ASSESSMENT 3: CASE STUDY 1 ASSESSMENT 3: CASE STUDY 6 6 ASSESSMENT 3: CASE STUDY Author's Note: Medicine Usage and Dose

The focus will be given to the two most important issues, non-adherence of the prescribed drug and its dosage, polypharmacy and developing two recommendations for each of the issue in order to address them by providing a rationale. The case study clearly indicates that there was issue related non-adherence of the prescribed drug and its dosage, polypharmacy, risk of overdose, drug interaction and side effects of medicines.

Running head: ASSESSMENT 3: CASE STUDY
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ASSESSMENT 3: CASE STUDY
Name of the Student:
Name of the University:
Author’s Note:

2ASSESSMENT 3: CASE STUDY
The correct usage of medicine is a collaborative effort of various factors and prior to
its use, it is important to have knowledge about it. In order to ensure the best possible
benefits, it is critical to understand its usage, dose and other queries from a healthcare
professional to gain maximum advantage. In this way, it is possible to mitigate any adverse
event that may occur due to medicine. The government of Australia utilises the Quality of
Medicine (QUM) as a policy for proper and effective utilisation of medicine and its access
(Lin et al., 2016). The aim of the essay is to critically evaluate the given case study of Mrs
McIntyre and infer the key issues raised from the perspective of QUM. The focus will be
given to the two most important issues, non-adherence of the prescribed drug and its dosage,
polypharmacy and developing two recommendations for each of the issue in order to address
them by providing a rationale.
Mrs McIntyre, a 79-year-old widowed woman, was suffering from a range of
cardiovascular disorders had a medical history of myocardial infarctions and had been
diagnosed with congestive heart failure, hyperlipidemia, hypertension and arthritis. She also
had been facing symptoms of gastro-esophageal reflux disease (GORD) and was brought to
the hospital following an episode of pneumonia by her daughter. As per the patient notes, she
has prescribed 11 medicines that clearly stated the dosage and time of consumption. When
inquired, she presented that she knew about them, however, on further investigation, it was
found she recognised her medicine by shape and colour and she consumes metolol, an
additional medicine for headache due to high blood pressure without consultation. She was
found to have an additional box of medicine having numerous addition drugs that she
administer as per her condition which was brought from the supermarket, pharmacy and by
her younger sister. The case study clearly indicates that there was issue related non-adherence
of the prescribed drug and its dosage, polypharmacy, risk of overdose, drug interaction and
side effects of medicines. According to the Centre for Disease Control and Prevention

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(CDC), it was estimated that non-adherence was responsible for causing 30% of failure in
chronic disease treatment and lead to the death of 125000 individuals. Some cases indicate
that 50% of people do not have medication as prescribed by physicians (U.S. Food and Drug
Administration, 2018). As per the case study, it was found that Mrs Mclyntyre had an extra
metolol due to headache caused by a high level of blood pressure. She was a shoebox in her
kitchen where she has certain drugs, namely, Nurofen, Valium, Panadeine Forte, Fish Oil and
St John’s Wort, which are not prescribed by her physician or pharmacist. Therefore, the
complications that may arise in this case are overdose, where she was administering extra
medication. Over a prolonged period, if the medication is continued, the side effects that may
occur were diarrhoea, tiredness, constipation, dizziness, breathing issues, rash and
bradycardia (Dransfield et al., 2019). From the case, the recent observation indicated that she
had a lower heart rate that is 66 per second, which, maybe due to the side effect of the drug.
Similarly, a complicated issue might be underlying due to the consumption of a handful of
medicines without any restriction. According to the Therapeutic Goods Act 1989 that is
responsible for the regulation of medicines, specifically prescription medicines, over-the-
counter medicines, vaccines, complementary medicine and other derivates (Day, 2018). From
the opinion of León et al. (2016), it can be stated that this is an essential activity as it helps in
limiting undesirable use of the drug for any individual. However, it was found that some
drugs are freely available in the supermarket, which can be brought by anyone without any
regulations. According to Masnoon et al. (2017), polypharmacy can be defined as the
continuous or concurrent use of multiple drugs or medications by a particular patient. This
kind of instances are found to be very common amongst the elderly and have been affecting
the 40 per cent of the elderly adults staying at home.
The issue of polypharmacy and non-adherence of prescription has complicated the
condition of Mrs Mclyntyre. Due to her age factor, her immune system is low; thus; these

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issues may have a more profound and significant impact on her health and well-being.
Therefore, it is to formulate recommendation specifically for each of the issue in order to
address the problem as well as limit the occurrence of such issue in the future. The issue of
non-adherence can be effectively controlled by restricting the sale of drugs in the market. The
Medicines and Poisons Act 2014 can consider this by enforcing reforms on health
professional and business involve and handling medicines (Brooker, 2019). In this way, Mrs
Mclyntyre or her younger sister would not be able to access medicines from the market at
their own convenience. The second strategy that can be used for addressing the issue is the
government approach to increase funding in the medical sector. Medicines Australia’s Code
of Conduct needs to take the initiative of increasing the promotion and advertisement of
prescribed drugs. This will help in spreading awareness about the negative impacts of using
non-prescribed medications, which will aid in expanding the knowledge base of ordinary
people (Grundy et al., 2018). From the perspective of QUM, it aims to promote safe and
judicious usage of medicine among the public. The issue of polypharmacy can be mitigated
by communication and conducting medication reconciliation. The physician or care provider
of Mrs Mclyntyre need to maintain effective communication that will help in preventing or
reducing the problem. The care provider will advise using prescribed medication, ensuring
dosage, informing of the harm or risk factor associated with medication interaction and its
effect. This will ensure that the individual is appropriately and safely using the drugs stated
by the physician. This is because the physician and healthcare professionals have studies the
complex topic of drug interaction and medical condition; therefore, they have more
knowledge about the therapeutic effect on human effect than the general population, and
consequently, it is crucial to abide by the advice rather than using own knowledge.
Pharmacodynamic tests, in addition to this, pharmacokinetic research for drugs for which a
disparity in disease progression and exposure-response relationship is expected, are found to

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be compared with the target population (Krekels et al., 2017). Conducting medication
reconciliation involves identification of an accurate list of medications for a patient in term of
name, dose, frequency and route in different settings. This can help in reducing adverse drug
events and hospital admission (Rose et al., 2017). This can be done at the hospital in
collaboration with the Society of Hospital Pharmacists of Australia (SHPA). The Eligible
Professional (EP) will be performing the reconciliation process to understand the specific
physical, emotion and therapeutic need of a patient. Thus, it can be stated that the process
needs to be conducted and the findings need to be critically explained to patient and family
members for ensuring that the use of the only prescribed drug is administered as and when
stated by the EP.
From the essay, it can be stated that the QUM is responsible for having an insight on
the appropriate usage of medicines. As per the case study, it can be seen that there were
issues related to ineffective and improper use of drugs even though, a list of the prescribed
drug was given to her. She used further six medicines that have negative effects on her health.
The key issues identified from the case study were non-adherence to the prescription and
polypharmacy. With respect to the issues, recommendations were formulated in conjunction
with legislation, regulation and professional framework was taken into consideration for safe
usage of medicines.

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References
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