Adult Male With A Birth Date Of 11 / 30 / 1964

Risk is an accepted part of everyday life. Everyone has the right to take risks and make decisions on their own. A balance should be found between service users participation in everyday activities and the carers duty of care. Social care and health policies are encouraging residents to increase their independence by being involved in the wider society such as leisure and work. It is impossible to eliminate risk completely, however minimising and being prepared for risk by preventative action.

This is giving the individuals the freedom of choice of what kind of care or treatment they would like to

The pharmacist must offer to discuss the unique drug therapy regimen of each Medicaid recipient when filling prescriptions for them. Each patient must be made an offer to be counseled by the pharmacist. The items to be addressed include, the name of the drug, intended use of expected action, common side effects and their avoidance, techniques for self-monitoring, proper storage, potential drug-drug or drug-food contraindications, refill

The patient was admitted to the hospital by her daughter after discovering that she had abandoned her medication and was significantly experiencing adverse effects from the withdrawal. The patients’ medical history included renal dysfunction, anemia, malnourishment, back pain, and a family history of mental health. The patient has a psychiatric history of being previously placed in the same clinical structure eight months ago due to related issues including the failure to take her medication and increased levels of mental health conditions that led

Hepatitis C (HCV) is a disease of the blood, caused by a history of intravenous (IV) drug abuse, blood transfusions received that were infected with HCV prior to 1992 when screening started, healthcare workers suffering from a needle stick, and recipients of donor organs that tested positive for HCV (Lewis, Heitkemper, Dirksen, & Bucher, 2014). A challenge that I have encountered in the office with getting treatment started for a patient is that not everyone in the clinic understands the clinical documentation and tests needed to receive therapy approval. The result of decreased knowledge of HCV treatment is the patient having to return to the clinic two or three times to obtain all required clinical data, which is prolonging the start of treatment. The purpose of this paper is to improve patient satisfaction with their treatment of HCV. I began with my pre-assessment of the novice to expert nurses, by asking them 30 questions. In the assessment, it tested the current knowledge that each individual had on HCV. After obtaining the needed data to come up with a program for the clinic, I was amazed at the different answers. I will be discussing the educational needs for improvement of HCV screenings, listing the questions used in the interview, listing the staff and their titles, listing educational needs I found during my assessment, and discussing what my case study topic will entail.

medications on the unapproved list. The patient will be responsible for the charges of the

denied by Humana. This was our first attempt to purchase this medication since our group (HM

A) Each of the injections is specifically formulated to protect against Hepatitis A, B, or C.

The carrier has denied coverage of the replacement insulin pump (E0784), as the requested service does not meet criteria for medical necessity. There is a letter from the carrier to the member dated 04/27/2016, which states in part:

That is how they finally receive treatment for the mental –illness. In 2013 the State

This 72-year-old claimant sustained a work-related injury on 04/22/07. The claimant continues to have discomfort in the right thigh, buttock area, and lumbar spine. She has a pain rating of 2-7/10. She takes Voltaren more regularly and the Tylenol only when the pain is greater. It was noted that she has been taking these medications for years with benefit. The claimant’s pain has decreased and the claimant is able to complete activities of daily living with the use of medications. However, this medication is listed as a “Non-Preferred” drug in the formulary. There is no documentation of failed trials of “Preferred” drugs and documentation indicating that this medication is more beneficial to the claimant than a “Non-Preferred”

If the Pharmacy is in the Network and the Drug is attached, claim rejects with Reject 70 - Plan Exclusion.

In general, a patient is infected with only one hepatitis C virus genotype. The strain of genotypes is not differentiated by the severity of the disease. However, there will make a distinction in the regimen and the duration of the treatment (CDC, 2016). Treatment for chronic HCV is based on guidelines from the Infectious Diseases Society of America (IDSA) and the American Associations for the Study of Liver Diseases (AASLD). The criteria of who should receive the treatment include how much the virus in the body, the strain of hepatitis C, the degree of liver inflammation or damage, comorbidity, and response to previous treatment (Infectious Diseases Society of America [IDSA], 2016). The highest priority for treatment should give to a patient with advanced fibrosis and compensated cirrhosis (IDSA, 2016). Moreover, treatment priority should provide to the patient who has a high risk of transmitting the disease from and to others, such as individuals who are active injection drug users and hemodialysis patients (IDSA, 2016).

The therapeutic class of interest that I choose was under respiratory agents. Since there are different subdivisions under the respiratory category, I proceeded to focus on the antihistamines therapeutic class. The first thing I did was to look at the drug names under this category in both formularies to see if it had the same drug names listed. In the Wellmark formulary, under antihistamines, the four drugs present are also listed in the UnitedHealth formulary. This means that under both plans a patient could have access to them. But UnitedHealth had several additional drugs under this category that where not included in Wellmark’s formulary. The second aspect I noticed is that one of the generic drugs in Wellmark called desloratadine (Clarinex) is offer as a Tier 1 drug, whereas in UnitedHealth it is cataloged under Tier 3 with some special indications such as supply limit (SL), may be excluded from coverage (E) and has 3 asterisks that indicate that it depending on a patients medication and/or benefit, notification o medical necessity criteria will be apply to determine if

Brooke is a 47-year-old female who suffers from a long history of Sheehan’s syndrome (E23.0). Brooke’s symptoms include onset growth hormone deficiency was brought on by a pituitary infarction (Sheehan’s Syndrome) resulting from post-partum massive hemorrhaging. Brooke would like to stay on the medications that have proven to work for her, which are the Genotropin Miniquick (DAW), Solu-cortef (DAW), and Vivelle (DAW). To switch to other medications requires months of physical adjustments, additional blood tests and lab work to find a new balanced level of all the medications. Brooke has learned from her doctors that patented drugs cannot be the same in order to be patented drugs. Denying coverage of a therapy when a patient has a significant