Summary of Common Conditions in OSCEs
| Condition | Key issues to consider and discuss |
| Statins Antihypertensive agents | Lack of obvious physical improvement Side effects (such as muscular pains with statins, ankle swelling with amlodipine) |
| Insulin | Phobia to needles Stigma – use of needles may look similar to illicit drug abuse to general public Inconvenience of using needle and apparatus if busy at work and during social activities (e.g. at cinema) Lack of obvious physical improvement |
| Inhalers | Lack of understanding about mechanism of action and the different roles of preventers versus relievers |
| Warfarin | Monitoring (with regular International Normalised Ratio) may be perceived to be arduous Lack of understanding about need for prevention |
| Steroids | Misperception of steroid (confusion with anabolic steroids used by sportsmen) Side effects (e.g. weight gain, bruising) |
| Antiepileptic agents | Lack of understanding about the need for prevention Lack of obvious physical improvement |
| Immunosuppressive medication | Side effects (e.g. gum hypertrophy with ciclosporin) |
| Tuberculosis medications | Duration of course Lack of understanding of public health issues and seriousness of disease |
Hints and Tips for the Exam
This is a common scenario in OSCEs as it assesses a broad understanding of psychosocial issues and the ability of candidates to think laterally and devise practical solutions that can be implemented in real life.
Solutions
The checklist above should help you establish the underlying cause of the patient’s non-compliance. The key to getting into the upper echelons of the pass mark and into the merit range is to devise a practical and realistic solution that both the patient and examiner find convincing. Here are some possible solutions that could be applied to any scenario.
Obtaining the Prescription
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