PSYCKES Clinical Note Client Name: Date: Medicaid Number: Psychotropic (or clinic) prescriber: Other Prescriber: Cardiometabolic Metabolic Condition Diabetes Hyperlipidemia Hypertension Obesity CVD Risk High Risk Antipsychotic(s) Polypharmacy 2 AP 3AP 2AD 3 AD 4PP (adults) 3PP (youth) High Dose: Adults: AP AD MS ADHD ANX Youth: AP AD MS ADHD ANX Youth (0-18) ≥3PP High Dose Psychotropics under 6 y/o CURRENT MEDICATIONS MEDICATION PLAN CHANGE NO CHANGE Plan Rationale Discontinue Client released from hospital in past 3 months Begin taper of Client prefers to stay on current regimen AOT order specifies current regimen Plan Supports Antipsychotic polypharmacy used for clozapine Define/discuss early warning signs of relapse augmentation Use rating scale to monitor symptoms (specify) Medication prescribed by outside provider Call to check in on client Unsuccessful attempt to reduce medications in Increase therapist/RN involvement the past 3 months telephone check in 3 previous trials of monotherapy at adequate discuss med concerns/adherence at dose for adequate time next appt. Client has history of serious violence to self or meet with client/family/social supports others increase frequency of visits Other Offer medication education groups Other Plan to address barriers to change Reassess in months Therapist to engage client around concerns Provide medication education materials Contact other prescribers of medication Notes: contact info in chart consent done Offer medication group/peer support Other Signature:
PSYCKES Clinical Note Client Name: Date: Medicaid Number: Psychotropic (or clinic) prescriber: Other Prescriber: Cardiometabolic Metabolic Condition Diabetes Hyperlipidemia Hypertension Obesity CVD Risk High Risk Antipsychotic(s) Polypharmacy 2 AP 3AP 2AD 3 AD 4PP (adults) 3PP (youth) High Dose: Adults: AP AD MS ADHD ANX Youth: AP AD MS ADHD ANX Youth (0-18) ≥3PP High Dose Psychotropics under 6 y/o CURRENT MEDICATIONS MEDICATION PLAN CHANGE NO CHANGE Plan Discontinue Begin taper of Plan Supports Define/discuss early warning signs of relapse Use rating scale to monitor symptoms (specify) Call to check in on client Increase therapist/RN involvement telephone check in discuss med concerns/adherence at next appt. meet with client/family/social supports increase frequency of visits Offer medication education groups Other Rationale Client released from hospital in past 3 months Client prefers to stay on current regimen AOT order specifies current regimen Antipsychotic polypharmacy used for clozapine augmentation Medication prescribed by outside provider Unsuccessful attempt to reduce medications in the past 3 months 3 previous trials of monotherapy at adequate dose for adequate time Client has history of serious violence to self or others Other Plan to address barriers to change Reassess in months Therapist to engage client around concerns Provide medication education materials Contact other prescribers of medication contact info in chart consent done Offer medication group/peer support Other Notes: Signature: