T2: Week 7 Flashcards
What is professionalism?
Set of attitudes and behaviors believed to be appropriateto to a particular occupation. How professions conduct themselves in professional situations
Why is professionalism important?
- You
- Profession of pahrmacy
- Members of healthcare team
- Patients
- Society
What are examples of business etiquette?
- Appropriate behavior in a business or professional setting
- Presents a professional image
- Good interactions with others at work
- Not the same as social etiquette
- Varies by organization, geographical location, and generations
How should you dress for professional interviews?
Wear well tailored, clean, conservative clothing that is within the geographical norms
What are the differnet styles of dress professional events?
- Formal (white tie, black ties, black tie optional)
- Semi-formal
- Business formal
- Business casual
What questions do you ask to conduct yourself?
- Where am I
- Who am I
- What am I doing
What is the art of a professional handshake?
- Watch for cues
- Both men and women
- Stand up
- 2-3 shakes
- Firm
How should you make professional introductions?
- State the name of the person being introduced to (‘higher-ranking’ person).
- Say “I would like to introduce” or “this is,” etc.
- State the name of the person being introduced (‘lower-ranking’ person).
- Offer some information to assist with starting the conversation
How do you formally address men?
Mr
How do you formally address women?
- Ms
- Mrs
- Miss
What are the parts of a formal email?
- Salution
- Honorific
- Professor’s last name
- Nicety
- Reminder of your connection
- Reason for your email
- Show that you tried to resolve the issue before you ask
- Polite clear restateme of what you want the professor to do
- Sign off
- Signature
- Follow-up
What are the conversational do’s?
- General interest
- Sports
- Topics unique to the profession
What are the conversational don’ts?
- Politics
- Religion
- Controversial topics
- Language or topics suited for a bar
Why is a thank you note important?
A written thank you is always appropriate when you want to show gratitude
What situations would you write a thank you note?
- An interview
- Recieving a gift
- Someone has done something for you
- After each rotation
What are the parts of a thank you note?
- Date
- Greeting
- Opening
- Body
- Closing
- Signature
What is medication adherence?
Missing a does or taking a dose late
How do we know whether or not a patient is adherent
Do they take the medication as prescribed?
Do they continue to take the medication?
Why do patients take medications?
- Feel and accept that something is wrong with them
- Feel motivated to prevent future problems by taking the medication
- Believe that in the long run the pros outweigh the cons of taking the medication
What are the types of nonaderence?
Intentional and unintentional
What are the characteristics of intentional non adherence?
- Resistance
- Does not meet reasons patients take medication
- Cost
- Adverse effects
What are the characteristics of unintentional non adherence?
- Lack of routine
- Confusion
- Trouble with device
- Lack of understanding of necessity
What is the reality of the misconception “Providers “manage” a patient’s chronic disease?”
- The only time a provider manages a disease is by follow-up
- Remainder of time the patient manages the disease
What is the reality of the misconception “Providers believe that they can motivate patients to adhere with their therapeutic regimen?”
- Behavior sciences have shown that all motivation is self-motivation
- Cheerleading style approaches have limited utility and may lead to decreasing rates of adherence.
What is the reality of the misconception “If providers clearly explain the risk of suboptimal adherence, patients will automatically be motivated to take their medication as prescribed?”
A threatening, chastising approach has limited utility and may lead to results that are opposite of what they are trying to accomplish.
What is the reality of the misconception “For chronic disease therapy, an 80% adherence rate has been hailed as the amount needed to get benefit?”
There has been no evidence to definitively support an 80% adherence rate for benefit.
What is the reality of the misconception “Elderly patients have lower medication adherence rates than younger populations?”
The elderly generally take more medications and have more barriers to adherence, their actual adherence rates are better than younger populations
What is the reality of the misconception “Educating the patient should be enough to ensure optimal adherence?”
That traditional educational programs have little/no effect on medication adherence in asymptomatic chronic diseases
What are the requirements for medication adherence?
- Sufficient understanding of the disease and medications
- Motivation to take the medication
- Implementation of necessary behavior changes
What are the risk factors for suboptimal medication adherence?
- Mental status
- Difficult living conditions
- Substance abuse
- Language/culture/health beliefs
- Complex treatment
- Lack of transportation
- Physical handicaps
- Previous adherence history
- Disease state
- Ability to pay
What are examples of mental health risk factors?
Dementia, depression, schizo
What are examples of difficult living condition risk factors?
Homeless, family stress, job stress
In what ways can we measure medication adherence?
- Subjective measures
- Objective measures
How can we subjectively measure adherence?
Patient interviews by open-ended and probing questions
How can we objectively measure adherence?
- Refill record (eyeball method and medication possession ratio)
- Pill counts
- Control of the chronic disease
- Serum medication levels
What are the limitations of subjective measures?
- Lack of accuracy with patient interviews due to forgetfulness
- Poor provider-patient rapport and communication due to embarrassment
- Telling the patient what they want to hear due to the desire to avoid punishment
What are the limitations of objective measures?
- Time consuming and impractical
- Limited access to refill records
- Filling at multiple pharmacies
- Variations in drug levels
- Masking nonadherence
What is the most accurate approach to measure adherence?
- Non fool proof method to determine
- Set the stage and use patient interview, plus one or more objective measures of adherence
How do we set the stage for patient interviewing for non adherence?
- Let them know you want their honest opinion
- Tell them you will ask about 3 issues at each visit
What are the 3 issues you addressing during adherence interviewing?
- How is the medication working
- What kinds of problems do you think the medication might be causing?
- What kinds of problems might you have in remembering to take your medications?
How should we respond to adherence issues?
- Focus on the issue, not the behavior
- Use active listening/reflection
- Normalize adherence issues
What are some behavioral interventions to improve adherence?
- Develop a routine
- Simplify the treatment regimen
- Minimize the cost
- Tailor the regimen
- Confirm administration technique
- Reward patient success
- Increase attention
- Enlist support of others
- Use adherence aids
- Use motivational interviewing
What are the types of electronic technologies to improve medication adherence?
- Electronic reminders
- Smart pills
- Smart bottles
- Smart caps
- Electronic medication dispensers
- Mobile technology
What are benefits of electronic reminders?
- Inexpensive
- Easily accessible
- Sound alerts
What are the comments of smart pills, bottles, and caps?
- Costly
- May require internet
- Sound and light alerts
4,. Notification and tracking - Caution with cap switching
What are the comments on electronic medication dispensers?
- Moderately expensive
- Controlled access capability
- Notification and tracking systems
- Need to replenish monthly
