Follow-Up Care Case

would not deny his prescription; however, I would inform Jack that I am going to refill his Crestor medication for one month only to last until he is seen in the office. I would have Jack schedule an office visit within the month for assessment and lab work before hanging up the phone.

2. What steps are required to get Jack’s therapeutic plan under control? Support your answer

Jack need to understand the importance of the drugs that he is taking and how they work in terms that are understandable to him. Cholesterol lowering can be beneficial after CABG because, it can halt the progression of atherosclerosis in both native and graft vessels. He should be informed while taking Crestor he may experience increased blood sugar levels and his last HgA1c, was nine. Therefore, he will be informed that his blood-sugar levels should be checked regularly while taking Crestor. He also needs to be aware of the consequences of not taking his medication and failing to return for follow-up visits.

Follow-up care is of great importance since people who have had bypass surgery have a significantly increased risk of more cardiac events, including recurrent chest pain, heart attack, heart failure, and increased risk of dying.

The risk of these problems is greatly reduced by closely following health care provider’s recommendations for rehabilitation, follow-up visits, and treatments. Over time, the treatment plan may change as heart health improves or other medical problems develop. Good communication skills, including active listening, are essential for good patient care and compliant behavior

 Educate Jack regarding his recommended treatment plan and why it is

necessary.
 Inform Jack regarding any alternatives, benefits, risks, and complications associated with the proposed treatment or test.
 I will provide clear oral and written instructions to Jack regarding diabetes, COPD, and HTN.
 I will emphasize the seriousness of his health condition and the urgency of the recommended treatment and lab test.
 Schedule referral and follow-up appointments before he leaves the office.
 Place reminder calls regarding upcoming appointments.
 Follow up on failed appointments.
 Document all noncompliant behavior including no-shows, cancellations without reappointments, and failure to follow recommendations regarding treatment, diagnostic studies, referrals to specialists, medication use, etc.
3. What is the role of the primary care provider in this scenario?

Compliance also increases if providers listen and respect patients’ concerns. Finding out patients’ attitudes and past experiences can deeply affect compliance and save time and problems later. If, for instance, if Jack is firmly opposed to routine primary care visits, the following open-ended question would be asked: When you came in today, what were you hoping that I might do for you instead of prescribing this medication?
•The role of the primary care provider would be to identify Jack’s non-compliance. Know what test or treatment was recommended and verify and document that Jack obtained notice of the recommendation. In a non-judgmental manner, I would ask if he understand his health recommendation and whether he is going to following them.
• I would clarify the reason for non-compliance. His reasons may include, but are not limited to financial difficulties, social problems, fear, or confusion.
• Jack should be educated about his medical conditions and his noncompliant risk, dealing specifically with the identified reasons for his nonconformity health habits. This may involve social services who can help access resources to aid with paying for medication or providing transportation to his medical appointments.