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If the patient is carrying their own epo I would assume it is already paid for. The problem would then lie in whether or not you can bill for and are covered for administration of the medication if you are not billing for a treatment. It would depend on the policies you need to follow.
In terms of whether it should be given or not, I would say it is important that they receive their epo on schedule. It takes 4 to 6 weeks to see the results of administration and missed doses can really screw up how you would adjust for future dosing as hgb would come back lower than it should be. This may cause you to increase the dose because it appears the patient needs more when the inadequate rise in hgb is really due to missed doses.
I would consult with the docs you work with and also with your policies. Are you giving the epo IV or subq? If subq, can these patients be trained to administer their own? When in developing countries I would assume you have to be creative with treatment options....just curious, where are you working?
In some caribbean countries, they already inject the EPO either IV or SC while dialysis is ongoing. Is this alright? Because i was trained before to administer it AFTER the treatment. But the nurses from Curacao and Aruba that i work with inject it DURING dialysis, and mostly IV. is there any significant difference?