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Final exam Flashcards

1
Q

Health definition – Biomedical model

A

-Good health is the absence of disease or illness
-Problems with this definition of health

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2
Q

Health definition – Psychosocial model

A

Health is a state of complete physical, mental, and social well-being and not merely the absence of disease or infirmity.” – WorldHealth Organization (1946)

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3
Q

Public Health

A

“the activities that society undertakes to assure the conditions in which people can be healthy, including organized efforts to prevent, identify and counter threats to the health of the public.” Public Health Definition

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4
Q

Scope and Activities of public health

A

-Protect against environmental hazards
-Prevent injuries
-Prevent epidemics and spread of disease
-Promote and encourage healthy behaviors
-Assure the quality and accessibility of health services
-Respond to disasters and assist communities in recovery

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5
Q

Recognize the major agencies and players involved in ensuring public health.

A

-World Health Organization
-U.S Public Health Service Organization
-Wisconsin Public Health

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6
Q

Describe the different core functions of public health

A

-Assesment
-Policy development
-assurance
-research

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7
Q

Assesment in public health

A

-Monitoring health status to identify and solve community health problems
-Diagnosing and investigating health problems and health hazards in the community

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8
Q

Policy development in public health

A

-Inform, educate, and empower people about health issues.
-Mobilize community partnerships to identify and solve health problems.
-Develop policies and plans that support individual and community health efforts.

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9
Q

Assurance in public health

A

-Enforce laws and regulations that protect health and ensure safety.
-Link people to health services and assure the provision of healthcare when otherwise unavailable.
-Assure a competent public health healthcare workforce.
-Evaluate the effectiveness, accessibility, and quality of personal and population-based health services

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10
Q

research in public health

A

New insights and innovative solutions to health problems

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11
Q

HP2030: Reduce the proportion of people who can’t get prescription medicines when they need them

A

-Target 6.3%, at 4.7%
-Target Met

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12
Q

HP2030: Reduce household food insecurity and hunger

A

-Improving
-Target 6%, at 10.2% but it used to be worse

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13
Q

HP2030: Increase the proportion of state and territorial jurisdictions that have a health improvement plan

A

-Little to no change
-Target 86%, at 79.7%

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14
Q

Status of US Health

A

-Not in the top performing countries
-The U.S. spent $3.3 trillion on health care services in 2016, ~$10,348 per person (more per person than any other country).
-Worse Life expectancy at birth rates
-Highest health expenditure costs
-Lowest spent of social services

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15
Q

Primary prevention

A

-Prevent disease/injury before it occurs
-Prevent exposures to hazard that cause disease or injury
-Alter unhealthy/unsafe behaviors that can lead to disease or injury

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16
Q

Secondary prevention

A

Activities that take place after disease has occurred, but before the person experiences symptoms or can be transmitted to others

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17
Q

tertiary prevention

A

Targets person who already has symptoms of disease

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18
Q

HP2030: Maintain the elimination of measles, rubella, congenital rubella syndrome, and polio

A

maintaing, o cases

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19
Q

HP2030: Reduce cases of pertussis among infants

A

Exceeding goals
Far below target and baseline goals

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20
Q

HP2030:Reduce the proportion of children who get no recommended vaccines by age 2 years

A

meeting goal

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21
Q

HP2030:Maintain the vaccination coverage level of 1 dose of the MMR vaccine in children by age 2 years

A

-below target and baseline

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22
Q

HP2030:Maintain the vaccination coverage level of 2 doses of the MMR vaccine for children in kindergarten

A

below target and baseline

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23
Q

HP2030:Increase the coverage level of 4 doses of the DTaP vaccine in children by age 2 years

A

-Improving
-Above baseline but below target goal

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24
Q

HP2030: Reduce the rate of hepatitis A

A

not meeting goals

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25
Q

HP2030: Reduce the rate of acute hepatitis B

A

-Improving
-Less than baseline but not meeting target

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26
Q

HP2030: Reduce the rate of deaths with hepatitis B as a cause

A

-Improving
-Less than baseline but not meeting target

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27
Q

HP2030:Increase the proportion of adolescents who get recommended doses of the HPV vaccine

A

Improving
Above baseline but approaching target

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28
Q

HP2030:Increase the proportion of adults age 19 years or older who get recommended vaccines

A

Developmental
No baseline data yet

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29
Q

HP2030: Increase the proportion of women who get the Tdap vaccine during pregnancy

A

Developmental
No baseline data yet

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30
Q

HP2030:Increase the proportion of people who get the flu vaccine every year (6 months and older)

A

Not meeting goals
Below baseline and target

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31
Q

HP2030: Decrease the percentage of children in the United States who receive 0 doses of recommended vaccines by age 19 to 35 months

A

Not meeting goals
Any reduction is wanted

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32
Q

HP2030: Increase the proportion of people with vaccination records in an information system

