Learning Goal: I’m working on a nursing discussion question and need the explanation and answer to help me learn.
Peer Responses
Length: A minimum of 180 words per post, not including references
Citations: At least two high-level scholarly reference in APA per post from within the last 5 years
Relate to another journal article
The FNP is conducting a routine follow-up on a patient with depression. The patient reports she is feeling like she can’t go on anymore. The FNP learns that this patient discontinued her medication 3 weeks ago because she couldn’t afford it. What should the FNP do in this situation? Support your response.
Depression has become a major public health concern with an increased prevalence and global disease burden due to the associated mental, social, and interpersonal dysfunction. According to the World Health Organization, by 2020, depression will be the second-highest known cause of disability worldwide (Marasine & Sankhi, 2020). As a healthcare provider its of great importance to take immediate action when the patient presents with symptoms of moderate to severe depression. In the case scenario presented above the patient should be reevaluated using the PHQ9 questionnaire to further assess the severity of her depression. Immediate action is to be taken if the PHQ 9 score is positive for moderately severe or severe depression. The provider will need to ensure patient safety by assessing for any thoughts of suicide or feelings of wanting to hurt herself or others. If a patient does present with suicidal thoughts, further action should be taken. The patient should be referred to an inpatient for observation and to be evaluated by a psychiatrist. Its a also important to perform further questioning on what are social determinants that are preventing the patient from being able to obtain medication should be further assessed. Furthermore, its important for the provider to further assess patient social determinants of health by using the PREPARE screening tool. This will assist the provider in identifying barriers to compliance with care. The provider may assist the patient by referring the patient to social workers if they dont have insurance or sending prior authorizations to assist with medication cost coverage. Providers can also provide patients with prescription discount cards such as Good RX and educate about pharmacy in the area that participate in the 340B Prescription Savings Program.
References
Marasine, N. R., & Sankhi, S. (2020). Factors Associated with Antidepressant Medication Non-adherence: A review. Turkish Journal of Pharmaceutical Sciences, 0(0).
Maurer, D. M., Raymond, T. J., & Davis, B. N. (2018). Depression: Screening and Diagnosis. American Family Physician, 98(8), 508515.
PRAPARE: Protocol for Responding to and Assessing Patient Assets, Risks, and Experiences Paper Version of PRAPARE for Implementation as of September 2, 2016. (n.d.).
