MEDICATION RISK ASSESSMENT AND AGREEMENT FORMMedication Risk Assessment and Agreement Form • May 9th, 2008
POSSIBLE RISK A-Initial DecisionYES NO N/A IF NO B -SUPPORT REQUIRED TO ENABLE SERVICE USER TO SELF-MEDICATE C-Final DecisionYES NO N/A Is the service user able to order and collect prescriptions if needed? • Can family members/informal carers collect?• Does community pharmacy deliver?• Consider level 1 support if no other option Can service user provide a list of their medicines?Do they know where allmedicines are stored in the home/service? • Contact GP if unable to establish what service user should be taking• Can informal carers tell you where medicines are kept? If able to assess, do medicines appear to be stored appropriately and does the service user understand how to storeeach medication? • Advise• Seek advice from community pharmacist if necessary Do quantities of medicines in the house appear to be appropriate? • Advise service user or informal carers to return unwanted medicines to the pharmacy• Advise service user to contact GP surgery if large amo
