3.1 Patient characteristics
Doctors, in line with the principles of the Hippocratic oath, “use
treatment to help the sick …, but never with a view to injury and
wrong-doing”, aim to ensure that medication is safe and beneficial.
Upon admission to the AMU, the patient’s presenting complaint and
clinical picture alongside immediate prescribing for acute treatments
were primary considerations in the prescribing of medicines. Doctors
acknowledged that it was important to ensure that the patient’s existing
therapy should not be interrupted so long as it continued to be
beneficial. The characteristics of the patient, such as confusion,
dehydration, or renal function, then modified this decision and acted as
a prompt for further prescribing actions. For example, if kidney
function was poor, this might prompt a decision to stop, or temporarily
withhold, medication, as illustrated by the following quotation: -
“We have a lot of people with renal failure, pneumonias and
things, so for example, some of the [medicines that are] not
continued, we identified as being nephrotoxic so we would not continue
the medication”. (Doctor, 2015)
Other patient characteristics included the age of the patient and level
of frailty, particularly in terms of a dose being perceived to be too
high or if a patient would no longer benefit from continuation of
medicines, or any further additions.