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PMP-103 > Disease Prevention - Intervention > Flashcards

Disease Prevention - Intervention Flashcards

1
Q

What is disease prevention?

A

actions to reduce or eliminate exposure to risks that might increase the chances that an individual or group will incur disease, disability, or premature death

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2
Q

Risk factors

A

Some risk factors for disease and disability are amenable to change (such as personal habits), while others (such as genetic endowment and family history) are not

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3
Q

What does health promotion involve?

A

Health promotion involves the development of behaviours that improve bodily functioning and enhance an individual’s ability to adapt to a changing environment

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4
Q

Why is disease prevention important?

A
  • WHO = 80% of chronic disease are preventable
  • lifestyle choices
  • unhealthy diet, physical inactivity, tobacco use
  • making healthier choices to reduce risk of early ill health and diseases = cancer, CV disease, stroke, respiratory disease and mental illness
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5
Q

What are healthy living habbits?

A
  • eat a healthy diet
  • maintain healthy weight (avoid obesity)
  • be active on most days
  • don’t smoke tobacco
  • limit alcohol use
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6
Q

Obesity harms health&raquo_space;> list the diseases that are related

A

Heart disease
Stroke
Type 2 diabetes
Liver disease
Cancer
Depression & Anxiety
Reproductive complications
Asthma
Sleep apnoea
Osteoarthritis back pain

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7
Q

Stats for global obesity:

A
  • tripled since 1975, and the UK ranks among the worst in Europe
  • 1/3 of children leaving primary school are overweight or obese and, on average, consume up to 500 extra calories per day
  • poor diet - linked to type 2 diabetes, high BP, high cholesterol, ^ risk of respiratory musculoskeletal and liver diseases
  • obese people - ^ risk of certain cancers, incl. x3 more likely to develop COLON cancer
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8
Q

How many causes of deaths IN WALES - alcohol??

A

1500

deaths are ^^^ in most deprived areas of WALES
Estimated cost of £1 BILLION of harm to society

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9
Q

in welsh health survey in 2015:

A
  • 40% adults reported drinking above the previous recommended daily guidelines
  • 24% reported binge drinking
  • 15% of adults were non-drinkers
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10
Q

What are the long term effects of high alcohol consumption?

A

Alcohol increases the risk of conditions including cardiovascular disease, cancer and liver disease. It can also cause emotional and relationship problems

The immediate risks of heavy drinking include alcohol poisoning and harm from accidents, violence and self-harm.

All put substantial pressure on the NHS

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11
Q

what is the recommended amount of consumption for alcohol

A

The UK Chief Medical officer’s guildelines on LOW RSIK drinking - 14 units Per week (should be spread out / NOT in one sitting)

Pregnant women are advised - not to drink at all

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12
Q

what are the stats for smokers in the UK?

A

Wales - 15.5 %
England - 13.9%
Scotland - 15.4%
Northern Ireland - 15.6%

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13
Q

Not assessed - stats on smoking for info

A

In the UK, around 1 in 4 (23.4%) people in routine and manual occupations smoked, this is around 2.5 times higher than people in managerial and professional occupations (9.3%).

In Great Britain, more than half (52.7%) of people aged 16 years and above who currently smoked said they wanted to quit.

In Great Britain, 5.7% of respondents in 2019 said they currently used an e-cigarette, which equates to nearly 3 million adults in the population.

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14
Q

How does smoking harm the body?

A
  • Heart = x2 risk heart attack
  • Lungs= 84% deaths from lung cancer/ 83% deaths from COPD
  • Circulation = ^ BP and heart rate
  • Fertility (Men) = impotence in men
  • Bones = weak + brittle and ^ risk of osteoporosis in women
  • Brain - ^ risk of stroke by 50%<
  • Mouth & throat = ^ risk of cancer in lips, throat, tongue, voice box and gullet (oesophagus)
  • stomach - ^ stomach cancer or ulcers
  • Fertility (Women) = harder to conceive
  • Skin = prematurely ages skin between 10 & 20 yrs
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15
Q

Look at “a healthier wales” principles:

A

principle number 5
“ we will ^ focus on health, wellbeing and prevention with all community pharmacies becoming health and wellbeing hubs, collaboratively working with the MDT within the primary care cluster”

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16
Q

Delivering a healthier Wales: Pharmacy
HOW??

A

An estimated 50,000 people a day visit a community pharmacy in Wales

Community pharmacies = community health assets, physically located in the heart of local populations.

All pharmacies = become health and wellbeing hubs.

All members of the pharmacy teams in patient facing roles = become health and wellbeing ambassadors with skills in health coaching, health literacy, behaviour change and cultural awareness

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17
Q

What are the key pharmacist roles?

A

Public awareness campaigns
Provision of leaflets / resources

Opportunistic counselling / advice with signposting
Make every contact count (MECC)

Delivering advanced services e.g. stop smoking

18
Q

what is the Public Health Campaign??

