Do you feel at all hesitant about stimulants as an option for this crowd? What is your experience trying to get Qelbree covered by insurance as first line for someone with those risk factors?
This is more of an ethical issue, I suppose.
Severely overweight patient, lives alone, diabetes, GERD, you name it. Says Trazodone & melatonin don't help, and the only thing that helped them "once" was Ambien (nothing recent in CRISPR). Refuses a sleep study and strongly rejects the possibility of OSA.
Would you even go the DORA route or just refer to a sleep specialist?
New patient denied use of pain medications, pain issues, and use of any other substances besides occasional marijuana, but reported previous SA with percocet (a few years ago); denies any ideation at the moment. I was setting her up on iScribe as a new patient after the appointment and found two new opioid prescriptions (percocet and one for oxycodone) on her profile, issued two weeks and then five days before our appointment date, as well as suboxone and clonidine scripts from two years ago.
What is the most effective way to bring this up with her, with still some chance of preserving the therapeutic relationship?