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Managing Depression and Medication Non-Adherence – The FNPs Role in Crisis Intervention

Managing Depression and Medication Non-Adherence – The FNPs Role in Crisis Intervention

Given this case where a patient suffering from depression has stopped taking her anti-depressant drugs due to financial constraints and is now expressing hopelessness, the Family Nurse Practitioner (FNP) must act fast and comprehensively in order to promote the well-being of the patient and ensure her safety. The primary concern should be conducting a full assessment of the mental status of the client with particular emphasis on suicidal thoughts or plans.

Depression is a severe mental disorder that affects one’s overall life functioning and satisfaction such that it may lead to self-destructive ideas or even suicide attempts when very serious (WHO, 2024). If the FNP determines immediate danger to self, then quick action needs to be taken, like activating emergency services, arranging for admission into hospital, or referring her Crisis Intervention Centre/ Emergency Department for urgent evaluation and management.

After dealing with all immediate safety issues, the FNP must adopt an empathetic approach to the patient’s circumstances. Validating sentiments expressed by clients while recognizing their difficulties can serve as a strong base for therapy alliance development and promoting trust between them (Hartley et al., 2020; Nicola et al., 2022). It is essential to convey that the patient is not alone in her struggles and that resources and support systems are available to help her overcome this difficult period.

The treatment priority should be to find different ways that are cheaper for the patient. One of which is checking if generic drugs are available as alternatives to the prescribed drug by the FNP, which can be much cheaper compared to brand names with the same effectiveness. In the same manner, another drug under the same therapeutic class but less expensive can be considered by the FNP. Not only this, but all other decisions must include patient involvement too; therefore, we must talk about the risks and benefits of various treatments while at the same time finding out what may hinder them based on different views.

Psychotherapy, cognitive behavior therapy, or even support groups (Shang et al., 2023) can also be recommended by nurses in addition to nonpharmacological methods as these are known suitable measures when dealing with depression, and sometimes they work together with drugs depending on how much one prefers it or severity of her sickness.

It is essential, therefore, that we evaluate her economic status so that we may discover resources for sponsoring medication prices. The FNP could chip in by researching specific companies’ patient aid programs where drugs can be bought at a lower cost or given free of charge to deserving persons who satisfy some eligibility criteria. Additionally, the FNP can refer the patient to social services or community organizations that offer financial assistance for healthcare expenses, including medication costs.

Subsequently, collaboration with other doctors may be beneficial in complex cases. The FNP may consult a psychiatrist or mental health specialist for a more complete examination and treatment recommendations. These specialists may assist in explaining alternative treatment techniques or financial solutions and have access to additional mental health care resources.

Further, regular follow-up appointments are needed to check on the patient, adapt their treatment plan, and give encouragement and support. During these appointments, the FNP may assess the chosen medicines’ effectiveness, address new concerns or side effects, and emphasize medication adherence. The FNP must also educate the patient to be honest about treatment plan issues. The FNP may assist patients in avoiding dropping out or relapsing by providing an environment of trust and open communication where they may discuss financial concerns.

In conclusion, FNPs must be diligent and sympathetic while treating depressed patients who have stopped taking their prescriptions due to cost and are despairing. Meeting patient needs requires immediate safety, cost-effective treatment options, resource use, and coordination with other medical specialists. FNPs should communicate, support, and include patients in decision-making to help patients overcome these challenges and enhance mental health.

References

Hartley, S., Raphael, J., Lovell, K., & Berry, K. (2020). Effective nurse-patient relationships in mental health care: A systematic review of interventions to improve the therapeutic alliance. International Journal of Nursing Studies, 102(1), 1–9. https://doi.org/10.1016/j.ijnurstu.2019.103490

Nicola, M., Correia, H., Ditchburn, G., & Drummond, P. D. (2022). Defining pain-validation: The importance of validation in reducing the stresses of chronic pain. Frontiers in Pain Research, p. 3, 884335. https://doi.org/10.3389/fpain.2022.884335

Shang, W., Guo, L., Liu, Y., Li, Y., Qian, W., Guo, K., Yang, M., Wei, L., Xu, Z., Niu, J., Li, X., & Yang, K. (2023). PROTOCOL: Non‐pharmacological interventions for older people with a diagnosis of depression: An evidence and gap map. Campbell Systematic Reviews, 19(4). https://doi.org/10.1002/cl2.1354

WHO. (2024). Depression. Www.who.int. https://www.who.int/health topics/depression#:~:text=Depressive%20episodes%20last%20most%

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Question 


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.

Managing Depression and Medication Non-Adherence - The FNPs Role in Crisis Intervention

Managing Depression and Medication Non-Adherence – The FNPs Role in Crisis Intervention

The FNP learned 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.