A

Co-ordinated approach across Wales

Supported by Community Pharmacy Wales

Leaflets, posters and other resources utilised by community pharmacy staff to start discussions with patients

19
Q

What is the Antimicrobial Stewardship Campaign 2021?

A

Aims to support community pharmacists and patients to join the fight against antibiotic resistance

CPs ideally placed to advise patients on the importance of only taking antibiotics when their prescriber advises and that antibiotics don’t work for colds and other viral infections

An antibiotic checklist can be used to ensure the antibiotic is appropriate and prescribed safely and to ensure that patients are aware of key messages around antibiotics

20
Q

IS ANTIMICROBIAL RESISTANCE A PROBLEM?

A

Resistance is a global health disaster that is already killing 700,000 people across the globe each year

The WHO have declared that AMR is of the top 10 global health threats facing humanity

21
Q

What is the acronym MECC?

A

Making Every Contact Count

Making Every Contact Count (MECC) is an approach to behaviour change that uses the millions of day-to-day interactions that organisations and people have with other people to support them in making positive changes to their physical and mental health and wellbeing.

22
Q

What is the MECC - explain=

A

With a focus on what a person thinks they may be able to do to make a positive change to their lifestyle.

They are often about ‘planting a seed’ for change or supporting someone to make a small step towards making a change.

Opportunities will arise during routine encounters within the Pharmacy

A quick conversation can start a patient on the right path to making healthier choices

23
Q

What are the simple 3As approach can be used undertaking a brief health chat:

A

ASK individuals about their lifestyle and changes they may wish to make, when there is an appropriate opportunity to do so

ADVISE appropriately on the lifestyle issue/s once raised

ACT by offering information, signposting or referring individuals to the support they need.

24
Q

Use ‘Vaccines’ as an example when using the 3As

A

ASK
“Are you / your child up to date with your immunisations?“

ADVISE
Keeping up to date with your immunisations is a quick, safe way of protecting you, your family and your friends from serious diseases
Immunisations are available to protect against a wide variety of serious illnesses in children and adults including measles, flu, whooping cough, cervical cancer and meningitis.

ACT
Signpost the client to the:
GP Surgery to find out if up to date and/or to arrange any immunisations. NHS flu vaccination is available from many community pharmacies too
NHS Direct Wales website for information on what immunisations are needed and when:www.nhsdirect.wales.nhs.uk/DoItYourself/vaccinations

25
Q

“Healthy eating example and use the 3As framwork…

A

ASK
“Are you interested in making changes to what you eat?”

ADVISE
Eat well including plenty of fresh fruit and vegetables
A healthy diet can reduce your risk of cancer, stroke, type 2 diabetes and heart disease
Eating well can make you feel better about yourself and give you more energy
Food plays a vital role in achieving and maintaining a healthy weight
Fruit and vegetables are part of a healthy balanced diet
They’re a good source of vitamins and minerals, including folate, vitamin C and potassium
Advise your client to try the following:-

5-a-day: aim to eat 5 portions of a variety of fruit and vegetables each day
Snack swap: swap high fat and high sugar snacks to healthier options such as fruit, diet yoghurts, vegetable sticks with lower fat dips,
Portion swap: reduce your portion sizes, use a smaller plate. Aim for a third of your plate to be vegetables as this will help you to feel full.
It takes a while for our brains to register we are full so try eating more slowly. Choose smaller portions of take away and convenience foods.

ACT
Signpost your client to: Change 4 Life website –www.change4lifewales.org.uk

26
Q

^^^ physical activity;

A

ASK
“Are you interested in being more active?“

ADVISE
Move more and more often
Aim for at least 150 minutes of moderate to vigorous activity per week including some physical activity each day in periods of 10 minutes or more
Being active helps to reduce and maintain weight, reduces stress and lifts mood, strengthens bones and muscles and decreases the risk of developing chronic conditions and diseases, including heart disease, diabetes and strokes
Advise your client to try the following:

Build walking and cycling into daily living routines by walking to the shops, to work, to school, or when visiting family and friends
Go out for a brisk walk most days
Make use of the parks and green spaces
Use the car less and make use of public transport
Try new activities in local centres, including strength & balance for older people
ACT
Signpost the client to: Change for Lifewww.change4lifewales.org.uk

27
Q

Why are stop smoking services important?

A

Smoking is the main cause of death of preventable death in the UK

Estimated that smoking is responsible for >5000 deaths each year in people aged 35 and over inWales
- nearly 1 in 5 of all deaths in this age group

Incredibly, one in every two smokers die from smoking related diseases

Passive smokingcan lead to a range of diseases, many of which are fatal, withchildren especially vulnerable

Smoking costs the Welsh NHS around £302 million per year.

28
Q

What are the opportunities for smokers?

