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M_Widget::define() should be compatible with C_Base_Module::define($id = 'pope-modul...', $name = 'Pope Modul...', $description = '', $version = '', $uri = '', $author = '', $author_uri = '', $context = false) in /home/.sites/625/site1122/web/wp_igmed/wp-content/plugins/nextgen-gallery/products/photocrati_nextgen/modules/widget/module.widget.php on line 54 Warning: Declaration of M_Third_Party_Compat::define() should be compatible with C_Base_Module::define($id = 'pope-modul...', $name = 'Pope Modul...', $description = '', $version = '', $uri = '', $author = '', $author_uri = '', $context = false) in /home/.sites/625/site1122/web/wp_igmed/wp-content/plugins/nextgen-gallery/products/photocrati_nextgen/modules/third_party_compat/module.third_party_compat.php on line 353 Warning: Declaration of M_NextGen_XmlRpc::define() should be compatible with C_Base_Module::define($id = 'pope-modul...', $name = 'Pope Modul...', $description = '', $version = '', $uri = '', $author = '', $author_uri = '', $context = false) in /home/.sites/625/site1122/web/wp_igmed/wp-content/plugins/nextgen-gallery/products/photocrati_nextgen/modules/nextgen_xmlrpc/module.nextgen_xmlrpc.php on line 630 Sind Kassen-Patientenärzte den Kassen-Schreibtischärzten hilflos ausgeliefert? – IGMed

Sind Kassen-Patientenärzte den Kassen-Schreibtischärzten hilflos ausgeliefert?

· Infos für Ärzte

Hier eine Begebenheit aus dem Ordinationsalltag (m)einer österreichischen Allgemeinpraxis: Eine 75-Jährige Patientin mit schwerer Osteoporose soll korrekt behandelt werden, der Versuch einer ABS-Bewilligung spricht für sich, in chronologischer Reihenfolge ist das Frage- und Antwort“spiel“ dargestellt.  Ein Auswuchs an „Erfordernissen“, wie er in wenigen Jahren wohl 90% (statt 30%) unserer Arbeit beherrschen wird (während Patienten im Wartezimmer warten). Es sei denn, der Grundgedanke, dass der Mensch im Vordergrund steht und nicht die Erfüllung irgendwelcher bürokratischer Auflagen, tritt wieder in den Vordegrund…..

#1.Anfrage
Referenznr.: 14703580
Anfrage am:
15.03.2011 09:15
Antwort am:
15.03.2011 09:21
beantragtes Medikament:
PROTELOS GRAN 2G         BTL 28 ST (2458482)     OP: 1
Langzeitverordnung: beantragte Monate:      bewilligt:      OP:
Diagnose:
schwere Osteoporose
Begründung:
sehr schwere Osteoporose mit T-Score -5,27, mehrere Wirbelkörpereinbrüche; Th mit Alendronsäurepräparaten über längere Zeit hat bislang nicht zu Besserungseffekten geführt. geplante LZ-Verschreibung, dies ist Erstverschreibung

#1.Antwort
ABLEHNUNG
-> Bei der angegebenen Begründung ist eine Bewilligung nicht möglich.
SV-Information:
Bearbeitet von: NACHNAME Vorname, Dr.

#2.Anfrage
Referenznr.: 14705579
Anfrage am:
15.03.2011 10:25
Antwort am:
15.03.2011 10:47
beantragtes Medikament:
PROTELOS GRAN 2G         BTL 28 ST (2458482)     OP: 1
Langzeitverordnung: beantragte Monate:      bewilligt:      OP:
Diagnose:
schwere Osteoporose
Begründung:
die Ablehnung bzw. die (nichtvorhandene) Begründung empfinde ich persönlich als Skandal und behalte mir Schritte vor. Pat. war zusätzlich bei Orthopäden (in dieser Angelegenheit und bekam auch von dort nach synoptischer Betrachtung des Krankheitsbildes die Empfehlung zu „Protelos“)
mit unfreundlichen Grüßen


#2. ABLEHNUNG
-> Bewilligung von Protelos nicht möglich, da regelkonformer Einsatz.  .Seit wann Therapie mit Biphosphonaten ?? WK Fraktur vor 3 Jahren  ?  Es stehen mehrere Präp. bei WK Fraktur mit RE 1 Regel im EKO  zur Verfügung . Mit freundlichen Grüßen
SV-Information:
Bearbeitet von: NACHNAME Vorname, Dr

#3.Anfrage
Referenznr.: 14708471
Anfrage am:
15.03.2011 13:12
Antwort am:
15.03.2011 13:37
beantragtes Medikament: PROTELOS GRAN 2G         BTL 28 ST (2458482)     OP: 1
Langzeitverordnung: beantragte Monate:      bewilligt:      OP:
Diagnose:
schwere Osteoporose
Begründung:
Bitte um Vorschlag, WAS ich der Pat. geben soll.Sie hatte vor >5 Jahren eine Magenblutung, allerdings keine Refluxkrankheit zuvor. Seit 2005 hatte Sie Rocaltrol und Alendronsäure, natürlich inkl oralem Kalzium, etc). trotzdem zunehmende Osteoporose-Auslenkung des T-Score(2003 nach QTC-Messung -5.0). Nach dieser Th-Dauer und erwiesener Unwirksamkeit sind (alle) Biphosphonate lt.EBM-Guidelines nicht mehr sinnvoll, ein Strontiumranelat (Protelos) m.E. das Vernünftigste. Prolia (Denosumab, kostet 250 Euro), Forsteo (Teriparatid, ein PTH-Analogon) kostet 400 Euro, Calcitonin ist erwiesenermaßen deutlich schwächer wirksam, als Biphosphonate, also aus naheliegenden Gründen genauso zu hinterfragen. Also bitte, WAS schlagen Sie vor? Nennen Sie doch Namen! Ich dokumentiere unseren Schriftverkehr ausführlich und werde das Ganze zur Diskussion stellen. Mir gehts nicht um Bewilligung ja/nein, mir gehts ums Aufzeigen, wie problematisch ABS ist..

#3.ABLEHNUNG -> Stellungnahme einer Osteoporose-Ambulanz zur weiteren Therapieplanung h. erbeten
SV-Information:
Bearbeitet von: NACHNAME Vorname, Dr