Meeting Summary and Action Plans

Meeting Summary

1. Practice MDT review of Arthur Pendelton (DOB: 12/04/1945, NHS: 485 729 1034) following recent hospital discharge for IECOPD. Current regimen includes salbutamol 100 mcg INH PRN and tiotropium (Spiriva®) 18 mcg INH OD. Discussed recurrent falls at home, declining mobility, and poorly controlled T2DM (latest HbA1c 68 mmol/mol).
2. Add gliclazide 40 mg PO OD to existing metformin 1000 mg PO BD. Refer to community respiratory team for pulmonary rehabilitation and community occupational therapy for a home hazard assessment.
3. High risk of further falls due to stairs at the property. Patient struggling with inhaler technique and adherence, compounded by mild cognitive impairment and spouse experiencing carer strain.

Action Points

1. Issue prescription for gliclazide 40 mg PO OD, switch inhalers to a spacer-compatible MDI regimen, submit urgent referral to the Community Falls and OT Service, and book a repeat HbA1c and renal profile.
2. Dr S. Patel (GP) to issue prescriptions and submit the OT referral; Sister J. Doe (Practice Nurse) to conduct the inhaler technique review; Reception team to schedule the phlebotomy appointment.
3. Prescriptions and OT referral to be completed by 17:00 on 24/10/2023; respiratory nurse review within 2 weeks; repeat blood tests in 12 weeks.