Ozempic / Weight-Loss PharmD

SUBJECTIVE
CC/Purpose: Patient here to assess appropriateness for pharmacologic-assisted weight loss approaches.

HPI: Patient is a new referral from MOVE clinic who had expressed interest in getting more information and seeking perhaps a drug therapy to assist in broader holistic weight management strategies. 

We discussed in lengthy detail today their PMH, current medications.  Also we discussed all FDA approved medication options to assist in weight management.  Further we discussed the general treatment principles, the pros/cons, risks/benefits, and limitations of our current knowledge.  As such we navigated the question of "is a medication needed at all" as a general principle along with some of the still uncertainties about longer term questions of treatment (aka "what will be the medication exit strategy" or "will I be on this medication long term?"). 

Taking into account the patients risk tolerances, personal perspectives and philosophies, we discussed how the patient wanted to proceed. 

FAMILY / SOCIAL HISTORY:
Relevant family history: [text name="variable_1" default=" "]
Physical activity: [text name="variable_1" default=" "]
Tobacco use: [text name="variable_1" default=" "]
Alcohol use: [text name="variable_1" default=" "]
Diet: [text name="variable_1" default=" "]
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OBJECTIVE
Vitals: 

Relevant labs:
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Allergies/ADRs:

Medication List:

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ASSESSMENT:         Key: [+] = Yes / True     [-] = No / False
CFU:
Current BMI: [text name="BMI" default=""]
[checklist name="variable_1" value="No history of pancreatitis|No history of severe GI disease|Patient is not pregnant or is not capable of becoming pregnant|No personal or family history of thyroid cancers"]
[select name="diabetes" value="Patient does not have diabetes|Patient has type II diabetes mellitus|Patient has type I diabetes mellitus"]
[conditional field="diabetes" condition="(diabetes).is('Patient has type II diabetes mellitus')||(diabetes).is('Patient has type I diabetes mellitus')"]
[checkbox name="variable_1" value="Patient has current or past history of diabetic retinopathy"]
[/conditional]
Medications that may be causing weight gain:
[textarea name="variable_1" default=""]
[checkbox name="variable_1" value="No medications identified that may contributing to weight gain"]
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- Given patient's comorbidities, labs, and goals, subq semaglutide is the best option to trial first for weight loss.

[checkbox name="labs" value="Patient is due for updated labs, including the following:"]
[conditional field="labs" condition="(labs).is('Patient is due for updated labs, including the following:')"] [text name="variable_1" default=""] [/conditional]

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PLAN:
- Initiate semaglutide 0.25mg subq once weekly x 4 weeks
- RTC clinic in [text name="variable_1" default=""] weeks for follow-up 
  appointment
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EDUCATION:
-Writer reviewed disease states and risks associated with them.
-A review of labs, goals andlaboratory values was discussed with the patient.
-Provided recommendations on diet and exercise.
-Reviewed all medication indications and the importance of adherence.
-A review of signs and symptoms associated with medications and disease state
 discussed with patient.Patient giveninstructions on how to contact the
 clinic in the event of an adverse drug reaction, questions or concerns.
-In the event of an emergency, patient instructed to seek immediate medical
 attention.
-Written materials given. Patient voiced understanding and agreement.

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