Background
A 49-year old female suffered a right elbow injury while working as a castor, resulting in a diagnosis of lateral epicondylitis. After undergoing multiple surgeries, she still had limited elbow movement and chronic elbow and shoulder pain requiring the use of five medications. She subsequently developed comorbid conditions of depression and anxiety.

Intervention
A comprehensive review of the claimant’s medical records and prescription history by the clinical pharmacist revealed potential central nervous system (CNS) and/or respiratory-depressant effects and inappropriate treatment of insomnia.

Results
Recommendations made by the clinical pharmacist included closer monitoring of the patient for excessive or prolonged CNS or respiratory depression, elimination of a drug from her regimen, and more appropriate treatment of insomnia. A correspondence submitted to the prescriber indicated that he would consider discontinuation of the patient’s sleep aid and utilize non-drug therapy for insomnia.

Potential Savings
Accepting therapy recommendations would result in decreasing the annual prescription cost by $2,084/year.