In the book and on her website , she makes the case that ssri antidepressant and add medications have dangerous side effects not only for the people taking them, but potentially for everyone. A total of 541 patients were studied including 52 from nine different centres from the uk the study was published in december 2004 in the new england journal of medicine and rifater. Trial therapy shall not be granted more often than once per year for the same issue. If the recipient has a previous history of rehabilitative services, trial therapy for the same type of services generally would be payable only when a significant change has occurred since the last therapy. Requests for subsequent diagnostic or trial therapy for the same issue would require documentation reflecting a significant change. See number 4 below for guidelines under a significant change. Further diagnostic or trial therapy for the same issue would not be considered appropriate when progress was not achieved, unless the reasons which blocked change previously are listed and the reasons the new diagnostic or trial therapy would not have these blocks are provided. The number of diagnostic or trial therapy hours authorized in the initial treatment period shall not exceed 12 hours per month. Documentation of the medical necessity and the plan for services under diagnostic trial therapy are required as they will be reviewed in the determination of the medical necessity of the number of hours of service provided. Diagnostic or trial therapy standards also apply to speech and occupational therapy. The following criteria additionally must be met: 1. There must be face-to-face interaction with a licensed therapist. An aide's services will not be payable. ; 2. Services must be provided on an individual basis. Group diagnostic or trial therapy will not be payable. ; 3. Documentation of the diagnostic therapy or trial therapy must reflect the provider's plan for therapy and the recipient's response. 4. If the recipient has a previous history of rehabilitative services, trial therapy for the same type of services generally would be payable only when a significant change has occurred since the last therapy. A significant change would be considered as having occurred when any of the following exist: new onset, new problem, new need, new growth issue, a change in vocational or residential setting that requires a reevaluation of potential, or surgical intervention that may have caused new rehabilitative potentials. 5. For persons who received previous rehabilitative treatment, consideration of trial therapy generally should occur only if the person has incorporated any regimen recommended during prior treatment into the person's daily life to the extent of the person's abilities. 6. Documentation should include any previous attempts to resolve problems using nontherapy personnel i.e., residential group home staff, family members, etc. ; and whether follow-up programs from previous therapy have been carried out. 7. Referrals from residential, vocational or other rehabilitation personnel that do not meet present evaluation, restorative or maintenance criteria shall be considered for trial therapy. Documentation of the proposed service, the medical necessity and the current medical or disabling condition, including any secondary rehabilitative diagnosis, will need to be submitted with the claim. 8. Claims for diagnostic or trial therapy shall reflect the progress being made toward the initial diagnostic or trial therapy plan. c. Occupational therapy services. 1 ; To be covered under rehabilitation agency services, occupational therapy services must be included in a plan of treatment, improve or restore practical functions which have been impaired by illness, injury, or disabling condition, or enhance the person's ability to perform those tasks required for independent functioning, be prescribed by a physician under a plan of treatment, be performed by a qualified licensed occupational therapist or a qualified licensed occupational therapist assistant under the general supervision of a qualified licensed occupational therapist as set forth in the department of public health, professional licensure division, rule 645--201.9 148B ; , * and be reasonable and necessary for the treatment of the person's illness, injury, or disabling condition. How should heart failure be treated? The aim of treating heart failure is to improve the quality of life of patients by: 1 improving symptoms or slowing their deterioration, reducing mortality, reducing the frequency of cardiac events and admissions to hospital, avoiding adverse effects from treatment, and improving end-of-life experiences. This Briefing concentrates on evidence supporting the drug treatment of heart failure, and will not discuss non-drug treatments, e.g. dietary advice, which form an important part of management.1, 29 Drug choice also depends on underlying or concomitant disease. A recent NICE guideline30 gives recommendations for patients who have had an MI and have heart failure. Any treatable cause of heart failure e.g. anaemia ; should be addressed initially.17 Although the drug treatment of heart failure is supported by good quality RCTs, applying the results to older people may be limited by the age of the population studied. Patients included in trials are often younger than the predominant heart failure population.3 There is no RCT evidence to recommend statins in patients with heart failure as these patients were usually excluded from the statin trials.30 The decision to use a statin should be based on individual circumstances. It is also not clear whether using aspirin alone or in addition to an ACE inhibitor ; in patients with heart failure MeReC Briefing Page 4 and rifampin. Acid blocking drugs are for heartburn and excess acid.