Term
| Definition of Public Health |
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Definition
| Science and the art of preventing disease, prolonging life, and promoting physical health and efficiency.. to ensure every individual in the community a standard ofliving adequate for the maintenance of health |
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Term
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Definition
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Term
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Definition
| Assure conditions necessary for people to live healthy lives, through community wide prevention and protection programs |
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Term
| Public Health vs. Medicine |
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Definition
Public health focus on population; promotes health for the whole community and has emphasis on prevention.
Medicine focuses on primarily the individual; it promotes care for the whole patient and has emphasis on diagnosis and treatment |
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Term
| Causes of death 1900 related to now |
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Definition
1900-Diarrhea, TB, and Pneumonia
Now-Heart Disease, Cnacer, Stroke |
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Term
| 10 Essential Public Health Services |
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Definition
Monitor health status
Diagnose and investigante health problems
Inform, educate, and empower poeple
Mobilize community partnerships
develop policies and plans
enforce laws and regulations
link people to needed personal health services
assure a competent health workforce
evaluate effectiveness accessability and quality
Research |
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Term
| Core Functions of Public Health Agencies |
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Definition
1. Assessment-The regular systematic collection, assembly, analysis, and adissemination of information on the health of the community.
2. Policy Development-exercise the responsibility to serve the public in the development of comprehensive public health policies
3.Assurance- the services necessary to achieve the agreed upon goals provided: encouraging actions of other entities, requiring action through regulation, providing services directly |
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Term
| Goals of Healthy People 2010 |
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Definition
1. Increase Quality and Years of Healthy Life
2.Eliminate Health Disparities |
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Term
| Healthy People 2010 Leading Health Indicators |
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Definition
1.Physical Activity
2.OVerweight and obesity
3.Tobacco use
4.Substance Abuse
5.Responsible Sexual behavior
6.Mental Health
7. Injury and violence
8. Environmental Quality
9.Immunization
10.Access to healthcare |
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Term
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Definition
Residual authority to act for public health.
Examples: Laws requiring vaccination, isolation, and quarantine
Reagulation of air and surface water contaminants
Restriction on the publics access to polluted areas |
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Term
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Definition
| The science and art of helping people change lifestyle to move toward a state of optimal health |
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Term
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Definition
| The activity undertaken by individuals for the purpose of maintining or enhancing their health, preventing health problems or achieving a positive body image |
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Term
| What relationship to disease factors have on disease? |
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Definition
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Term
| Uncontrollable disease factors |
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Definition
Cannot be controlled completely
Ex. Heredity/genetic traits
gender
Age
Environment |
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Term
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Definition
Can be controlled
Exercise
Nutrition and Diet
Rest and Sleep
Tobacco and Alcohol use
Drug use
Environment |
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Term
| What makes behaviors more resistant to change? |
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Definition
More likely to change when behaviors are still in developmental stages
Behaviors more resistant to changeinclude addictive, compulsive, and strong patterns and routines |
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Term
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Definition
Intrinsic factors that help or hinder a persons motivation to change
Ex. Knowledge, awareness, values, beliefs, "personal preferences" |
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Term
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Definition
Conditions in the environment that make it convenient or possible for desirable behavior to occur
-Usually immediate targets
-Include environmental conditions
-Skills and accessibility of resources
-Ex. Program/Resource |
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Term
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Definition
Positive or negative feedback after action.
Provides reward, incentive, or punishment for behavior
Ex. Negative reinforcement, no family support |
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Term
| Three levels of health behavior theories |
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Definition
Intrapersonal
Interpersonal
Community theories |
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Term
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Definition
| Individual charachteristics that influence behaviors |
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Term
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Definition
| A primary group, including family, friends, peers |
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Term
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Definition
| Social networks and norms, or standards which exist as formal or informal. |
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Term
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Definition
Focused on the relationship of health behaviors, practices, and utilization of health services.
