Patient is a 16 year-old male chronic parenteral nutrition dependence secondary to short bowel syndrome secondary to atresia. Despite several intestinal lengthening procedures at your center, he continues to receive the vast majority of his nutrition intravenously. Family complains that frequent in-depth clinic visits are interfering with quality of life. Family has an a consistent record of coming to ambulatory visits as scheduled.
What is the most appropriate next step?
A. Consult social work to develop a patient contract for non-compliance.
B. Offer to transfer care to an adult HPN provider within the next 6 months.
C. Provide education about the dangers associated with long-term HPN complications.
D. Offer less frequent visits with intermittent phone calls (non-standard practice) in order to maintain relationship.
E. Motivational interviewing to explore how frequent concerns about quality of life.