Page 50 - COMMUNITY PHARMACY PRACTICE
P. 50
02/04/2024
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. Positive points
• Establishes the severity and
S Site or location?
I Intensity or severity? nature of problem and if the
T Type or nature? patient has suffered from
D Duration? previous similar episodes
O Onset ? Negative points
W With (other symptoms)? • Fails to consider general
N Annoyed or aggravated? appearance of patient.
S Spread or radiation? • No social/lifestyle factors
I Incidence or frequency pattern? taken into account;
R Relieved by? • no family history sought
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• All more comprehensive than WWHAM,
• BUT they still are limited.
• None take into consideration all factors that might impinge on
a differential diagnosis.
• All fail to establish a full history from the patient in respect to
lifestyle and social factors or the relevance of a family history.
• They are very much designed to establish the nature and
severity of the presenting complaint. This, in many instances,
will be adequate but for intermittent conditions (e.g., irritable
bowel syndrome, asthma, hay fever) or conditions where a
positive family history is important (e.g., psoriasis, eczema),
they might well miss important information that reduces the
chances of gaining a correct diagnosis.
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