| Course | PA 536 Behavioral Medicine II |
|---|---|
| Week | 3 |
| Paper type | Medication trial appraisal |
| Length | About 770 words, 5 pages |
| Format | APA 7 student paper |
| School | Chamberlain University |
| Program | Master of Physician Assistant Studies (MPAS) |
| Updated | October 2026 |
Free sample paper for PA 536 Week 3
Adequate Trial Appraisal of D.K.'s Fluoxetine, April to June 2026: An Order Date, Two Fill Dates, a Birthday, an Eight-Day Gap in June and What Can and Cannot Be Established From Them
Student Name
Chamberlain University
PA 536: Behavioral Medicine II
Instructor Name
Month Day, Year
Adequate Trial Appraisal of D.K.'s Fluoxetine, April to June 2026: An Order Date, Two Fill Dates, a Birthday, an Eight-Day Gap in June and What Can and Cannot Be Established From Them
The Question
At the June 23 visit, D.K.'s PHQ-9 was 11, down from 17. Before deciding what comes next, the team needs to know whether this has been an adequate trial of fluoxetine, meaning an adequate dose taken for long enough. The definition used here is the one in the Massachusetts General Hospital Antidepressant Treatment History Questionnaire, which treats fluoxetine 20 mg daily as the minimum adequate dose and six weeks at or above it as the minimum duration (Chandler et al., 2010).
Two Dates, Not One
The chart says fluoxetine started April 7. That is the order date, the day it was prescribed, not the day D.K. began taking it. An order proves intention. A pharmacy fill proves the medicine left the counter. Only the person can say when it was first swallowed, and that comes with the uncertainty of memory.
Label Where Each Date Came From
Table 1
Dates Behind the Fluoxetine Trial and Where Each One Came From
| Date | Event | Source | Grade of evidence |
|---|---|---|---|
| April 7 | Fluoxetine 20 mg ordered | Clinic order record | Proves prescribing only |
| April 14 | 30 capsules collected | Pharmacy fill history | Proves collection |
| April 16 | First dose taken | D.K.'s account: "the day after my kid's birthday" | Recall anchored to a fixed date |
| May 5 | Dose raised to 40 mg | Clinic order record | Proves prescribing only |
| May 8 | 40 mg supply collected | Pharmacy fill history | Proves collection |
| June 7 | Refill due | Calculated from May 8 fill | Expected, not observed |
| June 15 | Refill collected | Pharmacy fill history | Proves collection |
Note. Note. No pill count was done. D.K.'s partner was not asked about doses.
Counting From the Earliest Defensible Day
The earliest date I can defend as a start is April 16. It is later than both the order and the fill, and D.K. ties it to a birthday rather than a vague "mid-April," which makes it the most precise account available. Counting from April 16 at 20 mg or more, six weeks run to May 28. Even if the true start were a few days later, the trial would still reach six weeks by early June, before the gap discussed below.
Leave the Gaps as Gaps
The 40 mg supply collected on May 8 was a 30-day supply and should have run out on June 7. The next fill was June 15. D.K. says "I missed maybe two days." The fill record allows anything from zero missed days, if a few capsules were left over from the first bottle, to eight. I cannot narrow that, so the eight days are recorded as an uncertain stretch and not used as evidence in either direction.
Keep the Account Attributed
D.K. says the medicine "started working around Memorial Day," when sleep improved and the dinner bolus came back on some evenings. That is D.K.'s report, and it is written as such. It fits the PHQ-9 falling from 17 to 13 by May 26, which was recorded at a nurse visit, but the two are separate pieces of evidence and are kept apart in the note.
Not Establishable Is an Answer
What can be established: an adequate trial of fluoxetine at 20 mg or more for at least six weeks, from April 16 to at least May 28, with partial response. What cannot be established: an adequate six-week trial at 40 mg specifically. From May 8 to June 19 would be six weeks, but the June gap of up to eight days falls inside that stretch, so continuous dosing at 40 mg cannot be shown. That second verdict is written as "not establishable" rather than as either adequate or inadequate.
What the Verdict Allows
Because the first criterion is met, the partial response counts as a real response to an adequate trial, and the team can discuss next steps. Because the 40 mg period is uncertain, one reasonable option is to continue 40 mg for another four weeks with confirmed refills; another is to add or switch now. That choice is the subject of the next brief, and this appraisal is attached to it so the dates do not have to be rebuilt.
