Block 3 Flashcards
Define QoL.
physical, mental, and social well-being, not just the absence of illness or disease
Define PRO
any endpoint directly from a patient’s perception
PCORI
Patient-Centered Outcomes Research Institute
4 PRO Domains
1) HRQoL
2) Health-State Utility
3) Willingness to Pay
4) Patient Satisfaction
3 health outcomes measures categories
1) economic
2) humanistic
3) clinical
General tool used for measuring general HRQoL?
SF-36
QALY equation
= additional life years * utility
Define QALY
measure of preference for x time with impaired utility compared to y time with full utility
Define willingness to pay
hypothetical measure of preference for items not typically traded in private markets
What is contingent valuation?
survey methods that asks how much an individual is willing to pay for a good or service
What is conjoint analysis?
method of contingent valuation that considers factors other than price
What are the goals of medication use?
1) alleviate symptoms
2) improve signs
3) cure
What were the 4 components of OBRA?
1) assessment of drug use data
2) educational outreach program
3) Prospective DUR
4) Retrospective DUR
3 pharmacist activities addressed in OBRA 90?
1) prospective dur
2) maintenance of patient records/profiles
3) patient counseling standards
What are the 4 methods in place to prevent med misuse?
1) OBRA 90 Standards
2) Patient Counseling Standards
3) MTM
4) MedRec @ transition of care
NCC MERP
The National Coordinating Council for Medication Error Reporting and Prevention
define medication error
any preventable event that may cause or lead to inappropriate medication use or patient harm while the medication is in control of the healthcare professional, patient, or consumer;
Inappropriate dispensing of a prescribed medication including a variation from the prescriber’s prescription order and failure to identify and manage DTPs
ISMP
institute for safe medication practices
How are root causes of med errors categorized?
1) knowledge deficiency
2) performance deficiency
3) system failure
5 A’s for responding to med errors.
1) acknowledge
2) ask
3) appreciate
4) act to resolve
5) appropriately document
how to reduce med errors?
C-HOLS
1) good patient history
2) improve order communication (tall man, zeroes, etc)
3) improve label/packaging recognition
4) counsel
4) system enhancements in the pharmacy
what is diffusion theory?
special type of communication with innovation & communication over time
an idea is perceived as new by an individual “innovation”
and participants create and share information
over time
What are the 2 major determinants of prescribing behavior?
1) practice characteristics
2) physician demographics
What components of practice characteristics may influence prescribing behavior?
1) location
- - rural, is monitoring difficult, detailing visits
2) nature of practice
- - solo/group, IT, types of patients, detailing policies
3) practice size
- - more patients, more opportunities for new drug
- - more prescribers, faster diffusion
How do physician demographics affect prescribing behavior?
less likely to adopt new drug with…
- increasing age
- female gender
How do manufacturers market their products?
historically, physicians & prescribers; but now, also DTC
1) DTC <15% of marketing costs
2) prescriber: 80% of marketing costs
What are potential interventions to influence prescribing behavior?
RACCE prescribing
1) reminders
2) audit & feedback
3) clinical practice guidelines
4) computerized decision support systems
4) educational outreach/academic detailing
What is the Alosa Foundation?
Part of the independent drug information service at harvard medical school.
Define interdisciplinary healthcare team.
a group of individuals with diverse training and backgrounds who work together as an identified unit or system
What are the specific components of a collaborative practice?
G-MAP
1) common goals
2) mechanisms for communication/monitoring
3) appropriate contributions
4) common patients
What are facilitating values in a collaborative practice?
1) knowledge –> trust
2) shared responsibility
3) mutual respect
4) communication
5) coordination & cooperation
6) optimism
What is the most effective delivery method of successful quality care?
optimism
What is necessary for the development of trust?
knowledge
What is the goal of academic detailing?
to close the gap between best evidence and actual prescribing to maximize efficacy, safety, and cost-effectiveness
What does SBAR stand for?
Situation, Background, Assessment, Recommendation
What are the important aspects for improving communication skills?
NVR LIE
1) non-verbal communication
2) verbal communication
3) build rapport
4) listen actively
5) involve the patient
6) empathetic
What is empathy?
the ability to see the world through another’s eyes
What are general categories for barriers to effective communication?
1) environmental
2) pharmacist
3) patient
4) financial/admin
5) time
