Personalized Medical Management Timelines Improve Clinical Outcomes in Medically-Complex Patients

Objectives: Management of medically-complex patients poses a great challenge to both health care providers and home caretakers. Patients taking multiple medications, from various sources, may have complex side-effects and serious drug-interactions. Personalized medical management timelines (PMMT) are chronological documentation of patient’s reported symptomatology and prescription medication timeline. Our study investigates whether PMMT can be utilized to improve clinical outcomes in a medically-complex patient.

Methods: Two D3 students, haven taken pharmacology course, conducted a retrospective chart review of a relative who is diagnosed with type II diabetes, stage II breast cancer, hypothyroidism, hyperlipidemia, and hypertension. Chronological sequence of patient’s symptoms and correlating prescription medications were documented. Patient medical records were gathered from one major hospital, including several specialists, as well as two private practices. Side-effects of medications were researched through online resources, while known drug-interactions were analyzed using online drug-interaction checkers.

Results: Over twenty hours, phone calls, even office visits were required to sift and organize relevant information from various sources into a neat, coherent timeline. After creating PMMT, care-taker’s understanding of the patient’s health history was significantly improved. Medication side-effects and interactions were also identified. Major symptoms caused by drug side-effects were noted and linked to specific medications. A medication causing severe side-effects was removed from medication list after consulting with physician. This drastically improved the patient’s condition. Several drug-interactions that were discovered had not been previously mentioned by the prescribing physicians, who may have been unaware. Medication and treatment regimens were modified after discussing with the physicians. Moreover, better-informed patient was motivated to seek out non-pharmacological lifestyle changes to better manage her health.
Conclusions: The lack of information on drug-side effects and interactions is obvious. The use of PMMT can contribute to optimal management of medically-complex patients. More unified documentation portals and patient-centered timeline approaches are needed.