The B-SMART Appropriate Medication-Use Process: A Guide for Clinicians to Help Patients— Part 1: Barriers, Solutions, and Motivation


Elizabeth Oyekan, PharmD, FCSHP; Ananda Nimalasuriya, MD; John Martin, MD; Ron Scott, MD; R James Dudl, MD; Kelley Green, RN, PhD

Winter 2009 - Volume 13 Number 1


Five Case Examples

1. AJ, a woman, age 57 years, was diagnosed with hypertension and given a prescription for Lisinopril. After one week, she stopped taking the medicine because she was too dizzy to focus at work. Six months later, she was taken to the Emergency Department with a severe headache and blood pressure reading of 210/100.

2. SB, a toddler age two years, was diagnosed with an ear infection. Her mother was told to give her a teaspoon of an antibiotic twice daily. So, twice a day, the mother poured a teaspoon of the medicine into her daughter's ears.

3. A man, age 62 years, stopped taking his atenolol because he did not like how it made him feel. Thirty-five days later, he was readmitted to the hospital with a second heart attack.

4. A man, age 37 years, got a prescription for nicotine patches to help him quit smoking. He plastered the nicotine patch on his mouth.

5. A woman, age 25 years, with depression stopped taking her Prozac because she did not feel better after two weeks. Her clinician did not tell her that it may take four to six weeks to feel the full effects of the medication.


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