All use cases

Prevent / Care

Dose-hold coaching on a side-effect spike

Your patient just stepped up their dose and the nausea came back hard. The agent steadies them and flags the care team to consider holding, before they quietly quit.

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What it does

A dose increase is exactly when side effects flare, and a patient who feels worse right after stepping up often decides the medication is not for them and stops. Most programs only hear about it at the next scheduled check-in, by which point the patient has already missed a dose or churned. The agent recognizes a side-effect spike that lines up with a recent step-up as a tolerance signal, gives protocol-safe comfort guidance in the moment, and surfaces the pattern to the clinician to consider holding escalation rather than pushing the dose higher. It never tells the patient to change their dose; that decision stays with the prescriber.

How it works

  1. 1
    Trigger. the patient reports rough nausea or vomiting in chat, or a logged-symptom event crosses a severity threshold, within the tolerance window after a recorded titration step-up.
  2. 2
    Decision. the agent loads the patient's current dose, step-up date, and side-effect history from memory, confirms the symptom spike aligns with the recent increase, and separates ordinary discomfort from red flags. Every patient-facing message passes the quality judge before it goes out.
  3. 3
    Action. the agent acknowledges the spike, delivers protocol-safe comfort guidance (hydration, smaller meals, timing) on the patient's channel, and sets the expectation that this often eases as the body adjusts.
  4. 4
    Follow-through. the agent assembles a clinician-facing note that the tolerance is poor at the new dose and that holding escalation may be worth considering, then routes it to the care team. Red-flag descriptions skip straight to escalation. The exchange writes back to memory so the next step-up is read in context.
Example
AgentYou stepped up your dose a few days ago, and a return of nausea around that change is common. Small, bland meals and steady fluids tend to help while your body adjusts. How strong is it on a scale of one to ten, and are you keeping liquids down?
PatientAbout a seven. I can drink but food is rough. Should I just go back down?
AgentI can't change your dose, but this is exactly the kind of thing your care team weighs. I'm flagging that you're finding this step hard so they can decide whether to hold here for now. In the meantime, keep fluids up, and if you can't keep anything down or the pain turns severe, I'll connect you to a clinician right away.

Configuration

How the agent is wired for this use case.

Triggera reported or logged nausea/vomiting symptom crossing a severity threshold within the tolerance window after a dose_stepped_up event from the clinical system
Tools & actions
  • Clinical/EHR system · read current dose, step-up date, and titration history
  • Patient memory store · load side-effect history and prior tolerance at earlier steps
  • Knowledge base · retrieve protocol-safe comfort guidance for the patient's stage
  • Messaging channel · deliver comfort guidance and the "often eases" reframe
  • Care-team queue · surface a clinician-facing "tolerance poor at new dose, consider hold" note
Autonomycomfort guidance runs unattended behind the quality judge; it is framed as education, never a dose instruction. The detect-then-escalate policy class governs the clinical step: the agent surfaces the tolerance signal and a hold consideration, and the prescriber decides any change. The agent never advises a dose change.
Channelschat · push · whatsapp
Escalationsevere or persistent vomiting, signs of dehydration, or any red-flag description hands off to a clinician immediately; a poor-tolerance pattern routes a non-urgent note to the care team.

What you need

The inputs this use case runs on. Your channels stay yours; the agent supplies the judgment.

Signals

a dose_stepped_up event with the step date, plus reported or logged side-effect events with severity

Data

current dose and titration history, per-patient side-effect history and prior tolerance, consent state, memory

Guardrails

judge gating on every message; education only, never a dose instruction; detect-then-escalate with no autonomous dose change; red-flag symptoms (dehydration, severe pain, unrelenting vomiting) escalate to a human instead of being coached

Metrics it moves

  • adherenceup: catching the post-step-up spike keeps the patient dosing through the rough window instead of stopping
  • churndown: a tolerance flare answered in the moment and surfaced for a possible hold prevents a silent quit
  • csatup: the patient feels heard at the worst moment and sees the care team respond to it

Related use cases

Prevent / Care

Titration-readiness clinician handoff

the step-up counterpart that assesses readiness, not a hold

Prevent / Care

GLP-1 side-effect education with red-flag escalation

the any-symptom education-and-escalate parent

Prevent / Care

Proactive dose step-up preparation

the pre-step-up prep that sets expectations before the spike

See it on your own customer journey

Bring one drop-off, one churn cliff, or one silent segment. We will show you what a proactive agent with memory and judgment does with it.

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