Medication Review Policy

Last updated: March 2023

Purpose of this Document

At ADHD Direct, we aim to provide the best service possible. We follow national guidelines, as well as recommendations provided by Healthcare Improvement Scotland (HIS). This document provides information on Medication Review appointments – including when and how often patients of ADHD Direct are expected to attend a Medication Review with our clinical team.

ADHD Treatment Initiation

Once the assessment process has been completed and an ADHD diagnosis is confirmed, patients of ADHD will be recommended a treatment plan, which may include one or various medications. Before our initiating pharmacological treatment, your clinician will discuss the following points with you:

1. The possible benefits and side-effects associated with the chosen treatment.
2. Alternative options, including non-pharmacological treatments and support.
3. The importance of a healthy lifestyle and how this may impact your experience of the chosen treatment.
4. Any concerns you may have about pursuing the chosen treatment.

ADHD Treatment Titration 

Titration is the process of slowly increasing the dose of a medicine over days, weeks, and sometimes months. This allows the clinician to understand how the medicine may affect their patient’s body, alongside any potential side effects. Medication Reviews will occur throughout the titration process, at 3–8-week intervals, to manage any adverse reaction a patient may be having to their new medication. Once the titration process has been completed and treatment is stable with no further changes to your medication or dosage required, patients may be asked to book Medication Reviews less often – every three, six, or twelve months. The frequency of these medication reviews will be determined by the clinical specialist, alongside the input of the patient or the patient’s family.

Medication Review – Measurements

During Medication Review appointments, the clinician specialist will review the patient’s response to their treatment. They will enquire about symptom-control and any positive effects provided by the medication, as well adverse side-effects, and ways the medication may be falling short. The Medication Review will help to determine if the patient is on the correct treatment, if the dose needs to be adjusted higher or lower, if the medication needs to be switched entirely, or if any additional medications need to be added to the patient’s prescription. The Medication Review will also consider any effects on appetite and sleep the medication is having, as well as impact on mental and physical health.

In every Medication Review appointment, the clinician will record the patient’s measurements. These include the patient’s blood pressure, pulse, and weight (as well as height if the appointment is for a child). These measurements can then be compared to expected baselines, as well as prior measurements submitted by the patient.

In the case when patients have booked virtual appointments, the blood pressure, pulse, and weight (as well as height if the appointment is for a child) must be taken by the patient and emailed into the clinic prior to the appointment. Some patients choose to purchase their own blood pressure monitor for this purpose – or else these measurements can be taken at a local GP or pharmacy.

Failure to provide these measurements can lead to delays in treatment, and repeated failure to provide measurements may result in the patient being discharged by the clinic. This decision will be made at the discretion of clinical staff alongside senior management – however the patient will be informed and warned prior to the event of being discharged.

Policy on Non-Interchangeable Medication Review Bookings

Effective immediately, our policy regarding the booking and interchanging of medication reviews has been updated to ensure clarity and fairness for all patients.

When a patient books a medication review, the specific appointment type and slot are reserved exclusively for them. Due to the personalized nature and preparation involved in different types of medication reviews, we are unable to interchange them.

Key Points of the Policy:

1. No Exchange Between Review Types: Patients cannot change a 20-minute standard medication review to a TOMIS or MDAS medication review, nor can they change an MDAS medication review to a TOMIS medication review. Each appointment type is tailored to specific needs and preparation, and changes disrupt the scheduling and availability for other patients.
2. Rescheduling: Patients may reschedule their medication review to a different date or time, subject to availability. However, this must be done at least 48 hours in advance, and the rescheduled appointment must be of the same type (e.g., standard medication review, TOMIS, MDAS).

This policy aims to maintain the integrity and efficiency of our services while ensuring all patients receive the highest standard of care. We appreciate your understanding and cooperation.