Consider a patient (Pt) aged 80 or older who presents with symptoms suggestive of heart failure. Routine blood tests reveal that the patient has mild microcytic anaemia (ferritin not checked in the past 12 months) and minimal hyperproteinaemia.

Upon examination, you observe that the patient has pitting legs oedema up to the knees 

The Pt is currently taking 20 mg of furosemide. However, the patient does not understand the purpose of this medication.

You also note that the patient has a systolic murmur, with the maximum intensity located at the aortic area (grade 3/6).

You consider an appropriate management plan (PGP-MP) and discuss it with the patient

The Pt agrees to follow the General Practitioner’s recommendations.

The proposed Patient GP Management Plan (PGP-MP) could include the following steps:

1. Recommend urgent blood tests for ferritin, protein electrophoresis, and BNP.

2. Perform a 12-lead ECG.

3. Refer for an echocardiogram.

4.  Increase the daily dose of furosemide.

5. Book an appointment for a non-fasting blood test for urea and electrolytes (U&E) two weeks after increasing the furosemide dose to monitor kidney function.

6. Record Home Blood Pressure Monitor (HBPM) two weeks after increasing the furosemide dose.

7. Have an urgent stool test for faecal immunochemical testing (FIT).

8. Have an urgent stool test for faecal calprotectin.

9. Arrange a face-to-face follow-up consultation in 3 weeks.

To help the patient remember this plan, you offer a printout of  PGP-MP so they can take the information home after the consultation. Additionally, the patient asks that the plan be emailed to their daughter, who will discuss it with their granddaughter, the patient's nurse. This way, they can remind the patient of the agreed actions.

In this situation, the PGP-MP serves as an effective and efficient means of communication with the patient.

If you would like to view the PGP-MP generated using the preset templates, please press this button.

Who Benefits:

- The Patient

- The GP has the opportunity to explain each point of the plan and the rationale behind each recommendation.

- The patient will not feel rushed and will appreciate that the plan is tailored to their individual needs.

  - The patient's family will be informed about the outcome of the consultation, enabling them to assist the patient in following the agreed actions.

- The GP

- The GP will not feel pressured to document the plan during the consultation, as the PGP-MP becomes an integral part of the consultation notes.

 - The PGP-MP can also serve as a medico-legal document in this context.

- Other Healthcare Professionals

- Any healthcare professional who reviews the consultation will have a clear understanding of what the patient agreed to with the GP.