NR 603 ADVANCED CLINICAL DIAGNOSIS WEEK 7 DISCUSSION
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Course
Nr 603 advanced clinical diagnosis
Institution
Nr 603 Advanced Clinical Diagnosis
NR 603 ADVANCED CLINICAL DIAGNOSIS
WEEK 7 DISCUSSION
1. The patient is a 58-year-old woman with chronic pain due to inflammatory arthritis. She presents for her first appointment with you in a primary care office. She states that she is aware that she is asking for an early refill of her Oxyco...
NR 603 ADVANCED CLINICAL DIAGNOSIS
WEEK 7 DISCUSSION
1. The patient is a 58-year-old woman with chronic pain due to inflammatory arthritis. She
presents for her first appointment with you in a primary care office. She states that she is aware
that she is asking for an early refill of her Oxycontin however she is traveling out of state and
she is concerned that she may have a flare up on her trip.
• Apply the steps in SBIRT to this scenario
Screening, Brief Intervention, and Referral to Treatment (SBIRT) is a tool used by
primary care providers to identify those at risk for substance use disorder and mental
health problems and provide interventions and services to help reduce the complications
arising from dependence and other severe symptoms (Hargraves et al., 2017). The
primary care provider is the first point of contact for the patients and the primary care
provider can identify those at risk and intervene early for better health outcomes and
provide additional referral services (Hargraves et al., 2017). It is important as primary
care provider to determine if the patient has taken opioid in the past and has developed
tolerance or addiction as this can help develop a trusting relationship between patient
and provider (Torres et al., 2017) The patient should be screened using the DAST drug
screening questionnaire to help in developing a plan that would benefit the patient by
reducing the use of opioid, providing education on the effects of opioid addiction, and
referring the patient to specialized services who specialize in substance abuse (opioid
addiction) (CMS, 2021).
• Identify additional questions for this patient
When were you diagnosed with inflammatory arthritis?
When did you start taking pain medications for your pain?
What medications have you taken and are taking for pain?
How long have you been taking oxycontin?
Who prescribes the oxycontin for you?
Have you followed up with your prescriber?
How frequently are you taking oxycontin?
What is the dosage of the oxycontin you are taking?
Have you tried any other pain medication?
Do you see pain specialist for pain management?
When was your last refill for oxycontin?
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