The Public - Sem1 Flashcards
1
Q
Describe the relationship between infectious disease and public health
A
- Control of microbes and understanding of infection is required to uphold public health
- Spread of infection has a negative effect on public health
2
Q
What is the role of the pharmacist in managing public health?
A
- Understand the cause of the disease
- Manage spread of disease: treatment of those infected and educating on preventing transmission
- Work with other clinicians to find best course of treatment
- Educate public on symptom recognition and management
3
Q
Describe the role of the community pharmacist
A
- Promotion of public health and pharmaceutical services
- Dispensing prescriptions
- Medicines disposal
- Encourage self care
4
Q
What are the advanced pharmaceutical services?
A
- MEDICINES USE REVIEW: Discussing treatment with patients, especially for those with long-term conditions
- NEW MEDICINES SERVICE: Working with patients for new medicines, important to improve adherence
- APPLIANCE USE REVIEW: Improving the way an appliance in used by a patient
- STOMA APPLIANCE CUSTOMISATION: Customisation of a stoma device to increase comfort for the patient
- FLU VACCINATION: Seasonal, given to those at a higher risk
5
Q
What are the local pharmaceutical services and what do they depend on?
A
- Depend on population needs
- Stop smoking
- Substance misuse
- Minor ailments
- Emergency hormonal contraception
- Chlamydia screening
6
Q
What is the national agenda for pharmacists in GP practices?
A
- 470 pharmacists in 700 GP practices, carried out over 3 years
- Scheme = £31million
7
Q
Describe the role of a GP pharmacist
A
- Prescription requests and medication queries/reviews
- Routine blood tests and patient clinics
- Reduce medication wastage
- Manage long-term conditions
- Train pharmacy mentees
8
Q
What are the outcomes of public health from pharmacists working in GPs?
A
- Better access to healthcare
- Pick up excess from GPs and nurses, from budget cuts
- Ensure effective use of medication
- Become a first point of patient care
9
Q
What are the entry levels of GP pharmacists?
A
- Pre-reg, senior staff have a support/mentoring role
- Junior pharmacist, senior staff support and mentor but juniors also support and mentor pre-reg. REFLECT on learning through this role
- Senior pharmacists, support those below them while reflecting on their now understanding of pharmacy
10
Q
Describe the career pathway for GP pharmacists
A
- Progression from pre-reg to senior pharmacist
- Learning through mentoring others
11
Q
Describe the direction of GPs and pharmacists
A
- Promote care through pharmacist - primary/secondary care
- Established career pathway, new roles for pharmacists
12
Q
Describe the role of industrial pharmacists
A
- Drug development - discovery, design and research
- Manufacture for clinical trials, more pharmaceutical development depending on response
- Patenting, sales and marketing of drugs
13
Q
Give an overview of the stages of drug development
A
- Understand the chemical properties of the drug and the importance to its design
- Design of formulation(s) and dose
- Understand how the chemical properties of the drug affect its absorption, solubility, metabolism,
- Understand how the rate/extent of absorption is affected by the dose and formulation
- Develop and manufacture the drug
- Create patent for the drug
14
Q
Describe the role of a hospital pharmacist
A
- Ward-based role
- Working in the dispensary, preparing prescriptions for in- and outpatients
- Extemporaneous preparation of medicines in a sterile setting
- Providing information on medicines
- Managing medicines for patients/clinicians
15
Q
Describe the role of an academic pharmacist
A
- TEACHING YOUNGER PHARMACISTS
- Involved in setting/marking assignments and exams
- Scholarship - Sharing of knowledge and practice and conferences
- Social - Media, events, school visits, expressing the importance of pharmacy in public health
16
Q
Outline the evolution of clinical pharmacy
A
- Traditional pharmacy activities (e.g. dispensing)
- Ward/clinical roles
- Increased role of pharmacists in hospitals
- Prescribing
17
Q
What are the pay grades for a hospital pharmacist?
A
- Newly qualified (Band 6) = £26, 041 - £34, 876
- Further study and training (Band 7) = £31, 072 - £40, 964
- Senior pharmacist (Band 8A-8D) = £39, 632 - £81, 618
- Senior pharmaceutical manager (Band 9) = £77, 850 - £98, 453
- Salary varies depending on skills, training and knowledge, as well as between NHS and private
18
Q
How do hospital and community pharmacists work together for patient care?
A
- Hospital pass on treatment plan to community after discharge
- Discuss information to improve compliance (MUR and NMS)
- Share info on patients with misuse history
19
Q
Identify the contribution of hospital/academic pharmacists to public health
A
- Integration of pharmacy into healthcare - increase public awareness of pharmaceutical services
- Uphold standards of patient care
- Comprehensive disease management (public education etc)
20
Q
What is the meaning of public health medicine? Identify its domains
A
PHM - Improving population health
- Health Improvement: Through monitoring public health and educating the population
- Improving Services: Planning new services based on evaluations of existing ones and their efficacy
- Health Protection: Protect from infection (prophylactic use of medication/education of reducing transmission)
21
Q
What are the limitations to public health education?
A
- Action depends on the individual and their circumstances
- Some may be adverse/unable to change
- No effect on poverty
- Not very effective
22
Q
Describe health promotion
A
- Combination of education and environmental/legislative change
- Makes healthier choices easier
- More effective than health education
23
Q
How can pharmacists improve public health?
A
- Monitor prescribing data and identify inequalities
- Develop policies and practices for health education
- Improve services through regular evaluation
- Health protection practices: monitoring bacterial resistance and managing epidemics
24
Q
Describe the role of the World Health Organisation in health promotion
A
- Worldwide guidance/standards for health and healthcare
- Working with governments to improve healthcare programmes
- Development and sharing of health technology and information
25
What are the 4 key commitments for the Bangkok Charter for Health Promotion?
Health Promotion should be...
1) A central part of the global development agenda
2) A core responsibility for all governments
3) A key focus of all communities
4) A requirement for good corporate practise
26
Define compliance, adherence and concordance
- Compliance and Adherence: Following a clinical prescription as directed by a clinician
- Concordance: Working with health professionals to decide a course of treatment (patient's needs taken into account)
27
How can compliance and adherence be measured?
- Direct: Measure drug concentration in the body, keep patients under observation during treatment
- Indirect: Tablet counts and dispensing records, electronic monitors, ask patient
28
What are the types of non-adherence?
- Intentional: Drug misuse/deliberately not taking for some reason
- Unintentional: Overdose/underdose due to poor understanding of treatment plan or poor fit to patient's life
29
What percentage adherence should be achieved to ensure efficacy of the treatment plan?
More than 80% adherence
30
How can adherence be improved?
- Simplify dose regimens: Lower frequency can make it easier for patients and prevent forgetfulness/effort to maintain treatment
- Alter formulation: May be able to combine medicines to prevent the amount taken/may make it easier for the patient to take
- Monitored dosage systems: Prevent over-/underdosing and forgetfulness
31
What can affect adherence?
- Disease: Long-term diseases may lower adherence due to the long duration of treatment and possible increase in the number of medications
- Patients lifestyle: Treatment plan should fit into their lifestyle as well as possible
32
How can concordance be measured?
- Patient's happiness regarding plan established together, ask about understanding of treatment plan (positives and negatives) and explain more if required
33
What is self care?
- Healthcare done by the patient themselves to maintain health and prevent illness
34
Why should self care be encouraged?
- Reduce resource wastage for minor treatments that do not require clinical attention
- Coping mechanism for a growing population
- Best mechanism for those with long-term conditions, they know best how the condition affects them and how to prevent this
35
What are the benefits of self care? (Patient)
- Better health and wellbeing
- Reduce severity of symptoms and disruption (e.g. from numerous hospital trips)
- Increased control, confidence and mental health
36
What are the benefits of self care? (Healthcare systems)
- Reduced need for emergency services
- Less wasted resources/unnecessary admissions
- Decrease GP visits by up to 40% and outpatient visits by up to 17%
- Decrease in A&E admissions by up to 50%
- Less use of medicines
37
What patients group would self care benefit the most?
- 60-80% of women
- Parents of young children
- Full time workers
- Elderly patients
38
Describe the role of the pharmacist in self care
- Decrease the amount of unnecessary GP appointments
- Treat minor ailments/give advice on treatment
- More convenient for quick visits
- Provide information on self care and make referrals where needed
- Provide information on medicines (e.g. suggesting non-proprietary version may reduce cost for patient)
39
What is the expert patients programme?
- Help for those managing long-term conditions
- Encourages patients to work with clinicians
- Run courses to teach patients self management
40
What is self medication?
- Selection and use of medications by the patient to treat a self-identified condition/manage the symptoms
- Can be used for prevention or treatment
41
What influences self medication?
- Less absence due to sickness
- Increased number of medicines from POM to P
- Better medicine availability
- May be better financially
- Communication regarding medicines
- Alternative treatments (e.g. home remedies)
42
What are the qualities of a profession?
