Scribd Logo
Upload

Welcome to Scribd!

  • 79 views

    GGP - Six Steps

    Uploaded by

    Dina Septiana
    This document outlines the six steps of the therapeutic decision process: 1) Define the patient's problem, 2) Specify the treatment objective, 3) Select the intervention, 4) Start the treatment, 5) Give information to the patient, and 6) Monitor (or stop?) treatment. Each step is then described in more detail, with definitions and considerations provided for properly defining the patient's problem, specifying the treatment objective, selecting appropriate and cost-effective interventions, prescribing treatment, informing the patient, and monitoring outcomes. The overall goal is to clearly define the patient's issue and appropriately manage their care through an evidence-based decision making process.

    Copyright:

    © All Rights Reserved
    Download as PPT, PDF, TXT or read online from Scribd

    GGP - Six Steps

    Uploaded by

    Dina Septiana
    79 views28 pages
    This document outlines the six steps of the therapeutic decision process: 1) Define the patient's problem, 2) Specify the treatment objective, 3) Select the intervention, 4) Start the treatment, 5) Give information to the patient, and 6) Monitor (or stop?) treatment. Each step is then described in more detail, with definitions and considerations provided for properly defining the patient's problem, specifying the treatment objective, selecting appropriate and cost-effective interventions, prescribing treatment, informing the patient, and monitoring outcomes. The overall goal is to clearly define the patient's issue and appropriately manage their care through an evidence-based decision making process.

    Original Description:

    GGP

    Original Title

    GGP -Six Steps

    Copyright

    © © All Rights Reserved

    Available Formats

    PPT, PDF, TXT or read online from Scribd

    Did you find this document useful?

    Is this content inappropriate?

    This document outlines the six steps of the therapeutic decision process: 1) Define the patient's problem, 2) Specify the treatment objective, 3) Select the intervention, 4) Start the treatment, 5) Give information to the patient, and 6) Monitor (or stop?) treatment. Each step is then described in more detail, with definitions and considerations provided for properly defining the patient's problem, specifying the treatment objective, selecting appropriate and cost-effective interventions, prescribing treatment, informing the patient, and monitoring outcomes. The overall goal is to clearly define the patient's issue and appropriately manage their care through an evidence-based decision making process.

    Copyright:

    © All Rights Reserved
    Download as PPT, PDF, TXT or read online from Scribd
    Download as ppt, pdf, or txt
    79 views28 pages

    GGP - Six Steps

    Uploaded by

    Dina Septiana
    This document outlines the six steps of the therapeutic decision process: 1) Define the patient's problem, 2) Specify the treatment objective, 3) Select the intervention, 4) Start the treatment, 5) Give information to the patient, and 6) Monitor (or stop?) treatment. Each step is then described in more detail, with definitions and considerations provided for properly defining the patient's problem, specifying the treatment objective, selecting appropriate and cost-effective interventions, prescribing treatment, informing the patient, and monitoring outcomes. The overall goal is to clearly define the patient's issue and appropriately manage their care through an evidence-based decision making process.

    Copyright:

    © All Rights Reserved
    Download as PPT, PDF, TXT or read online from Scribd
    Download as ppt, pdf, or txt
    of 28

    SIX STEPS

    Rustamaji
    Faculty of Medicine
    Universitas Gadjah Mada
    2011

    Objective
    After attending this lecture, students are expected to be
    able to:
    1.
    2.

    Explain the steps in therapeutic process


    Explain drug selection based on safety, efficacy,
    suitability and cost

    Six steps of

    therapeutic decision
    process
    Step
    Step
    Step
    Step
    Step
    Step

    1:
    2:
    3:
    4:
    5:
    6:

    Define the patients problem


    Specify the treatment objective
    Select the intervention
    Start the treatment
    Give information to the patient
    Monitor (or stop?) treatment

    (WHO,
    1994)

    Step 1:
    Define the patients problem

    Define the patients


    problem
    Patient presents with a complaint or a problem.
    To treat patient, physician should make a right
    diagnosis
    Right diagnosis based on the complaint as
    describe by patient, a detailed history, physical
    examination, laboratory tests, X-ray and other
    investigation
    Patient complaints are mostly linked to symptoms
    (is not diagnosis)