A

Developmental
No baseline data yet

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33
Q

strategies in place to increase vaccination rates

A

-shool vacination rates
-immunization information systems
-vaccines for children program
-site specific workflow strategies
patient interaction strategies

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34
Q

Apply the ethical principles of justice and autonomy to vaccination exemption

A

-Benefits: Prevent adverse effects of vaccine in the individual child, freedom to express autonomy
-Burden: Individual child is at risk of preventable infection but will be protected by herd immunity at low levels of exemption; high levels of non-medical exemptions lead to outbreak of disease in society

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35
Q

Explain how community pharmacies and pharmacists can overcome patient barriers to vaccination

A

increased access and education

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36
Q

List the challenges that affect pharmacist ability to provide vaccinations

A

time, liability, reimbursement,
timing of vaccinations, and keeping up to date

37
Q

vaccine barriers: patient

A

-limited access
-vaccine cost
-lack of awarness
-concerns about safety

38
Q

Vaccine barriers: health care provider

A

1)multiple competing priorities
2) Challenges in coordinating care among
multiple providers
3) Complicated immunization schedule
4) Vaccine cost and reimbursemen

39
Q

True or False: Wisconsin has room to improve routine pediatric immunizations, HPV for adolescents,
pneumococcal and zoster for adults, Tdap in pregnancy, and influenza for kids.

A

False, for everybody

40
Q

Describe the prevalence of tobacco use across the U.S.

A

-11.5% of adults are smokers
-is overall down from previos years

41
Q

Calculate an expected target market for tobacco cessation services

A

20% or 20%

42
Q

Identify the Healthy People 2030 objectives related to medication access and their
status (goal met, improving, worse, etc.)

A

(1) reduce the proportion of people who can’t get
prescription medicines when they need them (goal met)
(2) increase the proportion of adults under age 65 with
prescription drug insurance (improving but not yet at goal)

43
Q

List the four most common barriers to filling a new prescription

A

-financial hardship
fear or experience of side effects
-generic concerns about medications
-lack of perceived need for the medication

44
Q

Describe trends in the types of patients who use strategies to reduce prescription
costs

A

Insurance status and income are both important factors related to the use of cost-saving strategies for medications among
patients 18 and older.

45
Q

Describe the positive and negative aspects of patient assistance programs and
medication samples

A

-support the individual patient in accessing medications
-but may contribute to continued high cost of medications and cost of care overall.

46
Q

Explain how physical access to medications may be limited

A

lack of transportation or due to lack of pharmacies
(pharmacy deserts) which can occur in both rural and urban settings

47
Q

List the factors associated with pharmacy closures

A

-urban areas: low income populations
-independent pharmacies
-Black, Hispanic/latino areas

48
Q

List ways that pharmacies and communities can support physical access to
medications

A

-bring medications to patients
-fill transportation needs

49
Q

Healthy People 2030 leading health indicator related to chronic
disease management and recognize that there are many other objectives related
to chronic disease

A

-focuses on blood
pressure control

50
Q

Identify the three chronic disease focus areas for Wisconsin

A

-heart disease
-stroke
-diabetes

51
Q

Define comprehensive medication management and recognize included services

A

CMM is the standard of care that ensures each patient’s medications are individually assessed
to determine that each medication is appropriate for the patient, effective for the medical
condition, safe given the comorbidities and other medications being taken and able to be taken
by the patient as intended

52
Q

Explain the role of collaborative practice agreements in comprehensive medication
management

A

Some services within CMM cannot be independently provided by a pharmacist and require a
collaborative practice agreement with a physician

53
Q

List the broad categories of outcomes that result from comprehensive medication
management and recognize examples within each category

A

-better care: less adverse effects
-reduced costs: cost of medications
-improved patient provider experiance: satisfaction in care and work
-improved access to care: decreased wait times

54
Q

Explain the difference between medication therapy management and
comprehensive medication management

A

-MTM: more medication focused and episodic
-CMM: more interprofessional, patient centered, more accountibility

55
Q

List challenges to implementing comprehensive medication management

A

-reimbursement
-staffing/time
-management support
-awareness of value
-access to patient information
-limitation of pharmacist scope of practice

56
Q

ADR

A

-adverse drug reaction
-harm from appropriate use

57
Q

ADE

A

-Adverse drug event
-harm occurs from appropriate and inappropriate use

58
Q

why ADR
and ADE prevention is important

A

prevent adverse reactions

59
Q

Identify and describe the activities associated
with Initiating, Monitoring and Managing Drug
Therapy.

A

-Initiating: patient seeks treatment and gets drug
-Monitoring: identify progress, problems, act on data, document
-Managing: identify solutions, act, document

60
Q

Describe why falls prevention is a problem
among older adults and why MTM can help

A

-many drugs can increae falls risk
-pharmacist can help improve safety and reduce falls

61
Q

Identify and describe why specific aspects of the
MTM Falls Prevention program were designed
and the barriers that they overcame.

