Ms. M is a 66 year old Hispanic female with limited English comes in to the emergency room with a history of hypertension, hyperlipidemia, lumbago, gastroesophageal reflux, and diabetes type II.
Medications: Patient is currently taking Zestril (lisinopril) 20 mg PO daily, Zocor (simvastatin) 10 mg PO q pm, Vicodin (hydrocodone/acetaminophen) 5/500 1 tablet q 6-8 hrs prn lumbago, Prilosec (omeprazole) 20 mg PO daily, and Glucophage (metformin) 850 mg PO bid.
Lab: Patient reports she has been getting a FSBS around 180-210 when taking blood sugar every third day. Sometimes she does not take her blood sugar because the supplies are expensive. HgA1c results of 9.2.
Signs and Symptoms: Patient admits she is not taking metformin as prescribed because it cost too much money and she needs to buy food. Patient also reports when she goes shopping she will check her blood pressure. Patient reports she gets readings in the 140-160/88-100 range, but she really does not understand what that means. Patient reports she is well-controlled with her reflux. She lives alone in an apartment and drives a car. She does receive Medicare and social security, but often gives her money to her son to help him with child support so he will not go back to jail. Today she came to the clinic for headaches and feeling tired all the time.
Describe what you would tell the patient for education regarding her medications and health conditions to improve her outcomes. Take into account she is on a limited budget and will need cost effective care.
Examine how the safety, quality and cost effectiveness of health care can be improved through the active involvement of patients and families. Consider other health professionals and/or community resources that may help.
Examine common barriers (to include cultural aspects) to active involvement of patients in their own health care processes.
Describe strategies to empower patients or families in all aspects of the health care process.