    Define the patients


    problem

    Disease or disorder (diagnosis)


    Sign of underlying disease
    Psychological or social problems, anxiety
    Side effect of drugs
    Refill request (polypharmacy)
    Non-adherence to treatment
    Request for preventive treatment
    Combination
    Physician formulation may different with patient perceives

    Step 2:
    Specify the treatment
    objective

    Specify the therapeutic


    objective
    Therapeutic objective sometimes
    straightforward, sometimes less clear.
    Therapeutic objective can
    Make physician concentrate on the
    real problem
    Prevent a lot of unnecessary drug use
    Avoid unnecessary prophylactic drugs
    Discuss your therapeutic problems with patient

    Step 3:
    Select the intervention

    Select the intervention


    Make the inventory of possible
    treatments

    Information or advice
    Treatment without drugs
    Treatment with a drug
    Referral
    Combination

    Selection of the medicines


    Medicines should effective, safe,
    suitable to patient and cheaper
    Effective: please check to the reference
    standard to looking for the EBM
    Safety : check the side effects and
    frequency of side effects
    Suitability : check the contraindication
    of the drug
    Cost: check the total cost not only the
    price

    Efficacy of drug
    Data Pharmacodinamic
    Data pharmacokinetic (ADME)
    Compare the dosage and formulation
    on absorption, distribution,
    metabolism, excretion
    Efficacy should be supported by good
    clinical trial with control

    Safety
    Side effects
    Toxic effects (depend on dug
    concentration)
    If possible list he incidence of side effect
    Unpredictable side effect (allergic
    reaction) may be caused by drugs

    Suitability
    Contraindication of drug related by
    patient condition (renal failure, hepatic
    disorder, history of allergic reaction,
    other disease, other drugs (possibility of
    interaction))
    Change of patient physiology
    (pregnancy and lactation, extreme age)

    Suitability
    Are the active substance and dosage
    form suitable for this patient?
    Is the standard dosage suitable for this
    patient?
    Is the standard duration of treatment
    suitable for this patient?
    Pharmacokinetic data

    Cost
    Check the cheaper drug

    Discuss with the patient about the drug


    price

    Selection of medicines
    Patient suffer dry cough that can be
    very inconvenient
    Suppressing for a few day may have a
    beneficial effect
    Many cough preparation available in the
    market

    Step 4:
    Start the treatment

    Start the treatment


    Write a prescription
    Codein 30mg 3 x daily
    Prescription is an instruction from a prescriber to a
    dispenser
    Information on prescription
    Name and address of the prescriber with
    telephone number
    Date of prescription
    Name and strength of the drug
    Dosage form and total amount
    Information for the package insert
    Signature or initial
    Patient identity

    Step 5:
    Give information to the patient

    Give information
    Instruction and warning
    Effect of the drugs
    Why the drug is needed
    Which symptoms will disappear, and
    which not
    When the effect is expected to start
    What will happened if the drug is taken
    incorrectly or not at all

    Give information
    Instruction and warning
    Side effects

    Which side effect may occur


    How to recognize them
    How long the will continue
    What action to take

    Give information
    Instruction and warning
    Instruction
    How the drug should be taken
    When it should be taken
    How long the treatment should
    continue
    How the drug should be stored
    What to do with left-over drugs

    Give information
    Instruction and warning
    Warnings
    When the drug should not be taken
    What is the maximum dose
    Why the full treatment course should
    be taken

    Give information
    Instruction and warning
    Future consultation
    When to come back (or not)
    In what circumstances to come earlier
    What information the doctor will
    needed at the next appointment

    Give information
    Instruction and warning
    Everything clear ?
    Ask the patient whether everything
    understood
    Ask the patient to repeated the most
    important information
    Ask whether the patient has any more
    question

    Step 6:
    Monitor (or stop?) treatment

    Monitor and stop the


    treatment
    Was the treatment effective ?
    Yes and disease cured
    Stop the treatment
    Yes but not yet completed
    Any serious effect?
    No : Treatment can be continued
    Yes : reconsider dosage or drug choice

    No : check your all steps

    You might also like