breathing is doing well. Continue to use your inhalers as directed by your provider. Talk to your provider if you notice any symptoms that your breathing problem might be getting worse such as shortness of breath, wheezing, and/or increased sputum. Check with your provider to see if you are up to date on your pneumonia and annual flu vaccines. 4 COPD un Pt confirms COPD, denies asthma. Breathing has worsened. Discussed respiratory control and referred to provider. Controlling your breathing problem. It sounds like your breathing may not be as controlled as it could be. Ask your provider if adjustments to your breathing medicines should be made. This may help prevent worsening symptoms and reduce your risk for hospitalizations and/or the need for steroids or antibiotic therapy. Take 1 by mouth every day Take 1 by mouth twice every day 6 BP Discussed BP management; referred to MD for BP goal. Controlling your blood pressure. Maintaining a healthy blood pressure can help reduce the risk of heart attacks, strokes, and other health problems. Ask your provider what your blood pressure goal should be. Talk to your provider about other ways to reduce your risk for heart disease such as following a heart-healthy diet and maintaining a regular exercise regimen. Take 1 by mouth three times every day Take 1 by mouth four times every day 6 BP hypo Symtomatic low blood pressure can be concerning. Signs and symptoms of low blood pressure may include dizziness, lightheadedness, difficulty concentrating, and/or fatigue. Talk to your provider about your blood pressure and symptoms. Take 1/2 (one-half) by mouth every day Take 1/2 (one-half) by mouth twice every day 9/10 NTG ____: Pt does have NTG SL tablets on hand. Reviewed frequency of use and proper NTG administration, storage, and importance of checking expiration date. NITROGLYCERIN sublingual tablets for chest pain. Do not chew, crush, or swallow sublingual tablets. At the first symptoms of a heart attack, sit down and place one tablet under your tongue. Wait 3 to 5 minutes. If you still have pain, take a second tablet. Do not take more than 3 tablets in 15 minutes. If you still have symptoms, call 911. If you have had a heart attack in the past, 911 should be called if symptoms are not relieved 5 minutes after the first tablet. Make sure to store your NITROGLYCERIN tablets in the original container. Keep in a cool, dry place. Periodically check the expiration date to make sure your tablets have not expired. If opened, check periodically for tablet disintegration. Make sure to let your provider know how frequently you need to use this medicine. Don't hesitate to let your provider know if you begin using it more frequently than usual. Take 1 and 1/2 (one and one-half) by mouth every day Take 1 and 1/2 (one and one-half) by mouth twice every day 11 K+ ____: Discussed importance of regular blood work for monitoring K+ levels. Your blood work and POTASSIUM levels. Make sure you are keeping all appointments for blood work. You should have blood work checked at least once a year and after changes in medicines that affect potassium levels. 12 Statin ____: Discussed how statins can cause myalgia/myopathy. Pt DENIES myalgia/myopathy and dark, Coca-Cola colored urine at this time. ____ for your cholesterol. This medicine is known as a statin. Statins are very important for heart health and reducing cholesterol. For some people, statins may cause muscle pain and/or weakness. Continue to take ____ as directed. Follow up with your provider if you develop any persistent muscle pain. Take 1 by mouth at the same time every day Take 1 by mouth every evening at bedtime PNA Discussed pneumonia vaccines. Vaccinations for pneumonia. There are two pneumonia vaccines that are recommended for people over 65. Check with your provider or pharmacy to see if you have gotten the pneumonia vaccines, PNEUMOVAX or PREVNAR and if you are due for one of these now. Take 1 by mouth every week on an empty stomach with water only and remain upright for 30 minutes after taking Administered by a healthcare professional Vaccines Discussed vaccines. Staying up to date on your vaccines. Talk to your local pharmacist or provider about getting your ______ and ______ vaccines. Place 1 tablet under the tongue at first sign of chest pain. If no relief after 5 minutes, take a 2nd dose. If still no relief may, take a 3rd dose after five more minutes. Call 911 if no relief Dissolve 1 under the tongue ___ times a day Level 7 Inject ___ units under the skin once daily Inject ___ units under the skin every morning and ___ units every evening "3 Respiratory - Add Rescue Asthma: ___ COPD: ____ Other Breathing Problem: ____ Unknown Breathing Problem:_____ Current rescue inhaler on hand: _____ If YES, add inhaler to medicine list and re-run rules Previous rescue inhaler use: _____ Provider who manages breathing: ___________" Inject under the skin as directed based on blood sugars Inject ___ units under the skin before breakfast, ___ units before lunch, and ___ units before dinner "7 DM - Add Statin Do you have diabetes? YES Do you have active liver disease such as cirrhosis, varices, alcoholic liver disease, seeing a liver doctor regularly or taking medicines for liver disease (this does NOT include fatty liver disease)? NO Are you on dialysis or has your provider discussed starting dialysis soon? NO Have you taken a statin before? ______ If YES, was it stopped d/t muscle pain or weakness (myalgia or myopathy)? ________ If MUSCLE PAIN/WEAKNESS, did your provider try an alternate statin? _________ If YES, which statins were stopped AND why? _______________" Inject ___ mg under the skin once weekly Inject ___ mg under the skin once daily "7 Asthma - Add ICS Asthma: ___ COPD: ___ Other Breathing Problem: ___ Unknown Breathing Problem: ___ Have your breathing symptoms gotten worse recently: ____ Do you use SABA daily: ____ # awakenings due to breathing in the last month: ____ # steroid Rxs for breathing in the last year: _____ # Abx for breathing-related infections in the last year: ______ # ED visits for breathing or PNA in the last year: ______ # Hospitalizations for breathing or PNA in the last year: ______ Was a new medication(s) added after your ED/Hospitalization? YES or NO Have you used a controller inhaler in the past? YES or NO If you did use a controller, did you have a reaction to the controller inhaler you used in the past? YES or NO 3" Use as directed to check blood sugars ___ times a day Use alcohol swabs as directed to sanitize skin Use syringe as directed with diabetes medicine injections Use needles as directed with diabetes medicine injections Level 2/6 denies `NO per call script. Denies issues with adherence. Confirms taking ____ and cannot account for gaps in refill history. Educated on importance of adherence. Inhale 1 inhalation by mouth every day Inhale 1 inhalation by mouth twice every day admits `NO per call script. Admits to non-adherence with ____ related to ____. Educated on importance of adherence and advised to f/u with provider. Inhale 2 inhalations by mouth every day Inhale 2 inhalations by mouth twice every day Inhale 1 to 2 inhalations by mouth every 4 to 6 hours as needed or directed by your provider Inhale 1 inhalation by mouth four times a day as needed or directed by your provider Instill 1 drop in both eyes every day Instill 1 drop in both eyes twice every day ____: Pt reports taking _____. Claims show # ____ /____ days. Discussed discrepancy and referred to provider. Reinforced importance of adherence. Taking your medicines as prescribed by your provider. It is very important to take all of your medicines as directed by your doctor. This can help prevent serious problems from your conditions. If your conditions are not well-controlled, you may also end up in the hospital. Instill 1 drop in the left eye every day Instill 1 drop in the left eye every day How you should be taking ____. Ask your provider how you should be taking this medicine. If your dose was recently changed, ask your provider for an updated prescription to reflect the correct quantity and days supply. Ask your provider how you should be taking these medicines. If your doses were recently changed, ask your provider for updated prescriptions to reflect the correct quantity and days supply. Instill 1 drop in both eyes every evening Instill drops in the affected eye(s) according to provider instructions for procedure Your current dose of ______. Ask your provider about the dose of this medicine. Update the attached list by crossing off the strength you are no longer taking. Use 1 spray in each nostril every day Use 1 spray in each nostril twice every day Use 2 sprays in each nostril every day Use 2 sprays in each nostril twice every day After removing old patch, apply one patch to skin every day Apply to the affected area(s) every day as needed or directed by your provider No further questions or concerns.