Psychological disorders

Patient comes in today for recheck about his resent complaints of increasing shortness of breath and problems with breathing. He was placed on Breo medication that was started a couple of months ago and he is having a lot more relief when using this medication. He does state that he has some increased shortness of breathe some days, other days are better but when he uses his ProAir, he gets adequate relief. He, however, tried to get a prescription filled with the Breo on it cost $300 at Costco. He is on Medicare. So, he does not qualify for a coupon and unfortunately it seems that his insurance does not want to cover his medication. We will try to find him a medication that is equally effective that we can get covered through his insurance. Otherwise, Ron is doing well today and has no other complaints.

ASSESSMENT:
1. Moderate persistent asthma.
2. Allergic rhinosinusitis.
3. Psychological disorders.

PLAN:
1. At this time, I would like to try Advair 500/50 one puff twice a day to see if he can maintain adequate lung function on this medication and if we can get it covered through his insurance better. I also encouraged him to use a ProAir as needed for any times of increased shortness of breath.
2. We will continue the allergy immunotherapy to reduce his triggers of asthma from the allergens.
3. I will follow up with him in three months’ time to see how this is going. If he needs any help with his asthma or have any concerns, he can contact us any time sooner.

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