Health actions are motivated in relation to the degree of fear and expected fear-reducing potential of actions |
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Term
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Definition
States of Chance
Behavior change is a process NOT an event |
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Term
| Five Stages of Transtheoretical model |
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Definition
Precontemplation
Contemplation
Decision/Determination
Action
Maintenance |
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Term
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Definition
Defines behavior as a three way dynamic, and recripocal interaction of:
Personal factors
Enviornmental Factors
Behavior |
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Term
| Diffusions of Innovation Theory |
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Definition
| Addressed how new ideas, products, and social practices spread within a society or from one society to another. |
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Term
| Community Organization Theory |
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Definition
Helps identify common probles and goals, mobilize resources, and develop strateges
Consist of three models
Locality of deelopment, Social planning and social action |
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Term
| Which theory explains the challenges of health behavior change? |
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Definition
| No single theory dominates |
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Term
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Definition
| Makes assumptions about a behvaior, health problem, or condition of people or enviromnental that are: logical, consistent with everyday observations, supported by past research and similar to previous successful processes. |
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Term
| What would a health literate patient be able to do from a pharmacy perspective? |
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Definition
Understand medication instructions (dosing/side effects)
Be aware of alternate treatments
Evaluate effects of medication (including adverse effects)
Be compliant and adherent with this medication
Seek followup and further treatment as needed |
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Term
| Role of the pharmacist in health behavior change |
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Definition
| As health professionals, pharmacists can actively participate in health behavior education and interventions to positively impact the health of individuals and communites. |
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Term
| Three key tasks of health promotion |
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Definition
1. Planning-Process to decide : topic to address; problems to accack; how to use time and resources
2.Implementing-process of actually presenting program activities and making direct contact with clients
3.Evaluation-process of monitoring client reaction, checking reasults and accessing quality and effectiveness or program. |
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Term
| What do health promotion models provide? |
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Definition
| Direction and supply a framework on which to build |
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Term
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Definition
| Most popular and widely used of current health promotion models |
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Term
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Definition
Predisposing
Reinforcing and
Enabling
Causes in
Education
Diagnosis and
Evaluation |
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Term
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Definition
Policy
Regulatory and
Organization
Contructs in
Educational and
Environmental
Development |
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Term
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Definition
Administrate statement that guides planning and decision making
Overall direction and purpose of organization
Should contain philosophy of organization
Specifies level and type of services to be provided to which population |
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Term
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Definition
Statement of quantifiable desired future sate or condition
-Usually long range
-Relatively broad in scope
-Usually lacks deadlines
_Provides guidance for establishment of objectives |
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Term
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Definition
Short term, measurable, specific activity with time limpt for completion
Specify who, to what extent, under what conditions, what what standards activities are to occur, outcomes expected, specific tasks essential to accomplish already determined goals. |
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Term
| WVU SOP mission statement |
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Definition
| Improve the health and well being of WV's and society at large by education student and practitioners to provide optimal pharmaceutical care conducting vital research that advances scientific knowledge, pharmacy practice, and econnomic development; and prodicing direct and supportive servieces to pateients, the community and the profession |
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Term
| Pre diabetes/Pre diabetic |
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Definition
Impaired fasting glucose
Impaired glucose tolerance
Almost always precedes development of type 2
Increases risk of heart disease
Fasting Glucose 100-125
Random Plasmna Glucose 140-199 |
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Term
| Treatment of pre-diabetes |
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Definition
| Goals include greater/equal to &% weight reduction, at least 150 minutes of exercise per week of moderately inteste activity |
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Term
| Risk factors for development of type 2 diabetes |
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Definition
Age 45 or older
Overweight (BMI >25)
First-degree relative w/ diabetes
High risk ethnic group
Pre-diabetes
History of GMD or delivery of baby weighing >9lbs
Hypertension
HDL<35 and or TF>250
PCOS
History of vascular disease |
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Term
| Interventions for preventing diabetes |
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Definition
Lifestyle Modifications
-Weight loss (5-10%)
-Physical Activity (150 min/week)
Drug therapy
-Metformin may be considered in those who are at very high risk for developing diabetes and who are obese and under 60 years of age |
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Term
| Weight management/Lifestyle factors |
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Definition
Dietary management
Increased physical activity
Aquire new skills |
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Term
| Dietary management strategies to give patient |
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Definition
Access readiness to change
Access dietary habits
Formulate eating strategy
Direct patient toward nutrition resources
Establish follow up
Direct patient toward nutrition resources |
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Term
| Counseling theraoies for health behavior |
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Definition
Delveop goals Educate on componets of a healthy diet
-calorie reduction
-Reinforces progress
-Food diary
-and strategies
-Education of food portions |
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Term
| Skills patients need for behavior change |
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Definition
Self monitoring
Stimulus control
Goal setting
Cognitive restructuring
Problem solving |
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Term
| Important concepts related to the pharmacist and diabetes care management |
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Definition
Glucose monitoring
Glucose meter training
Insulin and Diabetic Medication Counseling |
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Term
| Who makes up the diabetes care team |
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Definition
Physician
Registered dietitian
Exercise physiologist
Pharmacist
Dentist
RN
ETC
Work together in collaboration with a patient and the different aspects fo that patient's healthcare needs involving each healthcare wrokers specialty
Team will cause a decrease in diabetic hospitilizations, better compliance to a mdication therapy, and better overall results with managing the disease |
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Term
| Results and Importance of the Asheville Project |
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Definition
Purpose-access the clinical, economic and humanistic outcomes of pharmaceutical care services provided for two self insured employer groups of patients in 12 community pharmacies in asheville NC
Results
-Significant reductions in A1C for the first 12 months of the program
-Reductions in LDL
-Decrease in total direct medical expenditures
-Decrease in sick days leading to greater productivity values at $18,000 |
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Term
| WV PEIA face to face program |
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Definition
Public Employees Insurance Aggency in WV
Based on Asheville Project
Offered to patients w/ diabetes and dependents
-Routine visitis w/ participating pharmacist of their choice for diabetes education and management
-Visits are goal oriented
-In return, patient receives waived co-payments (after meeting deduct) for specific mentioned diabetes related prescription drugs, supplies, and lab tests.
