FARM vs SOAP
Aug. 24th, 2013 08:53 pm![[personal profile]](https://www.dreamwidth.org/img/silk/identity/user.png){kind=small}
pharming_in_koreaIn Korea, or at least at SNUH, you 'FARM' when you work up patients.
Just to give some brief background information, at UCSF, we learn to 'SOAP' our patients. SOAP stands for 'subjective, objective, assessment and plan.' This means that you collect the subjective and objective data on a patient, and, sorting by problems, make an assessment and a plan for the patient. Usually we fill this out in a SOAP chart. In this SOAP chart, under S and O, we have the problems with subjective and objective evidence as well as current medications for the problems. Under A, we have the etiology and the evaluation for need for therapy, evaluation of current therapy (if available) and evaluation of available therapy options. Under P, we have the recommended drug treatments, any further tests necessary, goals, monitoring parameters and patient education.
In Korea, the preferred method of working up a patient is 'FARM.' While they use a different acronym, I find that the processes of FARMing or SOAPing is very similar, with an emphasis on similar things. FARM stands for 'finding, assessment, recommendation, and monitoring.' Under F, you include subjective information, objective information, and current medication therapy. Under A, you include the etiology and risk factors of problems, the severity of the disease, as well as evaluation of the current therapy - usually this involves recommending whether the patient has a problem that requires new/diff meds, less meds, or more meds. Under R, you include the goals of drug therapy, the non-pharmacological treatments, pharmacological treatments as well as evaluation of administration and formulation of the proposed recommended therapy, alternative therapies, and insurance considerations. Under M, you include monitoring parameters such as evaluating toxicity and effectiveness of the medication.
As you can see, they are fairly similar processes of working up a patient, just called different things.
For our patient case presentations, we are required to 'FARM' our patients. When we present our patients, we will be walking through the FARM process. Additionally, there is one more part we must discuss: the rationale for the intervention/recommendation. This rationale is much more detailed than we are required to give in America. For our patient presentation, we are required to, on top of FARMing, write out the rationale for the recommendation, which includes the pathophysiology of the medical problem, the treatment and pharmacotherapy, the pharmacology, the pharmacokinetics, the pharmacodynamics, and the evidence the backs up the recommendation, usually referring to well-accepted and popular 3rd degree references (including textbooks, Uptodate, Mixromedex), guidelines, and studies (including clinical trials, meta-analyses and systematic reviews). The rationale part ends up being quite lengthy and long, especially if you are pulling your data from multiple sources.
There will be two example presentations given to us by our preceptors on two separate topics - one on dyslipidemia and one on osteoporosis, which will help guide us on our own two patient case presentations we will be doing in the future. We'll talk about the specifics of these presentations in a future blog entry though! Right now, it's time to enjoy the weekend, which means trying not to die from the exhausting heat and humidity in the middle of summer in Seoul!
-Lena
Just to give some brief background information, at UCSF, we learn to 'SOAP' our patients. SOAP stands for 'subjective, objective, assessment and plan.' This means that you collect the subjective and objective data on a patient, and, sorting by problems, make an assessment and a plan for the patient. Usually we fill this out in a SOAP chart. In this SOAP chart, under S and O, we have the problems with subjective and objective evidence as well as current medications for the problems. Under A, we have the etiology and the evaluation for need for therapy, evaluation of current therapy (if available) and evaluation of available therapy options. Under P, we have the recommended drug treatments, any further tests necessary, goals, monitoring parameters and patient education.
In Korea, the preferred method of working up a patient is 'FARM.' While they use a different acronym, I find that the processes of FARMing or SOAPing is very similar, with an emphasis on similar things. FARM stands for 'finding, assessment, recommendation, and monitoring.' Under F, you include subjective information, objective information, and current medication therapy. Under A, you include the etiology and risk factors of problems, the severity of the disease, as well as evaluation of the current therapy - usually this involves recommending whether the patient has a problem that requires new/diff meds, less meds, or more meds. Under R, you include the goals of drug therapy, the non-pharmacological treatments, pharmacological treatments as well as evaluation of administration and formulation of the proposed recommended therapy, alternative therapies, and insurance considerations. Under M, you include monitoring parameters such as evaluating toxicity and effectiveness of the medication.
As you can see, they are fairly similar processes of working up a patient, just called different things.
For our patient case presentations, we are required to 'FARM' our patients. When we present our patients, we will be walking through the FARM process. Additionally, there is one more part we must discuss: the rationale for the intervention/recommendation. This rationale is much more detailed than we are required to give in America. For our patient presentation, we are required to, on top of FARMing, write out the rationale for the recommendation, which includes the pathophysiology of the medical problem, the treatment and pharmacotherapy, the pharmacology, the pharmacokinetics, the pharmacodynamics, and the evidence the backs up the recommendation, usually referring to well-accepted and popular 3rd degree references (including textbooks, Uptodate, Mixromedex), guidelines, and studies (including clinical trials, meta-analyses and systematic reviews). The rationale part ends up being quite lengthy and long, especially if you are pulling your data from multiple sources.
There will be two example presentations given to us by our preceptors on two separate topics - one on dyslipidemia and one on osteoporosis, which will help guide us on our own two patient case presentations we will be doing in the future. We'll talk about the specifics of these presentations in a future blog entry though! Right now, it's time to enjoy the weekend, which means trying not to die from the exhausting heat and humidity in the middle of summer in Seoul!
-Lena