References
Chandler, G. M., Iosifescu, D. V., Pollack, M. H., Targum, S. D., & Fava, M. (2010). Validation of the Massachusetts General Hospital Antidepressant Treatment History Questionnaire (ATRQ). CNS Neuroscience & Therapeutics, 16(5), 322-325. https://doi.org/10.1111/j.1755-5949.2009.00102.x
What the PA 536 Week 3 assignment asks for
The third week asks for an appraisal of whether a medication trial was adequate, built from the dates available rather than assumed from the chart. State the definition of adequacy you are applying, with its dose and duration and its source. Then separate the kinds of date that exist: when a medicine was ordered, when it was collected and when the person says they started taking it, and label each by where it came from. Count the trial forward from the earliest date you can defend, and say why. Periods nobody documented must be shown as gaps, not filled with a reasonable guess. What the person reports about how the medicine worked should stay attributed to them and separate from recorded measures. The instructions accept "not establishable" as a conclusion for any part of the trial that the records cannot support.
How the PA 536 Week 3 example is put together
The appraisal opens at the June 23 visit, with a PHQ-9 of 11 after 17, and applies the ATRQ definition of an adequate fluoxetine trial (Chandler et al., 2010). A short section explains why the April 7 order date cannot be the start. A table then lists seven dated events, from the order and the April 14 fill to D.K.'s first dose the day after a child's birthday, the May 5 increase to 40 mg, its May 8 fill, a refill expected June 7 and a fill on June 15, each graded by source. Counting from April 16 at 20 mg or more reaches six weeks on May 28. The gap section records the June stretch as zero to eight unknown days. D.K.'s "around Memorial Day" is kept beside a nurse-recorded PHQ-9 of 13 on May 26. The verdict separates an adequate 20 mg trial from a 40 mg period that is not establishable.
Where the points sit in the PA 536 Week 3 rubric
Faculty grade this appraisal on how the timeline was built. A verdict delivered without rebuilding the run of dates, taking the chart's start date as the day dosing began, loses the most. Next comes using the wrong kind of date, for example reading an order as proof of collection or a single fill as continuous use. Filling an undocumented stretch with an assumption, and then using it as evidence, is a further large deduction. Graders look for each date labeled by source and for the patient's own account kept attributed rather than turned into record. A clearly stated definition of adequacy, with its source, earns credit early. Concluding "not establishable" where the records do not settle a question is rewarded rather than penalized. Linking the verdict to the next decision, and citing correctly in APA, take the last share.
Common PA 536 Week 3 mistakes, and how to avoid them
Appraisals most often lose points by counting from the prescription date and calling the trial adequate because enough calendar time has passed. Others quietly accept "I missed maybe two days" as the record of a refill gap. Some never say which definition of adequacy they used. If your case supplies different records, such as a pill count, a pharmacy claims report or a partner's account, send them with your section's question; the appraisal prepared for you would label every date by source, count from the earliest defensible day, mark the undocumented stretches and give a verdict for each part of the trial, including "not establishable" where it applies. If your faculty prefer a different adequacy standard, for instance a guideline's minimum dose table, it will be named and applied in place of the ATRQ.
Get a PA-536 Week 3 example written to your instructions
Send the assignment, the rubric and every piece of the case your section supplied, including any collection history or note dates it gives you, since those are what the appraisal is built out of. A custom PA-536 Week 3 appraisal is written to that material and returned inside 24-48h, the first one free.
More PA 536 papers and MPAS samples
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- PA 532 Week 3: Preoperative Risk Summary
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PA 536 Week 3 questions, answered
Our case gives no collection or refill history at all.
Then the appraisal says what the material does and does not establish, which is a legitimate finding here rather than a shortfall. Build the timeline from the dates you were actually given, mark the stretch between them as undocumented, and name the one record that would close it. In this week an appraisal that marks the end of its own evidence scores above one filling the remainder with what probably happened.
Can the appraisal end without saying adequate or not?
It can end in three ways rather than two: adequate, not yet, or not establishable from what is here. Check what your section published, since some require a binary answer and those versions still want the uncertainty written into the reasoning above it. Where a verdict is mandatory, name the single date the whole verdict rests on, so a reader can see what would overturn it.
Where does what the person says about those months belong?
In the document, in their words, with the attribution kept on. An account of a difficult few months is often the only evidence that exists for that stretch, and removing the marker turns it into something the chart appears to assert. Write it as reported, say when it was reported, and let the verdict above it carry whatever weight you decided that account deserves.
Where can I find a free PA 536 Week 3 sample paper?
The full PA 536 Week 3 adequate trial appraisal, which rebuilds a fluoxetine trial from an order, two fills, a remembered start date and a refill gap, can be read on this page.
What does the PA 536 Week 3 sample conclude about the 40 mg dose?
It concludes that a continuous six-week trial at 40 mg cannot be established, because an unexplained gap of up to eight days in June falls inside that period.