A

-tools
-technology
-collaborations
-communication
-payment

62
Q

Understand the mortality and morbidity of prescription opioid misuse
and abuse in Wisconsin

A

-claims that “concerns about opioid addiction are basically unwarranted”

63
Q

Describe multiple roles for a pharmacist as it relates to the opioid
epidemic

A

-naloxone dispensing: standing order allows dispensing ithout perscription

64
Q

Explain the role of the pharmacist in prescription drug abuse
prevention

A

-naloxone
-drug take back
-naltrexone injections

65
Q

Describe the statewide naloxone standing and its allowances

A

allows dispensing of naloxone without a perscription

66
Q

Differentiate the PDMP’s role from the prescriber and dispenser
perspective

A

-perscribers must check beore dispensing controlled substances

67
Q

Summarize the CDC’s opioid guidelines

A

-try non-opiod therapy first
-realistic pain goal
-immediate release first
-test patient for illict use
-more

68
Q

identify areas in which
pharmacists can be involved in opiod prevention

A

-communication
-look for red flags
-verify susicious perscriptions
-consult PDMP
-talk to perscriber

69
Q

Explain why the impact of medication use on the environment is a current and growing
concern

A

-global population is on the rise
-increased medication use=more enviormental impacts

70
Q

List ways that medications enter the environment and their resulting impact

A

-release from production facilities
-excreted by humans/animals
-inappropriatly disposed

71
Q

Explain why environmental plastic is an important concern for health care

A

-healthcare generates a lot of plastic waste
-91% is not recycled

72
Q

Explain how disposal of plastic impacts the environment and human health

A

-Plastic has multiple impacts on human health when it is inappropriately disposed and ends up intact in the environment as well as when it is “appropriately” disposed in a landfill or
incinerated
-CNS, respritory, cardiac, hormonal effects

73
Q

List two types of medications that contribute to greenhouse gas emissions

A

-anestesia gases
-metered dose inhalers

74
Q

Provide examples of how a pharmacist can minimize waste and optimize disposal of waste
in their care settings

A

-recycle
-minimize waste
-easy disposal system
-education
-more

75
Q

Explain how a focus on preventive care can reduce the environmental impact of health care

A

-reduce demand for healthcare services
-overall, reduces impact of healthcare

76
Q

Describe the origins of apothecaries and their role in Western Civilization.

A

-developed over 1000 years
-values passed along generations
-small buissness mentality
individualism and personal reputation
-first arose in Islam

77
Q

Discuss how American pharmacy evolved.

A

-1821
-eastblished by druggist and apothecaries
-night school
-taught chemistry and materia medica

78
Q

Define characteristics of socialization in pharmacy

A

-confidentiality
-caring
-responsibiliy
-accuracy
-integrity
-frugal and practical
-problem solving

79
Q

Outline educational shifts to address professional aspirations in US pharmacy

A

-advocate for pharmacist rather than druggist
-Durham-Humphrey Amendment
-code of ethics
-growth in hospital pharmacy
-new drugs

80
Q

Characterize the paradigm shift in pharmacy practice that occurred with the general
adoption of Clinical Pharmacy in the 1960s and 1970s

A

-“Right Drug, Right Patient, Right Time”
-The mission of pharmacists is to help people
make the best use of their medicines: patient oriented

81
Q

Explain the importance of interrole congruence in pharmacist-patient communication

A

-Communication length and content are increased
-communication problems can occur when there is incongruence

82
Q

List barriers that inhibit the patient from asking the pharmacist questions

A

how they perceive the pharmacist, or because of their own fear
or misconceptions of the pharmacist’s role

83
Q

List barriers that inhibit the pharmacist from initiating counseling and asking questions of
the patient

A

fear of the patient’s reaction or waiting for the patient to
initiate

84
Q

Describe the Care and Respect Cycle

A

the cycle of dysfunctional pharmacist and patient behaviors that reinforce each other, resulting in lack of counseling and low quality patient care

85
Q

Describe the discrepancies between patient and pharmacist expectations in each others’
roles and where the pharmacist role is congruent

A

-Pharmacists: expectations for patients regarding the patient’s information-sharing and
responsible behavior roles than patients have for themselves. -Pharmacists also have more expectations for their own responsible behavior role than patients have for them.
-Patients and pharmacists agree on the pharmacist’s information-sharing role.

86
Q

Define CRO and PRO and explain how these impact pharmacist-patient communication

A

CRO and PRO are the pharmacist’s and patient’s attitudes toward communication with each other,
respectively. High CRO results in an increased incidence of verbal instruction, interaction time, and
pharmacist approachability. High PRO increases length and content of communication.

87
Q

List strategies to improve pharmacist-patient communication

A

Communication can be improved by addressing the barriers and changing expectations and attitudes.

88
Q

Contextual cues

A

any stimuli to which an individual is exposed in a pharmacy environment which can
affect a patient’s or pharmacist’s cognitions and behaviors as related to pharmacist-patient communication

89
Q

Five A’s

A

-ask
-advise
-assess
-assist
-arrange

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