Monitoring Requirements Before commencing immunosuppressant therapy Sample Clauses

Monitoring Requirements Before commencing immunosuppressant therapy. Record patient’s blood pressure, weight and height if clinically indicated. • Screening for lung disease should be undertaken at clinician discretion on a case- by-case basis. The extent of screening should be influenced more by a patient’s clinical features and risk factors for lung disease (e.g. underlying autoimmune disease or smoking history) rather than subsequent immunomodulating choice. Pre-existing lung disease should not be considered an absolute contraindication to any imunomodulating medication. • Consultant to consider ECG where appropriate especially when commencing medications associated with hypertension • Screen for viral hepatitis B&C and HIV in all patients • Investigate patient medical history including co-morbidities and previous immunomodulating medication use. Consultant/specialist monitoring schedule Baseline followed by 2 weekly monitoring until on a stable dose for at least 6 weeks • FBC • ALT and/or AST and albumin • U&E including creatinine/ eGFR • Serum Pro Collagen III measured only in Psoriasis (not Psoriatic arthritis) Annually review the patient and advise the GP promptly on when to adjust the dose, stop treatment or consult with the specialist. GP responsibility monitoring schedule In patients following the 6 weeks of dose stability conduct monthly monitoring for three months followed by three monthly monitoring thereafter of: • FBC • ALT and/or AST and albumin • U&E including creatinine/eGFR For rheumatic patients CRP/ESR may be done every 3 months (this is not done for dermatology patients). These tests are part of the assessment of the underlying rheumatic disease rather than a requirement for monitoring of immunomodulating therapy. The monitoring CRP/ESR may be coordinated between secondary and primary care on an individual basis. Leflunomide in combination with MTX requires extended monthly monitoring for at least 12 months. Patients who have been stable for 12 months can be considered for reduced frequency of monitoring on an individual patient basis. Dosage increase For dose increase, monitor fortnightly until stable for 6 weeks. Dose and monitoring to be agreed with consultant. • FBC • ALT and/or and albumin • U&E including Creatinine/eGFR Monitoring to then revert to previous schedule. When restarting treatment after an abnormality has been detected repeat bloods in 2 weeks and then monthly for 3 months. Following this resume monitoring frequency to what it was prior to the abnormality. Actions to be taken 1. Immun...
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Related to Monitoring Requirements Before commencing immunosuppressant therapy

  • CHILD AND DEPENDENT ADULT/ELDER ABUSE REPORTING CONTRACTOR shall establish a procedure acceptable to ADMINISTRATOR to ensure that all employees, agents, subcontractors, and all other individuals performing services under this Agreement report child abuse or neglect to one of the agencies specified in Penal Code Section 11165.9 and dependent adult or elder abuse as defined in Section 15610.07 of the WIC to one of the agencies specified in WIC Section 15630. CONTRACTOR shall require such employees, agents, subcontractors, and all other individuals performing services under this Agreement to sign a statement acknowledging the child abuse reporting requirements set forth in Sections 11166 and 11166.05 of the Penal Code and the dependent adult and elder abuse reporting requirements, as set forth in Section 15630 of the WIC, and shall comply with the provisions of these code sections, as they now exist or as they may hereafter be amended.

  • Tuberculosis Examination The examination shall consist of an approved intradermal tuberculosis test, which, if positive, shall be followed by an X-ray of the lungs. Nothing in Sections 5163 to 5163.2, inclusive, shall prevent the governing body of any city or county, upon recommendation of the local health officer, from establishing a rule requiring a more extensive or more frequent examination than required by Section 5163 and this section. § 5163.2. Technician taking X-ray film; Interpretation of X-ray The X-ray film may be taken by a competent and qualified X-ray technician if the X-ray film is subsequently interpreted by a licensed physician and surgeon.

  • Random Drug Testing All employees covered by this Agreement shall be subject to random drug testing in accordance with Appendix D.

