Hep C Treatment Visit

HEP C Treatment Visit Dot Phrase. Please read in detail and delete what is not relevant. Do not just copy and paste. 

 

DELETE EVERYTHING ABOVE HERE--

 

Clinic Note and Treatment Plan

HPI -
No H/o Jaundice, GIB, Varices, Encephalopathy, SBP, or Ascites


PE -
GENERAL - A&O x4, NAD
HEENT - HNCAT, PERRLA without scleral icterus, neck supple without gland enlargement
HEART - RRR S1+S2, no murmurs, rubs, or gallops
LUNGS - CTA bilat, AEE bilat, no crackles, wheezes or rhonchi,
ABDOMEN - Soft, nontender, BS x4 NA, no organomegaly, no ascites, no r/g
EXTREMITIES - no edema, no clubbing
DERM - no jaundice, no spider angio, no caput medusa, no abnormal bruising, no ulcers
PSYCH - Appropriate mood and affect

LABS (INSERT RESULTS WITH DATES)
INSERT CREATNINE
.heplab
HIV (within the last 30 days)

AFP result if cirrhotic
Fibroscore result
Pregnancy test (this visit)

Insert Hep  C genotype (and NS5A testing result when applicable)

Hepatitis A/B antibody results show immunity OR Prior Hepatitis Vaccinations completed or started - _

DIAGNOSTICS
Prior Imaging (within the last 6 months)- US/CT INSERT RESULTS
Prior Studies - Bx INSERT RESULTS IF DONE


Assessment/Plan

I have verified that patient meets inclusion criteria.

- Patient agreement signed
- Cerner message to AFMC Case Manager Pool
- Fatigue screen completed:
- PHQ 9 completed: Score _


Prior Tx with novel agent- NO
Cirrhosis – YES OR NO
Decompensated = NO - no h/o Varices, Encephalitis, Ascites, Jaundice, or hospitalization for complications of liver disease
*If Evidence of Fibrosis score >4, decompensated cirrhosis, or any h/o failed prior Tx, the patient will be referred to Hepatology Clinic.

The following items are present-
* Fatty Liver on U/S - NO

*Women of child bearing age - NO
* Healthcare worker - NO
* Hep B co-infection - NO
* Diabetes - NO
* HIV co-infection - NO
*Debilitating Fatigue- Fatigue questionnaire - INSERT SCORE.

**NOTE: If the patient also has HIV, these patients will be staffed and co-managed by Dr. Pawson. Please message Dr. Pawson.


GOLDCOAST: Hepatitis C All Genotypes

Based on the above classification the patient will undergo Treatment with the following:

  1. F0-3: Mavyret x 8 Weeks, 3 tabs po daily with food.
  2. F4 w/ compensated cirrhosis (Child Pugh A): Mavyret x 12 weeks, 3 taps po daily with food.

 

Medication reconciliation to be performed with case manager. 


Instructions were given on the importance of not missing medication dosage, follow-ups and lab draws. All questions answered. The patient wishes to proceed with treatment and will be scheduled for a Nursing appointment for further information and instructions.

 

CVS caremark Rx filled out and forwarded to care manager. Next step will be f/u with care manager. Message sent to AFMC Case Manager Pool who will schedule apt.

Follow Up Visits and Labs:

Care manager will schedule f/u visits with prescribing physician as noted below at the start of treatment to ensure pt does not get lost to f/u. PCP will order the subsequent lab at each visit.

8 Week Regimen:

  • At week 4 of treatment: CBC, CMP, Viral Load, Coags
  • At week 5 of treatment: PCP Visit
  • At week 6 of treatment: Viral load only if no response at week 4
  • At week 8 of treatment: AST/ALT
  • At week 9 of treatment: PCP Visit
  • At week 20 of treatment: Viral load
  • At week 21: PCP Visit

12 Week Regimen:

  • At week 4 of treatment: CBC, CMP, Viral Load, Coags
  • At week 5 of treatment: PCP Visit
  • At week 6 of treatment: Viral load only if no response at week 4
  • At week 8 of treatment: AST/ALT
  • At week 9 of treatment: PCP Visit
  • At week 12 of treatment: Viral load
  • At week 13: PCP Visit
  • At week 24: Viral load
  • At week 25: PCP Visit

 

  • All templates, "autotexts", procedure notes, and other documents on these pages are intended as examples only.  Your documentation in the medical record should always reflect precisely your specific interaction with an individual patient.  Merely copying and pasting a prewritten note into a patient's chart is unethical, unsafe, and possibly fradulent.