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Dr Okafor Pull up this patient's last three HbA1c results and current medications.

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Wren AI HbA1c has risen across the last three tests, from 58 to 64 millimoles per mole. Latest was 12 August. She's on five active medicines: gliclazide, ramipril, furosemide, atorvastatin, and ibuprofen as needed.

HbA1c (mmol/mol)

Target ≤ 53 · trend +6 over 11 months

Active prescriptions

SQL · 2 queries · 184 ms

SELECT result_date, value
FROM lab_results
WHERE patient_id = @patient_id AND test_code = 'HBA1C'
ORDER BY result_date DESC LIMIT 3;

SELECT drug_name, dose, frequency
FROM prescriptions
WHERE patient_id = @patient_id AND status = 'active';

Dr Okafor They're asking for metformin — any contraindication with what they're already on, or recent renal flags?

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Wren AI Two things before prescribing. Her last eGFR was 41, but that's from January — over eight months old and down from 52. And she's on ibuprofen with ramipril and furosemide, which raises kidney injury risk. I'd recheck renal function first.

Stale lab · renal Latest eGFR 41 mL/min/1.73m² and creatinine 128 µmol/L, dated 14 Jan 2026 (260 days ago). Previous eGFR 52 in Jul 2025. At eGFR 30–44, metformin needs a reduced maximum dose; avoid below 30. A current value is needed to dose safely.

Prescription conflict Ibuprofen 400 mg PRN (issued 17 Sep) + ramipril + furosemide. NSAID with ACE inhibitor and diuretic increases AKI risk, which in turn raises metformin-associated lactic acidosis risk.

No direct interaction found between metformin and gliclazide, atorvastatin or ramipril.

SQL · 3 queries · 241 ms

SELECT test_code, value, result_date,
       CURRENT_DATE - result_date AS age_days
FROM lab_results
WHERE patient_id = @patient_id
  AND test_code IN ('EGFR','CREAT')
ORDER BY result_date DESC LIMIT 4;

SELECT p.drug_name, i.severity, i.note
FROM prescriptions p
JOIN drug_interactions i ON i.drug_a = p.drug_code
WHERE p.patient_id = @patient_id AND p.status = 'active'
  AND i.drug_b = 'METFORMIN' OR i.rule = 'NSAID_ACEI_DIURETIC';