Test 2 Flashcards
CER
the generation and synthesis of evidence that compares the benefits and harms of alternative methods to prevent diagnose treat and monitor a clinical conditions or to improve the delivery
1972
Office of Technology Assessment; advised congress on the effectiveness of healthcare
1975
national center for healthcare technology; endorsed research on a team
1989
Agency for Healthcare Policy and Research aka Agency for healthcare Research and Quality; led to 2003
2003
the medicare prescription drug, improvement and modernization act; facilitate the development of evidence and update practice guidelines
2010
Patient Centered Outcomes Research institute
American Recovery and Reinvestment Act
Feb 2009; increased CER by 1.1 billion; federal coordinating council for CER
federal coordinating council
to assist agencies of the federal government in coordinating comparative effectiveness and related health services research; includes AHRQ, NIH, CDC, CMS, FDA, VA
coordination functions
research infrastructure, workforce development, methods development
efficacy
extent to which a healthcare intervention is beneficial when administered under optimal circumstances
effectiveness
extend to which a healthcare intervention does more good than harm in real world patient populations
tenets of CER
from patient perspective or population perspective
compares at least 2 alternative methods
describes the results at the population and subgroup levels
measures outcomes
employs methods and data sources appropriate for the decision of interest
conducted in settings similar to where the intervention will be used
different types of data sources utilized in CER
experimental studies
prospective observational studies
retrospective studies
decision models with or without cost information
systematic reviews of existing research including meta analysis
stakeholder
individual organization or communities that have a direct interest in the process and outcomes of a project research or policy endeavor
stakeholder
represent a broad range of individuals selected to create a shared understanding and make effective decisions; patients and consumers, clinicians, healthcare providers, payers and purchasers, policymakers, regulators, life science industry, researchers, research funders
race
ones physical characteristics and or genetic/biological makeup; social construct; associated with superiority and inferiority; 15 on the last census
ethnicity
characteristic of ppl who share a common and distinctive racial, national, linguistic, or cultural heritage; geographic origins, religion, roles, patterns, etc; 2 on the last census
culture
integrates pattern of human behavior; passed from generation to generation, a given person can have numerous of these; changes overtime
3 ways culture can effect a persons health and experiences of healthcare
perceptions of health and illness beliefs about why and how illness occurs health behaviors how symptoms are described and how concerns are expressed how treatment is pursued and followed
unconscious bias exists
acquiring and storing social knowledge fro experiences and learning
2 or more ways health care providers can minimize the harmful impact of their biases
stereotype replacement counter stereotypic imagining individualization perspective taking increasing opportunities for contact with individuals from different groups partnership building
CLAS standards
culturally and linguistically appropriate services; dept of health and human services as a way to improve quality of services provided to all individuals which will help achieve health equality
TOC
transitions of care; movement of patient within a healthcare system or between healthcare systems and providers to receive care
pre discharge
med rec
patient education
discharge planning
scheduling of followup appointments
post discharge
follow up phone call
communication with ambulatory provider
home visits
bridging
transition coach
patient centered discharge
clinical continuity with inpatient / outpatient providers
patient groups at risk
older adults persons with limited health literacy terminal patients children with special needs patients taking more than 5 meds cognitive complex medical behaviors health conditions patients with disabilities lower patient incomes new admits LTCF homeless
pharmacists roles and responsibilities
medical reconciliation
participate in rounds
evaluate appropriateness of drug regimen
anticipate and resolve drug problems
communicate changes in drug therapies to providers
adapt teaching of drug regimen to level of education/literacy
preform hoe visits
review automated refill programs
help with interpretation of discharge paperwork
assist with third party formulary review and selection of covered medications for patients
plan for improving medication management during TOC
start patient education earlier
use established educational techniques
follow up with patient after discharge
health literacy
the degree to which individuals have the capacity to obtain process and understand basic health information needed to make appropriate health decisions
federal health literacy initatives
Section 3507 of the ACA - label and print advertising
Healthy Ppl 2020 - increase reports easy to understand instructions, repeating back directions, help fill out forms
other national initiatives
National Action Plan to improve health literacy - goal that health services are delivered in ways that are easy to understand and that improve health longevity and quality of life
health literacy online
health literacy workgroup
health literacy initiative in Alabama
alabama health literacy initiative
health literacy resources for pharmacists
AHRQ patient assessment tools pharmacist specific: AHRQ Pharmacy Health Literacy Center CDC health literacy Health care providers collaborate health literacy tool shed
cost of health literacy
increased hospital visits and admissions increased prevalence and severity of chronic disease states increased mortality increased med errors decreased preventative services
prevalence of health literacy
80 million US adults
12% of US adults are expected to have proficient or effective health literacy
5 steps in which a pharmacist can help execute to help improve the health literacy of a community
identify patients at risk for health literacy conduct screenings
evaluate how pharmacy setting is set up to serve patients with limited health literacy
conduct a feasible interventions to target all levels of health literacy
conduct interventions to targeted patient populations
consistently evaluate health literacy change to validate efficacy
