| Yes | No |
---|---|---|
1: Have you collected the main complaint of the patient? | â–¡ | â–¡ |
2: Have you and your patient discussed the treatment goals from his own point of view? | â–¡ | â–¡ |
3: Have you compiled a full list of all the patient’s drugs at admission? | □ | □ |
4: Have you decided for every single drug whether | ||
 ▪ the patient will indeed take it as prescribed? | □ | □ |
 ▪ the indication of the drug is correct for this patient? | □ | □ |
 ▪ the risk of side effects (present or expected) is less than the benefit incurred? | □ | □ |
 ▪ the dose is correct for this individual patient (age, comorbidities)? | □ | □ |
 ▪ there is no alternative drug with a better benefit-to-risk ratio? | □ | □ |
5: Have you decided whether a new drug is indicated? | â–¡ | â–¡ |
6: Did you involve the patient in the changes you are proposing? | â–¡ | â–¡ |
7: Have you provided the patient with a discharge medication list together with an invitation to use it? | â–¡ | â–¡ |
8: Have you motivated the patient to consult the family doctor/general practitioner within 7Â days? | â–¡ | â–¡ |
9: Did you send the list of modified or newly introduced medications to the family doctor/general practitioner? | â–¡ | â–¡ |
10: Was there any contact with the general practitioner during the hospital stay in view of the imminent discharge of the patient? | â–¡ | â–¡ |