A
  • pharmacies provide brief interventions on stopping smoking and ^ access to stop smoking service
  • e.g. when NICOTINE-STAINED FINGERS are observed, the purchase of a smokers toothpaste or repeated requests for cough remedies.
29
Q

What are the Motivating facts for opportunistic contacts?

A
  • Quitting - never too late (benefits start straight away)
  • 3days = taste and smell start to improve, breathing will become easier, ^ energy levels
  • 1 year risk of having a heart attack will 1/2 compared to a smoker
  • quitting = saves money
    20 cigs a day = £2,000 a year
  • protecting loved ones - 2nd hand smokers = the same risk as smokers (cancer / heart disease)
    Children exposed&raquo_space; ^ risk of bronchitis, pneumonia, asthma attacks and ear infections
  • x4 more likely to stop smoking using an NHS STOP SMOKING SERVICE that to quit ALONE
30
Q

What are the benefits of vaccinations?

A
  • WHO = 3 million lives saved = immunisation
  • globally = STILL 400,000 children still die per year from ~MEASLES alone, even when a safe effective vaccine has been avail. for 30yrs
  • important = babies/ children are immunised
  • risks of vaccines are VERY small compared to risk of getting diseases
31
Q

Why are vaccines efficient?

A
  • tetanus, diphtheria = rare because of immunisation
  • While polio was declared eliminated in Europe in 2002 through immunisation, the threat of other diseases such as measles and meningitis have not gone away in the UK today.
  • Vaccination has played a pivotal role in the management of the COVID-19 pandemic
  • Misinformation leads to vaccine hesitancy and lower vaccination rates
32
Q

What is the vaccine misinformation?
What year was the SCARE???

A
  • 2017 :
    resulted in a fall in whooping cough immunisation:
    Leading to over 100,000 cases of whooping cough.
    An estimated 100 deathsin the years which followed, with
    Large numbers permanently brain damaged by the disease
33
Q

What happened after the investigation of the vaccination scare in 2017?

A

Astudy investigating the risk later reported that acute reactions did occur, but full recovery was usual. There was insufficient evidence to say DTP increased the overall risk of long-term damage

[Pharmacists are also well placed to address vaccine hesitancy and worries]

34
Q

Community Pharmacy Vaccination Services

A
  • 1 in 10 NHS seasonal influenza vaccinations are now provided by pharmacies and pharmacies have played an important role in delivering our hugely successful COVID-19 vaccination programme particularly in our most rural areas.
  • Influenza vaccines can be provide free of charge to patients falling within the “at risk” groups
  • Some Pharmacies will also offer a private (paid) service to patients who fall outside of the “at risk” groups.
35
Q

What are the Influenza “at risk” groups?

A

As defined by the “Vaccine Green book”

65 years or over,
chronic respiratory disease (including COPD and asthma),
significant cardiovascular disease (not hypertension),
immunocompromised,
diabetes mellitus,
chronic neurological, renal or liver disease.
Pregnancy
Morbid obesity

36
Q

How did community pharmacies play a role during the COVID - 19 pandemic?

A

Delivering primary and booster doses for patients
Advantages include:

Increased convenience for patients
Improved access for rural areas and for patients without transport to access the mass vaccination centres
Trusted and familiar health-care setting which may help address vaccine hesitancy including in hard to reach groups e.g. ethnic minorities

37
Q

STTT service

A

Sore Throat Test and Treat

38
Q

Sore Throat Test and Treat - explain what happens and why:

A

Enhanced service for community pharmacists to manage acute sore throats
Include use of clinical scoring tools to assess severity (FeverPAIN and Centor scoring)
Patient’s scoring high, will be offered a throat swab to check for the presence of bacteria
If the throat swab is positive the patient will be offered a course of antibiotics by the pharmacist
If negative, they will be given self-care advice and advised to seek medical attention if they get any worse

39
Q

What is the service aim?

A

Safely reduce antibiotic prescribing for acute sore throats
Distinguish between viral or bacterial sore throats

Moving care of these patients to community pharmacy, removes pressure from GP practices
Allows GPs to spend more time on assessing more diagnostically difficult patients
Assessment and explanation around why antibiotics are not needed will often take more time than issuing an antibiotic prescription

Reducing antibiotic prescribing is important to reduce the spread of antibiotic resistance, which is a major threat to health-care.

40
Q

STTT pilot results??

A

Original pilot results:
72% (n=1239) of patients screened were eligible for antigen testing
28% (350) were positive for GABHS, 27% (340) received antibiotics

Overall service prescribing rate was 20% (340/1725) patients

Prescribing rates in SBUHB for GP consultations is 70%

41
Q

What are the Future roles:

A

Prevention of cardiovascular diseases, through early screening and detection?:

Health screens
Cholesterol
Blood pressure
Diabetes screening
Waist circumferences

PMP-103 (33 decks)

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