What are your current health conditions ?

Can you provide the names, dosages, and frequencies of each medication you are taking,
including prescription drugs, over-the-counter medications, herbal supplements, and vitamins ?

Are you aware of the purpose of each of your medications and the potential side effects ?

Are there any difficulties or challenges in taking your medications as prescribed ?

Have you ever missed doses or stopped taking any of your medications without discussing it
with your healthcare provider?

Have you noticed any new side effects when taking some of your medications together ?

Are there any specific risks associated with polypharmacy that concern you, such as confusion,
memory problems, or falls ?

Have you experienced any adverse reactions or allergies to any medications in the past ?

I will Review the patient's medication list and note the names, doses, frequencies, and
indications for each medication.

I will make sure the patient knows each medication is for what condition.

I will Identify any potential drug-drug interactions and drug-body interactions.

I will identify duplications (x2 medications from the same category) and discontinue
unnecessary medications.

I will Determine if any medications have been prescribed for a limited duration and need to be
discontinued.

I will identify Impacts of the medications on the functional status (Timed Get Up and Go test).
ARMOR assessment tool

1- Assess medications, side effects, knowledge of the patient, and adherence to

medications :

Can you provide the names, dosages, and frequencies of each medication you are taking,
including prescription drugs, over-the-counter medications, herbal supplements, and vitamins ?
Are you aware of the purpose of each of your medications and the medical condition related to
the medication ?
Are you aware of the potential side effects of your medications ?
Are there any difficulties or challenges in taking your medications as prescribed ?
Have you ever missed doses or stopped taking any of your medications without discussing it
with your healthcare provider?

2- Review drug-drug interactions :

I will Identify any potential drug-drug interactions by reviewing Lexicomp®

3- Minimize non-essential medications :

I will eliminate medications whose risks outweigh benefits, which have high potential for
negative impact on primary functions (appetite, weight, pain, mood, vision, hearing, bladder,
bowel, skin, swallowing, activity level)
I will Determine if any medications have been prescribed for a limited duration and need to be
discontinued.
I will identify duplications (x2 medications from the same category) and discontinue
unnecessary ones.

4- Optimize MEDICATIONS TO READINGS :

- I will adjust renally cleared medications to creatinine clearance (glomerular filtration

rate).

- I will adjust oral hypoglycemics to blood sugar target and HbA1c.

- I will adjust anticoagulants for international normalized ratio (INR) guidelines
- I will adjust beta blockers to allow physiological heart rate response.
- I will adjust seizure medications with free phenytoin level.
- I will consider gradual dose reduction (GDR) for antidepressants.

5- Re-assess the following :

- I will re-assess Heart rate, blood pressure (sitting and postural), and oxygen saturation rate all at REST and
ACTIVITY.
- I will re-assess Functional status (Timed Get Up and Go test)
- I will re-assess Cognitive status (Mental Status Examination)