- Specialised knowledge and skill applied to their work
- No self interest in their actions
- Objective and non-judgemental
- Adhere to guidelines for the profession
43
What are the benefits of being a professional?
- Status and higher social class
- Intellectually challenged
- Intellectual interests
- Job security
44
What is professional socialisation?
- Selection, training, recruitment and regulation of a profession
- In regards to those hired
45
How did medical, nursing and pharmacy professions develop into their current status?
- Regulations set
| - Monopolies created - Single aim for each profession
46
Why is Pharmacy considered a profession?
- Specialised knowledge of drug use/pharmaceutical science
- Can prescribe
- Need to be present for sale of POMs
- Regulatory bodies (GPhC and Fitness to Practise)
- Advice and health promotion given
47
Why isn't Pharmacy considered a profession?
- Less skills needed for dispensing
- Medicines not always sold in pharmacies
- May be instructed by other clinicians
- Not exempt from self interest (sale of medicines in community)
48
How will current initiative affect the professional status of pharmacy?
- Increased professional status
- Reduce number of medicines sold OTC
- Training undertaken to prescribe
49
What qualities are required of pharmacy students? (Patient)
- Ability to communicate
- Ability to show empathy and compassion
- Accept patient diversity and always remain confidential
- Adhere to code of ethics
50
What qualities are required of pharmacy students? (Pharmacist)
- Be aware of personal limitations and learn from/fix mistakes
- Continue to develop knowledge as medicine develops
- Teamwork
- Maintaining a professional appearance
51
How has the role of the community pharmacist in health promotion developed?
- Provide more health advice than was given before the NHS
| - Dispensing of medicines and educating patients on proper use
52
What are the different levels of involvement for pharmacists within health promotion?
- Self-led by patient and supported by pharmacy team
- Programmes run by members of pharmacy team
Programmes run by qualified pharmacist
53
What are the barriers to involving pharmacies in health promotion?
- Time: For the pharmacist and patient
- Money: Pharmacist payment for services as well as financial status of patient to pay for treatment
- Privacy: Presence of consultation rooms
- Public view: Are pharmacists trusted?
- Relevance: Pharmacist's ability to help
54
What are the national priorities of the 'Choosing Health' strategy?
- Protect and improve national health
- Reduce health inequalities
- Create sustainable health care services
- Improve the public health system
55
How can a pharmacist contribute to the 'Choosing Health' strategy?
- Aim to reduce antibiotic resistance (education/avoid unnecessary use)
- Reduce incidence of TB (educate on transmission)
- Reduce the population undertaking harmful lifestyles (smoking, heavy drinking, obesity)
56
Define tolerance
- Loss of/reduced normal response to a substance
57
Define abuse
- Excessive use of a substance that is unrelated to medical practice
58
Define psychological dependence
- A feeling that requires administration of the substance to prevent related discomfort
59
Define physical dependence
- Physical disturbances that occur from not taking a regularly used substance
60
What are the patterns of drug use?
- Experimentation: Does not always progress into addiction or abuse
- Recreational: Used for fun
- Problematic: Affects mood/ability to function, individuals may resort to crime as a form of supply
- Addiction: Dependent on a drug
61
What affects the addictive potential (high) of a drug?
- Route of administration: Injecting creates a much faster and more prominent high, therefore more likely to create and addiction
62
What types of drugs are there?
- Stimulant: Quickens action of nervous system, creating euphoria and excitement
- Depressant: Dampens action of nervous system, causing euphoria, content and wellbeing
- Hallucinogen: Perceptions become distorted, and something of a fantasy
63
What are the legal drug classes? (Give examples)
- Class A: Most serious; include, LSD, ecstasy, heroin, cocaine, crack, mushrooms, injecting amphetamines
- Class B: Amphetamines, cannabis, ritalin, pholcodine
- Class C: Painkillers, ketamine, tranquillisers
64
How is drug misuse measured?
- Offences (responsible for 68% of crime in Britain)
- Surveys
- Treatments (although not all misusers may be identified)
65
Why is 'harm reduction' adopted in terms of drug misuse?
- Drug abusers may not stop just because of damage to health
- May not seek advice due to fear of getting charged
- Approach to help misusers inject safely if they're going to do so - prevent wasted resources from injury through drug misuse
66
What techniques are used for harm reduction in drug misusers?
- Education: Teach them how to safely inject
- Supply: Give sterile equipment to reduce the incidence of disease such as HIV
- Safe disposal: Ask for used equipment to be returned and dispose of it properly (prevent diseases from sharing of needles)