  • Health Screening The Contractor shall conduct a Health Needs Screen (HNS) for new members that enroll in the Contractor’s plan. The HNS will be used to identify the member’s physical and/or behavioral health care needs, special health care needs, as well as the need for disease management, care management and/or case management services set forth in Section 3.8. The HNS may be conducted in person, by phone, online or by mail. The Contractor shall use the standard health screening tool developed by OMPP, i.e., the Health Needs Screening Tool, but is permitted to supplement the OMPP Health Needs Screening Tool with additional questions developed by the Contractor. Any additions to the OMPP Health Needs Screening Tool shall be approved by OMPP. The HNS shall be conducted within ninety (90) calendar days of the Contractor’s receipt of a new member’s fully eligible file from the State. The Contractor is encouraged to conduct the HNS at the same time it assists the member in making a PMP selection. The Contractor shall also be required to conduct a subsequent health screening or comprehensive health assessment if a member’s health care status is determined to have changed since the original screening, such as evidence of overutilization of health care services as identified through such methods as claims review. Non-clinical staff may conduct the HNS. The results of the HNS shall be transferred to OMPP in the form and manner set forth by OMPP. As part of this contract, the Contractor shall not be required to conduct HNS for members enrolled in the Contractor’s plan prior to January 1, 2017 unless a change in the member’s health care status indicates the need to conduct a health screening. For purposes of the HNS requirement, new members are defined as members that have not been enrolled in the Contractor’s plan in the previous twelve (12) months. Data from the HNS or NOP form, current medications and self-reported medical conditions will be used to develop stratification levels for members in Hoosier Healthwise. The Contractor may use its own proprietary stratification methodology to determine which members should be referred to specific care coordination services ranging from disease management to complex case management. OMPP shall apply its own stratification methodology which may, in future years, be used to link stratification level to the per member per month capitation rate. The initial HNS shall be followed by a detailed Comprehensive Health Assessment Tool (CHAT) by a health care professional when a member is identified through the HNS as having a special health care need, as set forth in Section 4.2.4, or when there is a need to follow up on problem areas found in the initial HNS. The detailed CHAT may include, but is not limited to, discussion with the member, a review of the member’s claims history and/or contact with the member’s family or health care providers. These interactions shall be documented and shall be available for review by OMPP. The Contractor shall keep up-to-date records of all members found to have special health care needs based on the initial screening, including documentation of the follow-up detailed CHAT and contacts with the member, their family or health care providers.

  • Initial Forecasts/Trunking Requirements Because Verizon’s trunking requirements will, at least during an initial period, be dependent on the Customer segments and service segments within Customer segments to whom CSTC decides to market its services, Verizon will be largely dependent on CSTC to provide accurate trunk forecasts for both inbound (from Verizon) and outbound (to Verizon) traffic. Verizon will, as an initial matter, provide the same number of trunks to terminate Reciprocal Compensation Traffic to CSTC as CSTC provides to terminate Reciprocal Compensation Traffic to Verizon. At Verizon’s discretion, when CSTC expressly identifies particular situations that are expected to produce traffic that is substantially skewed in either the inbound or outbound direction, Verizon will provide the number of trunks CSTC suggests; provided, however, that in all cases Verizon’s provision of the forecasted number of trunks to CSTC is conditioned on the following: that such forecast is based on reasonable engineering criteria, there are no capacity constraints, and CSTC’s previous forecasts have proven to be reliable and accurate.

  • DRUG/ALCOHOL TESTING Drug/alcohol testing shall be conducted solely for administrative purposes and the results obtained shall not be used in criminal proceedings. Under no circumstances may the results of drug/alcohol screening or testing be released to a third party for use in a criminal prosecution against the affected employee. The City conducts the following types of drug/alcohol testing to determine if employees are in compliance with this policy and associated rules of conduct: pre- employment, reasonable suspicion, and post-accident. In addition, employees are tested prior to returning to duty after a positive drug or alcohol test and subject to follow-up testing conducted during the course of a rehabilitation program recommended by a substance abuse professional. A Medical Review Officer (MRO) reviews test results and determines which tests are positive and which are negative. The City shall test for the following drugs: marijuana, amphetamines, opiates, phencyclidine (PCP), cocaine, barbiturates, benzodiazepines, methadone, methaqualone, and propoxyphene.. An initial drug screen is conducted on each specimen. For those specimens that are not negative, a confirmatory gas chromatography/mass spectrometry (GC/MS) test is performed. The test is considered positive if the amounts present are above the minimum thresholds established in 49 CFR Part 40. An alcohol concentration of .04 percent or greater is considered a positive alcohol test, and in violation of this policy. If a drug or alcohol test produces a positive result, the City may take such actions as authorized in Section 14.6 herein. Sick leave and/or other paid leave may be used while participating in a rehabilitation program. Otherwise, the employee will be placed on leave without pay until return to work following a negative alcohol/ drug test and authorization by the SAP.

  • Drug Testing (A) The state and the PBA agree to drug testing of employees in accordance with section 112.0455, F.S., the Drug-Free Workplace Act.

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