Standardised monitoring of patients on long-term medication in primary care

A three-year pilot study was initiated in collaboration with three general practices to develop a standardised monitoting (SM) system to ensure that chronically sick patients on long-term medication, such as thyroxine, diuretics angiotensin convening enzyme (ACE) inhibitors statins and antirheumatics were reliabily monitored following fixed protocols. A high standard of care was achieved, which included identifying and following up patients with borderline or unacceptable results and persistent non-attendees. In addition, the scheme guaranteed that a current set of results was provided in time for clinical review.