safe med Flashcards
when a patient receives a prescription but never gets it filled
primary nonadherence
example of unintentional nonadherence
forgetting to take meds
example of intention nonadherence
not taking meds because you don’t like the side effects
therapy related factors that can influence adherence
regimen changes frequently
drug side effect
complex admin technique such as use of a spacer
med requires multiple daily dosing
(expensive is not a THERAPY related factor)
likely ways a pharmacist would assess med adherence of a patietn
ask patient to self report
assess patient’s refills
assess clinical response to med (BP Monitoring)
administer a questionnaire (SEAMS)
NOT electronic monitoring devices– those are mostly used in trials
concept of self efficacy means
assessing a person’s confidence that they can take their medications as prescribed
what adherence measure is endorsed by the pharmacy quality alliance (PQA)
proportion of days covered (PDC)
what is the PDC threshold above which patients are generally considered to be adherent
80%
Morisky-4 assesses for?
forgetfulness, abatement of disease symptoms, side effects
NOT affordability
what med adherence tool assesses self efficacy
SEAMS
Merck Adherence estimator assesses
affordability
harm/side effects
beliefs about meds
NOT forgetfulness
how can pharmacists improve med adherence
adherence packaging
med sync
simplifying the regimen
asthma control test
for patients 12 and older
(5 items, asks about the last 4 weeks)
depression screening with PHQ-2
is SCREENING only; not a diagnosis; have to get evaluated
GAD-7 is used for
screening for generalized anxiety disorder
what is DAST-10
questions on drug use, using yes/no questions
what is the opioid risk tool
self-administered tool assessing a patient’s history of substance abuse for alcohol and prescription/illicit drugs, includes personal and family history, male/female changes score, history of psych diseases is included in scoring
brief pain inventory short form
asks about how pain impacts patient’s daily living activities
stanford pain scale
uses 0-10 pain scale with detailed descriptions for each number ranking
what is STEADI
screens for fall risk
REALM-SF
does not assess for numeracy
requires subjects to read 7 lay medical terms
takes less than a minute
newest vital sign (NVS)
nutritional label to assess health literacy
assesses numeracy
health risk assessments
some payors ask pharmacists to conduct
cover topics like diet, exercise, medical conditions, living situations
pharmacists can use to identify opportunities for patient services
when to administer NAC for APAP overdose
4 hr levels > 150 mg/dl
can’t plot it prior to 4 hr
acute on chronic toxic ingestion
elderly patient home meds include digoxin, etc and took triple their normal dose of digoxin
naloxone effect in individuals without acute opioid toxicity or chronic opioid dependence
no effect
naloxone is a reasonable treatment option for overdose of which substances
opioids, loperamide, dextromethorphan
t/f: when treating a digoxin overdose, if total serum digoxin levels rise 2 hours after Digi-Bind administration, give another vial of digi-bind
false
treatment of local snakebite (crotaline) species
elevate the limb
DO NOT TOURNIQUET OR ATTEMPT TO EXTRACT VENOM
poison help line number
1 800 222 1222
elimination techniques
gastric lavage
activated charcoal
whole bowel irrigation
hemodialysis
sodium bicarbonate is used for what toxicity
aspirin/salicylate
what type of med error: electronic order received, 10 times the recommended dose
error of commission
which occurs most frequently and which occurs least frequently: ADE, DRHC, medication error
most frequent: med error
least frequent: ADE
what type of incident is this: a patient developed AKI after receiving a combo of vancomycin and zosyn
ADE
patient’s INR was not checked. in what process node did this error occur
monitoring
computer provider order entry was developed to prevent medication errors in what node
prescribing
smart pumps prevent errors in what node
administration
guidelines for prescribers to adhere to when ordering medications
use a leading zero
do not use a trailing zero
use the metric system
strategies for low health literacy
use everyday words
use the teach back method “show me”
encourage questions
easy to read materials
repeat key messages
ADL assessments
Katz- assesses basic ADLs
Lawton IADL- assesses advanced activities like medication responsibility, shopping
cognitive impairment assessments
Mini-Mental State Exam (MMSE)
Mini-Cog
Abbreviated Mental Test (AMT)
Montreal Cognitive Assessment (MoCA)
Wong-Baked FACES pain rating scale
asks the person to choose the face that best describes how much pain they have. can be used in ages 3 years and older. commonly used in hospitals
CAT
COPD assessment test- not diagnostic- uses to assess disease severity
