Patient Compliance Case Study

D-This writer met with the patient upon her request to complete the dose change request form to lower her dose as the patient experience she wants to start tapering off methadone as the patient haven't used any illicit drugs for several months. This writer completed the dose change request form with the patient pressence and also, assessed the patient that she has not experience any withdrawals since prior increase based on her order history. The patient denies any cravings and withdrawals. Furthermore, while completing the request, this writer learned that the patient is prescribed with Albuterol inhaler and strongly urges the patient to bring in the RX script tomorrow. The patient complained that no one has ever told her of this and this

D-This writer agreed to meet with the patient as he was placed hold to attend group. Reported stability on his current dose and denies the need for a dose increase when offered by this writer. This writer reviewed the patient's record and learned that he obtained his 3rd take home bottle on 01/04/2017. The patient is aware that he in order for him to obtained the 4th take home bottle, he must attend the take home bottle group. Addressing his medication, this writer noticed that the patient has not refilled the following medications:

D-Met with the patient as the Women's Group was cancelled due to low attendance. This writer addressed with the patient about her AWOL status, at which the patient started to get emotional as she is struggling with transportation, borrowing her mother's car, her husband is still having issues getting into the Hartford Dispensary-tested postiive for methadone, and too much stressors in her life, which is causing the patient to not eat. This writer validated the patient's feelings, provided support, and made suggestions. The patient admits to relapsing yesterday by purchasing 10 bags of heroin, but using 6 and gave her husband 4 bags-use of method was IV. The patient feels guility of using, but her stress factors are overbearing her recovery process and the patient struggles with coping. She then says, " When I come to the Women's Group, I feel good....I was hoping there was going to be group today....I don't know." This writer provided empowerment and encouragement to the patient to focus on her recovery process and proceeded to discuss risk factors of what she will lose.

Research identity-theft cases from medical offices.Explain the case and prepare a one-page paper on prevention strategies based on the case found.

A-Based on this writer;s assessment, the patient appears to be alert, engaging, and oriented. There was no evidence of SI/HI.

D-The patient arrived on time for her appointment. Reports stable on her dose and denies the need for a dose increase when offered by this writer. This writer commends the patient complying with daily dosing; however, this writer addressed the patient UDS result patterns of positive and negative. The patient last two urines were positive for cocaine. According to the patient, a lot has been going on in her life. The patient's father has had a heart attack this past month. Also, the patient has an estranged relationship with her mother and her 17 year old daughter. During the course of the session, the patient discussed her drug history and her dysfunctional family. Alternatives and suggestions were discussed as well.

D-The patient arrived on time for her appointment. Reports stable on her dose and wants to continue to voluntary taper dose until she reaches 10mgs. The patient is going through some financial difficulties as her significant other lost his employment and the family is surviving on savings, which will end by the end of the July. This writer provided the patient with a list of temp. agencies and also, information about CT works for further assistance.

D-According to the patients she has a surgery on 04/22/2016 for stems in both legs. The patient signed an ROI for Dr. Vandisht for this writer to contact the doctor to obtain a letter stating that the patient can inf fact dose on the day of her surgery. The patient showed this writer with some improvement of her hand with a condition she is unfamiliar that her dermatologist gave her an ointment that cleared her skin. The patient is scheduled to see her dermatologist on 04/29/2016. The patient spent the session discussing an issue with her Fern Manor and its staff members. The patient then signed a ROI for her Pulmonary Doctor. There's still no communication with her older daughter, but the patient still reaches out to her daughter.

Information sharing can take place over the phone with approved family members or hospital employees. Another location is in the departments when transferring the patient.

D-Met with the patient upon request. Upon meeting with the patient, the patient appeared upset and addressed her frustration in this writer's office. According to the patient, she's upset with her PCP forcing the patient to admit herself to the psych. ward to get on medication. Failure to do so, her PCP will complete the medication protection for her electricity. The patient owes over $3000 and with the protection, her light company cannot turn off her lights. Please note, the patient was pacing back and forth and getting emotional. This writer consolet he patient and validated her feelings. According to the patient, she reports that CMHA informed her that she in order to get into their clinic, an evaluation is needed whereas the evaluation can be completed at a hospital; however, the patient is worried about being admitted. Please note, the patient denies any suicidal or homocidal ideation when questioned.

D- The patient arrived on time for her session and reports being stable on dose and haven't used any illicit drugs. This writer advised the patient that this writer was in fact in receipt of missed phone call about coming to the session at 10:30 am rather than 10 am due to her mother in the process of selling the house. This writer addressed with the patient about letter from CHR from her counselor, Jade Bray stating about the patient non-compliance with her appointment due transportation barrier. According to the patient, she is going through hardship as her mother is no longer taking her to her appointment as the patient says, " She's tired of bringing me everyone, Charlene. She complains about bringing me here and does not understand why I can't even get a bottle...:Like c'mon. What do I have to do?" This writer explained to the patient about TEAM decision, at which the patient disagree with the decision. This writer asked the patient about her "judgement." According to the patient, she feels she is making judgement by not engaging any further altercation with patient at the clinic, dosing daily, coming to her counseling session, and trying to get help from Chrysalis for

The writer inquired from the patient about what will work for him for the sake of the patient to take his recovery serious. According to the patient, he did not have a logic answer, besides the clinical intervention that was already implemented. The patient reported that he haven't used for nearly a month; however, his recent UA dated on 9/25/2017 was positive for opiates and cocaine. The patient deny relapsing, but the writer shared with the patient with regard to his past UA results as to how this result is incorrect. No response from the patient besides, " I am

D-The patient reports that he is not stable on his dose and is aware that his current dose was just increase since yesterday and he has to wait three consecutive days for another increase. The patient reports he used illicit drugs last night, heroin-2 bags, by IV. This writer addressed with the patient about his UDS result, + heroin and cocaine. This writer proceeded to discuss the patient's triggers and addressing alternatives to his ongoing use.

D-The patient reports she is stable on her current dose and haven't experienced any withdrawals and/or cravings. The patient further mentioned that work is going okay, but still exploring other job opportunities. This writer provided positive feedback towards the patient's recovery process. In addition, the patient reports she has to do a pneumonia test as it was suggested by her PCP today. This writer requested for the patient to detailed if she's experiencing any symptoms and would like to consult with the clinic medical doctor. Based on the patient, she reports she was experiencing some backaches, but now, feels okay. During the remainder of the session, the patient discussed her plans for the Easter holiday and also shared with this writer that today is her son birthday.

The patient reports, " I am stable with my dose." However, this writer addressed with the patient about her UDS and dosing history. This writer addressed concerns about this patient results of testing postive for opiates and cocaine. The patient