Level 4 outcome
Avoid unnecessary
or inappropriate intervention
To read a vignette, just click on the title.
P01S05: Pneumonia (drug interaction)
Information on pneumonia was used to justify the management of the patient (Levaquin). It contributed to avoid an inappropriate treatment (Doxycycline).
P03S04: Antidepressant withdrawal
Information on antidepressant withdrawal was used to justify the management of the patient and to persuade the patient to make a change (do not stop medication, but continue decreasing the dose). It contributed to increase patient knowledge, and avoid unnecessary diagnostic evaluation.
P04S01: Dyslipidemia
Information on dyslipidemia (lipid-lowering agents) was used to persuade a physician to make a change (from adding a new medication to maintaining current medication). It contributed to avoid unnecessary treatment and blood tests.
P06S04: Transient Ischemic Attack (replace aspirin)
Information on Transient Ischemic Attack (TIA) was used to justify the management of the patient (replace aspirin by clopidrogel). It contributed to increase patient knowledge, avoid an inappropriate treatment, and prevent health deterioration.
P06S07: Diabetes mellitus
Information on diabetes mellitus was used to justify the management of the patient (continue medication). It contributed to avoid an unnecessary intervention and prevent health deterioration.
P07S05: Back and neck pain
Information on back and neck pain was used to justify the management of the patient (prescription). It contributed to avoid inappropriate treatment.
P07S06: Vertigo (drug dosage)
Information on vertigo was used to justify the management of the patient (maximum dosage of the medication). It contributed to avoid unnecessary intervention and inappropriate treatment.
P07S07: Insomnia (benadril)
Information on insomnia was used to justify the management of the patient and to persuade the patient to make a change (medication). It contributed to avoid unnecessary treatment.
P09S01: Back pain
Information on low back pain was used to modify the management of the patient, and to persuade other health professionals to make changes regarding the treatment for this patient who cannot use NSAIDs. It contributed to increase patient knowledge, and avoid an inappropriate treatment.
P11S02: Urinary incontinence (drug-induced)
Information on urinary incontinence was used to justify the management of the patient, and to persuade the patient and other health professionals to make a change (discontinue medication causing incontinence). It contributed to increase patient knowledge, avoid an inappropriate diagnostic procedure and improve patient health.
P11S05: Crestor and grapefruit
Information on Crestor and potential interaction with grapefruit was used to justify the management of the patient (new prescription for Crestor). It contributed to increase patient knowledge, avoid an inappropriate treatment and prevent health deterioration.
P14S03: Atrial fibrillation
Information on atrial fibrillation was used to modify the management of the patient (drug already stopped, and not re-started with higher dose), and to persuade another health professional to make changes (no increase of drug dose). It contributed to avoid inappropriate treatment.
P14S06: Drug interaction (Warfarin and Probenecid and Septra)
Information on drug interactions (Warfarin and Probenecid and Septra) was used to persuade other health professionals to make changes (double the dose of Warfarin). It contributed to avoid inappropriate treatment.
P14S07: Attention-deficit hyperactivity disorder (ADHD): Drug options
Information on Attention-deficit hyperactivity disorder (ADHD) was used to justify the management of a patient (avoid second line treatment). It contributed to avoid inappropriate treatment.
P16S02: Adverse effect of an anticoagulant
Information on an adverse reaction of an anticoagulant was used to better understand a specific issue regarding a patient (metallic taste associated with Warfarin medication). It contributed to increase patient knowledge, and to avoid an inappropriate procedure (e.g. switch to another drug) or unnecessary health care visit (e.g. referral to another MD).
P16S04: Drug interaction (Famvir and Warfarin)
Information on a drug interaction between Famvir and Warfarin was used to justify the management of a patient (Warfarin dosing and INR monitoring). It contributed to increase patient knowledge and to avoid inappropriate procedure.
P18S03: Acne vulgaris
Information on acne vulgaris, specifically drug interactions between tetracyclines and warfarin, was used to justify the management plan for a patient (switch back to previous prescription of tetracycline), and to persuade other health professional to make this change. It contributed to increase patient knowledge and to avoid inappropriate treatment.
P18S09: Clozapine adverse effects
Information on Clozapine adverse effects was used to maintain the management of the patient (no change in medication). It contributed to avoid inappropriate treatment and prevent health deterioration.
P23S02: Transient ischemic attack (replace a drug combination)
Information on Transient Ischemic Attack (TIA) was used to modify the management of a patient (replace the combination aspirin/clopidrogel by clopidrogel alone). It contributed to increase patient knowledge, and to avoid inappropriate treatment.
P24S01: Urinary tract infection in breastfeeding woman
Information on urinary tract infection (UTI) was used to justify the management of a patient (use the right medication for lactating postpartum patient with UTI). It contributed to avoid inappropriate treatment.
P27S03: Migraine (prescribe triptan)
Information on migraine was used to modify the management of a patient (prescribe triptans). It contributed to avoid inappropriate treatment, and to improve health.
P28S02: Acute low-back pain
Information on acute low-back pain was used to justify the management of a patient (use the right management for acute mechanical back pain). It contributed to increase patient knowledge, to avoid inappropriate procedures, to prevent health deterioration and to improve health.
P28S04: Refractory high blood pressure
Information on high blood pressure was used to justify the management of a patient (increase dose of an anti-hypertensive medication). It contributed to avoid inappropriate procedures, and to prevent health deterioration.
P28S06: Chest pain
Information on acute coronary syndrome was used to modify the management of a patient (potential drug interaction and no use of nitrates). It contributed to increase patient knowledge, and avoid inappropriate treatment.
P29S01: Constipation (adverse drug effect)
Information on constipation (adverse drug effect) was used to justify the management of a patient (starting Buspirone while gradually stopping Lyrica). It contributed to avoid inappropriate treatment.