Skip to main content

Table 2 Follow-up categories and descriptive codes × number of flags

From: Examining clinician choice to follow-up (or not) on automated notifications of medication non-adherence by clinical decision support systems

N

Ref

Category/Sub-Category/descriptive decision code

Explanatory notes

Example codes

71

F

Followed up

  

20

F.1

Adverse Outcomes

  

1

F.1.1

Died

 

“Pt has died”

14

F.1.2

Hospital Admission

Different dispensing system, no data

“Recent hospital admission discharged 12/3. case manager confirmed current compliance”

5

F.1.3

Incarcerated

Different dispensing system, no data

“Given antipsychotic and oral meds in June. (so likely a delay in PBS data) This client is now in remand. Prison health service has been made aware of his medications. No longer residing in our catchment area.”

46

F.2

Confirmed adherence

  

6

F.2.1

Ambiguous source of confirmation

Ie., source was not named in the notes

“Compliant with medication (Data incorrect collects scripts every month)”

5

F.2.2

Client Confirmed

 

“25/5/20 contact with client. confirmed compliance. no problems”

14

F.2.3

Clinician or Case Manager Confirmed

 

“Case manager: According to CPMS all medication has been dispensed for every month”

5

F.2.4

Clozapine

Monitored elsewhere in service

“R/v client file. P/c and 1:1 with Hyde and partners GP. Client presented for GP appt and collected script for clozapine on 10/08/2020. Nil concerns raised”

2

F.2.5

Depot records showing compliance

 

“Accumulating data from all sources client received depot as prescribed on the below dates”

4

F.2.6

Family confirmed

 

“His mother pick-ups the medication and deliver at his place”

13

F.3

Confirmed non-adherence

  

1

F.3.1

Appointment booked to discuss compliance

 

“Awaiting appointment for follow up with information regarding compliance of medication”

2

F.3.2

Client lost to follow-up, case manager pursuing

Client disappeared, or disengaged

“Client whereabouts unknown. Case manager aware of non-compliance”

2

F.3.3

Client refused further intervention

 

“P/C to client, declined services. Fax sent to GP.”

7

F.3.4

Discontinuation confirmed on follow-up

 

“Ceased September 2020 was doing well then come unstuck and thought he needs to go back to the GP and re-commence taking it”

3

F.3.4.1

Ambiguous

Unclear who initiated/supported

“Intentional cessation”

1

F.3.4.2

Initiated with Medical professional support

 

“Spoke to client, stopped antipsychotic as recommended by [clinician]”

3

F.3.4.3

Patient initiated, unsupported

 

“Stopped taking medication as he had been on it for a long time (2 months) and it did not help.”

260

N

Not followed-up

  

140

N.1

Likely to be Clinician Supported

  

11

N.1.1

Changed Medication

 

“Paliperidone injection monthly changed to 3-monthly (TRINZA)”

1

N.1.1.1

Changed to depot

 

“Change to depot”

13

N.1.2

In residential care

Monitored by facility in Aus. context

“Lives in boarding house where medication is supervised”

79

N.1.3

Likely PRN

PRN = taken as needed

“PRN medication such as diazepam and oxacepan should not set triggers”

22

N.1.4

Script likely a short-term solution

 

“Was a once off script, regular GP visits”

15

N.1.5

Seen their GP, while

 

“Seen GP since, assuming it was intended as CPZ was commenced since”

13

N.1.5.1

Compliant with other medications

 

“Regular in everything else, likely per Gp”

2

N.1.5.2

Started a new medication

 

“GP seemingly trying different antidepressants”

133

N.2

Unclear without further investigation

  

14

N.2.1

Assumed to be a trial

 

“As only once dispensed I assume that it was poorly tolerated”

68

N.2.2

GP visit regularity only source of data for assumption

 

“Several GP appts since- assuming intentioned”

42

N.2.3

Irregular prescription pickup pattern

Ie., assumed normal behaviour for pt

“Likely timing issue, he picked up the last repeat too early, long term very reliable”

9

N.2.4

Patient known to be non-compliant, not followed up

 

“Patient has a history of noncompliance with limited benefit of medication, as such likely real alert but no action taken before next scheduled review”

2

N.2.4.1

Patient has case manager

Unclear if C.M. was followed up

“Case managed, known non-compliance”