Click here to export this guide to PDF

Recipe Name:

Identify all active patients with at least one chronic condition who are eligible for a Medication Review

Rationale:

Patients with chronic conditions often are taking multiple medications and would benefit from a review of their medications. This will ensure appropriate medications are prescribed and helps to reduce side effects and other medication related risks.

Target:

To identify active patients with a chronic condition and five or more medications who would benefit from a Home Medication Review (DMMR).

CAT Starting Point:

  1. CAT Open
  2. Population Extract Loaded and Extract Pane "Hidden"

CAT Starting Point:


CAT Open - "CAT4" view (all reports) loaded

Population Extract Loaded and Extract Pane "Hidden"


Filter Steps


On the "General" tab under Activity select "Active (3x in 2yrs)



On the "Date Range (Results)" Tab select "12 mths" or another date range



Click 'Recalculate' and 'Hide Filters'


Report Steps


Select 'Disease' tab 'Count'

Click on the "Diabetes Type II, Diabetes Type I, Undefined Diabetes, Asthma, COPD, CHD, Heart Failure, Hypertension, Stroke, Inflammatory Arthritis, Renal Impairment, Atrial Fibrillation" segments of the graph

Any combination of chronic conditions can be selected, this will show all patients with at least one of the selected conditions



Select the 'Medications' tab 'Medications per Patient'
Click on the "'with 5 meds', 'with 6 meds', 'with 7 meds' and 'with 8+ meds'" segments of the graph



Select the 'MBS Items' tab 'Not recorded'
Click on the "'900 (DMMR)' or '903 (RMMR)'" segments of the graph



Click on the 'Report' icon on top of the screen to cross-tabulate all selected report views to see the list of patients selected



This will display a list of all patients for whom the selected MBS item has not been claimed in the last 12 months.



The last three columns show disease, medication count and the date of the last claim or simply "not recorded" if the items has never been claimed in your practice.

To Export Patient List to Microsoft Excel:

1.  Click on the “Export Icon”  at the top of the Patient Reidentification window.

2.  Click on “Excel”

3.   Choose a file name and a location to save to (eg. Create a folder C:/ClinicalAudit/CAT Patient FollowUp)

4.  Click “Save”

 

The steps above will produce a list of patients with contact details in MS Excel which can then be used to:

1.   Go back through the individual patient records in the GP Clinical Desktop System (CDS) and update known records

2.  Phone patients to update their record

3.  Produce a mail merge to recall patients for follow up


Topbar prompts can not be created for missing medicare items, as the MBS App in Topbar automatically indicates, which items are relevant. So for our patients with a chronic condition and more than 5 current medications Topbar will already show a prompt for a medication review. However if you want to create a separate prompt for patients with more than 8 medications then the steps below will show you how to create a CAT Plus prompt based on a list of patients in CAT4.



Create a prompt to display in Topbar

 

Remember you need to be in the CAT4 Daily View to be able to create prompts. Other pre-requisites are:

  • Topbar is installed
  • CAT4 is linked to Topbar via Edit/Preferences/Topbar - check here for details: Linking CAT4 to Topbar

 To start CAT4 in the Daily View, click on the 'Daily View' icon in the dashboard:



Once you have applied the filter(s) and displayed the patients of interest as described above, you can create a prompt that will be shown to all clinicians using Topbar if a patient meeting the prompt criteria is opened in their clinical system. The full guide is available at CAT PLUS PROMPTS and a short guide on how to create prompts in CAT4 can be found at  Creating a Prompt in CAT4

To start you have to use the drop-down menu at the bottom of the patient details report and select "Prompt at Consult - Topbar" then click on "Go" to give the new prompt a name.

 


The name you enter is the prompt text displayed in Topbar, so choose a simple but clear name that tells the clinician seeing the prompt what should be done.