Priority WizardPriority Wizard©

Patient: DOE, JANE E.  Age: 49  Date:12/24/18

Provider: SMITH, JOHN F.

Conditions Conditions: Diabetes, Hyperlipidemia, Hypertension
Cardiovascular Risk Cardiovascular Risk: Risk of having a heart attack or stroke over the next 10 years is X%. Risk over your lifetime is X%.

 Tobacco  CV Risk from 7% to 5%

  • Tobacco use is identified. Assess readiness and consider varenicline (Chantix), bupropion (Zyban) or nicotine patch, gum, lozenge, or inhaler. Consider referring to MTM for smoking cessation counseling.

Tobacco Use: YES

No Medications

 Lipids  CV Risk from 7% to 5%

  • Goal: Consider intensifying statin therapy
  • Statin initiation or intensification is recommended due to diabetes and CV risk. Many experts recommend high intensity statin doses for CV risk > 7.5%
LDL (mg/dl) 93 12/23/2019
HDL (mg/dl) 46 12/23/2019
TRIG (mg/dl) 127 12/23/2019
TC (mg/dl) 164 12/23/2019
LDL (mg/dl) 93 12/23/2019
  • Atorvastatin Calcium Tab 20 MG

 Blood Pressure  CV Risk from 7% to 5%

  • Ideal BP < 120/80
  • A blood pressure reading in the last year is not found
  • A potassium test (K) is often recommended yearly for people taking hypertension medications
  • A kidney function test (Cr/GFR) is often recommended yearly for people taking hypertension medications
BP (mm Hg) 128/88 2/15/19
Last BP (mm Hg) 132/86 1/07/19
eGFR (ml/min) 60 2/15/19
K (mmol/L) 3.6 2/15/19
  • Hydrochlorothiazide

 Glycemic Control  CV Risk from 7% to 5%

  • Blood glucose tests are suggestive of diabetes. Consider further evaluation and document diabetes on the problem list if indicated
  • Annual kidney function tests(GFR) are recommended for metformin use
A1c (%) 8 2/15/19
Cr (mg/dl) 0.9 1/07/19
eGFR (ml/min) 60 2/15/19
GLUCOSE (mg/dl) 189 2/15/19
  • Liraglutide Soln Pen-Injector 18 MG/3ML (6MG/ML)
  • Metformin HCI Tab 500 MG

 BMI (Weight)  CV Risk from 7% to 5%

  • Discuss advantages of reducing weight by 10-20 lbs. Potential actions are listed on patient interface.

BMI: 31.3

No Medications

 ASPIRIN OR BLOOD THINNERS

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 Chronic Kidney Disease

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 OPIOID USE

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 Cancer Prevention

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 RELEVANT INFORMATION AND RECOMMENDATIONS

  • Aspirin - Lorem ipsum dolor sit amet, consectetur adipiscing elit, sed do eiusmod tempor incididunt ut labore et dolore magna aliqua. Lorem ipsum dolor sit amet, consectetur adipiscing elit, sed do eiusmod tempor incididunt.
  • Lipids - Lorem ipsum dolor sit amet, consectetur adipiscing elit, sed do eiusmod tempor incididunt ut labore et dolore magna aliqua. Lorem ipsum dolor sit amet, consectetur adipiscing elit, sed do eiusmod tempor incididunt.
  • Glycemic Control - Lorem ipsum dolor sit amet, consectetur adipiscing elit, sed do eiusmod tempor incididunt ut labore et dolore magna aliqua. Lorem ipsum dolor sit amet, consectetur adipiscing elit, sed do eiusmod tempor incididunt.
A1c (%) 8 2/15/19
Cr (mg/dl) 0.9 1/07/19
eGFR (ml/min) 60 2/15/19
GLUCOSE (mg/dl) 189 2/15/19
  • Liraglutide Soln Pen-Injector 18 MG/3ML (6MG/ML)
  • Metformin HCI Tab 500 MG

Disclaimer: The Priority Wizard© suggestions are based on electronically available data and are not intended to be a substitute for clinical judgment. Alternative actions to those that the Priority Wizard© suggest may be indicated. Exercise independent clinical judgment, review allergies, and follow product labelling instructions before choosing Wizard prescribing suggestions.

Mayo Statin Tool

Hypertension

Current BP: 139/80, Date   Last BP: 139/80, Date

Medication Adherence Score (MAS)* Medication(s) Medication Instructions
N/A Insufficient Data Lisinopril 10mg Take 2 Tabs by mouth 2 times a day with morning and evening meals.
19%Potential Adherence Issue Chlorthalidone 25mg Take 1 Tabs by mouth daily.
87%Good Adherence Benazepril 25mg Take 1 Tabs by mouth daily.

Glycemic Control

A1C: XXX, Date

Medication Adherence Score (MAS)* Medication(s) Medication Instructions
 0%Potential Reconciliation Metformin 1000mg bid Take 2 Tabs by mouth 2 times a day with morning and evening meals.
79%Potential Adherence Issue Bromocriptine mesylate 10mg Take 1 Tabs by mouth daily.
80%Good Adherence Empagliflozin 25mg Take 1 Tabs by mouth daily.

Lipid Management

LDL: XXX, Date

Medication Adherence Score (MAS)* Medication(s) Medication Instructions
 N/AInsufficient Data Simvastatin 40mg Take 2 Tabs by mouth 2 times a day with morning and evening meals.

Pharmacist Outreach: Click Patient Declines or Provider Declines to prevent a phone call to the patient from the pharmacist working with your clinic on improving medication adherence.

*Medication adherence issue is defined as a medication adherence score (MAS) of less than 80%. The MAS is determined by comparing how a patient is supposed to be taking a medication based on the active medication list in EPIC with the amount of medication that has been dispensed. For example, if a patient is expected to have used 360 metformin pills in the last 6 months, but has only been dispensed enough for 180 days, the MAS is 50%.

Disease Specific CDS