Case Summary | Right Decisions

Right Decisions
Polypharmacy guidance: realistic prescribing
Case Studies
Back
Case 5: Chronic pain with multimorbidity
Case Summary

Please update your RDS mobile app to version 4.7.1

We are pleased to advise that deep linking capability, enabling users to directly download individual mobile toolkits, has now been released on the RDS mobile app. When you install the update, you will see that each toolkit has a small QR code icon the header area beside the search icon – see screenshot below. Clicking on this icon will open up a window with a full-size QR code and the alternative of a short URL for sharing with users. Instructions are provided.

You may need to actively install the update to install RDS app version 4.7.1 to see this improvement. Installing this update is also strongly recommended to get the full benefits of the new contingency arrangements – specifically, that if the RDS website should fail, you will still be able to download new mobile app toolkits.

To check your current RDS version, click on the three dots bottom right of the RDS app screen. This takes you to a “More” page where you will see the version number. To install latest updates:

On iPhones – go to the Apple store, click on your profile icon top right, scroll down to see the apps waiting to be updated and update the RDS app.

On Android phones – these can vary, but try going to the Google Play store, click on your profile icon top right, click on “Manage apps and device”, select and update the RDS app.

Please get in touch with ann.wales3@nhs.scot with any questions.

Patient Details

70 year old woman

Current Medical History

Total knee replacement
GI reflux
Hypothyroidism
Hypertension

Results

All blood results are normal
Normal X ray
Normal MRI
BMI 23.5 kg/m2
BP 123/74 mmHg (sitting)
Cholesterol 4.5 mmol/l

Lifestyle

Retired cleaner
Ex-smoker 20 years
Little exercise
Alcohol units 20 /week

Current Medication

Co-codamol 30/500 8 tablets daily
Ibuprofen 400 mg 1 three times daily – as required (max 1.2 g in 24 hrs)
Omeprazole 20 mg once daily
Levothyroxine 25 micrograms once daily
Bendroflumethazide 2.5 mg once daily
Simvastatin 40 mg every night

Previous medication

Buprenorphine patch 20 micrograms/hour , post knee replacement 18 months ago

Current Function

A brief Pain Inventory questionnaire was completed showing an average pain score of 6 and an average interference score of 4 (see Pain Strategy)
No inflammation or swelling of joints, some stiffness on remaining in the same position for a long time
Good range of movement
No neuropathic symptoms
Some symptoms of postural hypotension on standing

Most Recent Consultations

At her most recent consultation her pain management was stable and she was feeling a bit constipated and tired
Feels tiredness is impacting on looking after her granddaughter
Dizzy on standing