Outcome evaluation

• Monitor the patient for symptom relief. Have the desired outcomes jointly developed by the health care team and the patient/caregiver been achieved and to what degree. Inspect the daily diary completed by the patient/caregiver since the last clinic visit and quantitate the clinical response (e.g., number of micturitions, number of incontinence episodes, and pad use). If a diary has not been used, ask the patient how many incontinence pads have been used and how they have been doing in terms of "accidents" since the last visit. If appropriate, administer a short-form instrument used to measure symptom impact and condition-specific quality of life and compare to previous result(s).

• Elicit adverse effects of drug therapy using a nonleading approach and ask the pa-tient/caregiver to judge their severity and what measures, if any, the patient/care-giver used to ameliorate them. Assess adherence (ask patient/caregiver about missed doses or do a pill count if the prescription container was brought to the visit).

• The balance of clinical response and tolerability will dictate the approach to adjusting drug dosage. Potential approaches include dosage increase, maintenance, or decrease. If adverse effects are quite bothersome to the patient and patient safety and/ or adherence are compromised, stop, or taper, the offender and initiate another drug option.

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