Continue, Revise, Discontinue, or Transition Care

Turn monitoring evidence into a care decision

A monitoring note should end with one of six decisions: continue, intensify, reduce, revise, discontinue, or transition. Continue when the diagnosis remains active, the intervention is safe and feasible, and progress matches the expected trajectory. Intensify when the diagnosis remains important, the mechanism is sound, delivery and tolerance are adequate, but the dose is insufficient and a higher dose is safe. Reduce when benefit is present but the current dose or burden exceeds need or creates risk. Revise when the diagnosis, etiology, route, product, strategy, schedule, target, or implementation plan no longer fits. Discontinue when the indication has resolved, goals are met and sustainable, benefit no longer outweighs harm, the intervention is ineffective after an adequate trial, or the patient declines after informed discussion. Transition when care remains necessary but responsibility, setting, route, or level of support changes.