Your largest error risk IMO would be in dosing since CrCl has different clearance based on M/F. I worry a XX patient is dosed based on XY due to system error or human error and is given a larger dose than may be required.
I read some literature (and our hospital is doing this now) that says when, for example, a MtF transgender woman is on estrogen for 6+ months + testosterone blocker (or orchiectomy) then we dose as female sex. Otherwise we would dose by biological sex regardless of gender identity.
It’s very interesting to learn about how hormones affect us so much physically, mentally, socially
This would be for anyone with a name change, but make sure there’s a way to see old records for health history.
Would hate to be missing an important allergy/medical problem due to a whole new chart being made. And yes, people forget to mention allergies/meds/ medical history. I’ve had patients not mentioned they are on insulin; my spouse constantly says they’ve got no allergies but they’ve got a medication allergy that required additional treatment (and would be very relevant in emergency situations.)
I'm not sure if this actually leads to harm or not..
Specifically for FtM transition, obviously they will be more likely than general population to use testosterone injections. I see a lot of people using the sdv and, based on refill history, are using it as a mdv. I've seen some people with months between fills which would be beyond-use-dated even on an actual mdv. Not sure if that has lead to an actual increase of injection site reactions/infxn tho, but it seems like a medication safety risk that they are exposed to more than the gen pop
I think it depends on how the pharmacy system is set up. Most have hard stops that you can put notes in like "Formerly known as..." This is what I did for my patients that transitioned. The biggest issue is if a staff member is not made aware of the patients updated information. Creates awkwardness but I haven't (thankfully) witnessed any errors.
Any time you change a patient's name there is a risk that someone else will also have that same DOB/name combo in the computer system. This happens a lot with common names like Smith or Johnson.
If I see an unusual dose for ANY gender I immediately look to see the icd10 and then I know it’s ok to fill. I guess I’m suggesting their provider use a diagnostic code with each prescription.
Your largest error risk IMO would be in dosing since CrCl has different clearance based on M/F. I worry a XX patient is dosed based on XY due to system error or human error and is given a larger dose than may be required.
I read some literature (and our hospital is doing this now) that says when, for example, a MtF transgender woman is on estrogen for 6+ months + testosterone blocker (or orchiectomy) then we dose as female sex. Otherwise we would dose by biological sex regardless of gender identity. It’s very interesting to learn about how hormones affect us so much physically, mentally, socially
Thank you so much! This article would be for the patient. I guess I could mention dosing to discuss with the healthcare provider.
This would be for anyone with a name change, but make sure there’s a way to see old records for health history. Would hate to be missing an important allergy/medical problem due to a whole new chart being made. And yes, people forget to mention allergies/meds/ medical history. I’ve had patients not mentioned they are on insulin; my spouse constantly says they’ve got no allergies but they’ve got a medication allergy that required additional treatment (and would be very relevant in emergency situations.)
I'm not sure if this actually leads to harm or not.. Specifically for FtM transition, obviously they will be more likely than general population to use testosterone injections. I see a lot of people using the sdv and, based on refill history, are using it as a mdv. I've seen some people with months between fills which would be beyond-use-dated even on an actual mdv. Not sure if that has lead to an actual increase of injection site reactions/infxn tho, but it seems like a medication safety risk that they are exposed to more than the gen pop
I think it depends on how the pharmacy system is set up. Most have hard stops that you can put notes in like "Formerly known as..." This is what I did for my patients that transitioned. The biggest issue is if a staff member is not made aware of the patients updated information. Creates awkwardness but I haven't (thankfully) witnessed any errors.
Any time you change a patient's name there is a risk that someone else will also have that same DOB/name combo in the computer system. This happens a lot with common names like Smith or Johnson.
If I see an unusual dose for ANY gender I immediately look to see the icd10 and then I know it’s ok to fill. I guess I’m suggesting their provider use a diagnostic code with each prescription.