Our New HRT - Initiation & Monitoring template has been designed to replace our Menopause & HRT template in the future and will allow clinicians to record information on the treatment of Menopause.
At present this can be found by typing HRT Initiation & Monitoring in the search features box at the bottom left hand side on your SystmOne screen and clicking on HRT Initiation & Monitoring *NEW*. Please see screenshot below:
The HRT Initiation & Monitoring template can be used on its own or used beside the Menopause *New* Template depending on the patient.
This template is split between 5 tabs; Home, Counselling, Initiation, Monitoring and Resources.
Home Tab
The Home Tab will give you access to the different pages of the template (Counselling, Initiation etc), as well as a summary of relevant medical history for the patient. Please see our Home Tab Support Article for more information.
Counselling Tab
The HRT Counselling Tab is based on the guidance from the British Menopause Society (BMS) and NICE (NG23), and allows you to document the benefits and risks following the different guidance.
It is split between 4 headings; Proven Benefits, Potential Benefits, Proven Risks and Potential Risks.
Each of the headings have tick boxes that can be selected for the patients along with a note next to some stating the guidance it follows as both the BMS and NICE guidance differs in some circumstances.
A hyperlink to the NICE Discussion Aid is available at the bottom right of the template for convenience.
Initiation Tab
This tab is to be used in conjunction with the Menopause *New* Template to start a patient on HRT and is split into 3 sections; Assessment, Impression and Management.
The Assessment section allows the clinician to free text any information relating to relevant cancers along with any risks the patient may have. For the clinician's convenience we have created some pre-sets, which help the clinician to record any possible cautions or contraindications to HRT or absence thereof.
To use these, simply click on the icon and using the Cntrl key highlight the notes you wish to add and click the OK button.
Please note that clinicians should have already recorded the patient's relevant parameters e/g/ weight, BP on the menopause template before accessing this page.
Once entering the assessment information the Impression section can be completed following the green, amber and red tick boxes. The option selected in this section will then light up the relevant Management section options below. If a patient has contraindications to HRT, the template prompts the clinician to consider referral to an appropriate specialist and the other management tickboxes will not be available for selection.
Under the Management section there is a drop down box to HRT plan along with a link to the Menopause & HRT Formulary. There are also tick boxes available for shared decision making, advice and follow up arranged with shortcuts to the right of relevant Ardens resources following the guidance. A free text Plan box could also be used with useful pre-sets available through the pre-set icon if applicable.
Monitoring Tab
This tab is useful for reviewing patients who have already been commenced on HRT and is again split between the 3 sections of Assessment, Impression and Management.
At the top of the Assessment section it is possible to record the HRT review itself along with a numerical box covering the number of years the patient has been on HRT as well as reviewing the indication for HRT. Menopausal symptoms findings can be recorded with the use of the pre-set button along with a shortcut to the Menopause Symptoms tab on the Menopause *New* Template if required.
There are also numeric codes available within the template to continue recording lifestyle parameters at each HRT review as well as the opportunity to record that the patient is using sufficient endometrial protection or that their LNG-IUD remains in date. The clinician also can record a reassessment of possible cautions and contraindications has been done at the review along with a link back to the cautions/contraindications page. A red flag tick box is also available along with shortcuts to the unscheduled bleeding template and possible gynaecology template.
The Impression section has a dropdown box to record if the patients condition is stable, worsening or
improving.
The Management section has a drop down list for HRT plan and a link to our Menopause and HRT Formulary template. Applicable shared decision making, HRT Discussion and advice tick boxes are available along with a follow up option and referral and plan boxes if necessary.
Resources Tab
To learn more on how to use our Resources tab, please see our Using the Resources Tab Support article for more detail.