The outcome of the medication review | Frequency (%) | Pharmacist recommendation |
---|---|---|
Change of therapy | 5 (1.61) | a) Change of basal-bolus insulin to premixed insulin (n = 1) b) Change amlodipine to perindopril (n = 1) c) Change bolus insulin to gliclazide (n = 1) d) Change simvastatin to atorvastatin (n = 2) |
Dose alteration | 3 (0.97) | a) Reduce dose and frequency of metformin 500 mg BD to 750 mg OD (n = 1) b) Reduce the dose of metformin from 1 g BD to 500 mg BD (n = 1) c) Reduce dose of premixed insulin from 14iu BD to 10iu BD (n = 1) |
Deprescribing | 7 (2.26) | a) Off prazosin & perindopril (n = 1) b) Off gliclazide & amlodipine (n = 1) c) Off perindopril (n = 2) d) Off HCTZ (n = 1) e) Off frusemide (n = 1) f) Off bisoprolol & HCTZ (n = 1) |
No change in therapy | 295 (95.16) | - |