-Pilot 6 counties in WV (May 04-April 05) for patients with type to DM
Initially 24 pharmacists
Positive comments from PEIA members as well as clinical indicators promped PEIA to expand program statewide
2,000 active participants
120 pharmacists
PEIA weight management program reimburable if BMI>40; patient must share wt manaement journal with RPH at each F2F visit |
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Term
| Role of MTM in diabetes care |
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Definition
"Distinct service or group of services that optimize therapeutic outcomes for individual patients"
May include:
-Formulating a medication treatment plan
-Monitoring and evaluating response to therapy, inc safety and effectiveness
-Identify/resolve/correct medicatrion-related probelms
-Provide education and training
-Coordination of care |
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Term
| Pharmacists role in diabetes care specialists or diabetes educators |
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Definition
Select pharmacists can assist and reinforce DSME topics:
-Blood glucose meter selection and training
-SMBG follow up
-Download blood glucose readings
-Insulin injection technique and device training
-Self care topics
-Medication management
-Disease state management |
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Term
| Trends in adult cigarrete consumption in the US and factors for the increase in cigarette consuption over the last centrury |
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Definition
Cigarette smoking is the chief, singe, avoidable cause of death in our socity and the most important punblic health issue of our time
-Greatly started to rise after entrance into WWI, GreatD relaplse,
-Small relapse after link to cancer
-Marketing of filtered cigs=grow
-Surgeon general report=nall drop
-Nonsmokers movements rights, fderal tax doubles, Cali bans smoking in bars all made use drop |
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Term
| Smoking stats. How many use; how many want to quit? |
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Definition
1/5 US adults smoke
70% want to quit |
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Term
| Smoking by sociodemographic areas? |
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Definition
East>West
Highest=WV, Tennessee, Oklahoma
Nevada=high |
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Term
| Who is the biggest component to tobacco control? For every 1 dollar control spends, how much is spent by component? |
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Definition
Tobacco industry
1 dollar control=25 dollars industry |
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Term
| Tobacco marketing strategies |
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Definition
Smoking in movies
Marketing light cigs
Role models
Specific ages/groups targets |
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Term
| Main conclusions related to smoking/tobacco use? |
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Definition
Cardiovascular disease-29% Smoking
Lung Cancer-28%
Respiratory disease-23%
Secon hand smoke-11%
Cancers other than lung 8%
Other<1%
Reproductive Effects
Pulmonary diseases
Periodonatal effects (tobacco)
Oral lekoplakia
Cancer (Oral, Pharyngeal) |
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Term
| 2006 Surgeon General Report |
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Definition
Second hand smoke causes premature death and disease in nonsmokers
-Childen increased death SIDS, resp infections, ear problems, more severe asthma, resp symptoms/slowed lung growth
-Adults
*immediate adverse effects on cardiovascular system
*Increased reisk for coronary heart disease and lung cancer
*eliminate smoking indoors fully protects non smokers |
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Term
| Benefits related to quitting smoking |
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Definition
-Improved circulation; easier walking
-Lung unction increases (2 weeks-3 months)
Excess risk of CHD decreases to half of the continuing smoker (1 year)
Lung cilia regain normal function
Ability to clear lungs of mucous increases
Coughing, fatigue, SOB decreases
(1-9 years)
Risk of stroke is reduced to that of people who have never smoked (5 years)
Lung cancer death rate drops to half that of continuing smoker
Risk of cancer of mouth, thjroat, esophagus, bladder, pancreas, decrease (10 years)
Rish of CHD is similar to that of people who have never smoked (After 15 years) |
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Term
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Definition
Cigarettes-most common
Smokeless tobacco
Pipes
Cigars
Clove Cigaretts
Bidis
Hookah |
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Term
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Definition
Cigs/Tobacco Addictive
Nicotine causes it
The pharmacologic and behavorial processes that determine addiction to drugs such as heroin and cocaine |
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Term
Pharmacology of Nicotine
-Pharmacokinetics |
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Definition
Pharmacokinetics
A,D,M,E
Absorption-pH dependent(in acidic; ionized. Alkaline=neutral crosses membrane;7.4 it crosses
mouth pH=7.0
-Acidic=cigs (limited ab)
-Alkaline-Pipes cigars, others
Can be absorbed through the skin
Rapidly absorbed across lung(ph-7.4. Alveoli)
Distribution= Reaches the brain 1--20 seconds.
Metabolism=10-20%excretedunchanged
7-=8-% metabolized to cotinine; 10%oto other
Excretion
Half life=2 hr.
Contine=16 hr
Through kidneys (pH dependent_
Through breast milk |
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Term
| Nicotine Pharmacodynamics |
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Definition
Binds to receptors in the brain and other sites in the body.
Predominatey stimulatory effects
CNS
-Pleasure
Arousal
Improved task performacne
Anxiety Relief
Cardiovascular
Increase HR, Cardiac Out, BP, Coronary vasoconstriction; cutaneous vasoconstriction
Other: Appetite supression; Increased metabolic rate; Skeletal muscle relaxation |
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Term
| Biology of nicotine addiction, dopamine role, reward path. Withdrawl effects |
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Definition
Nicotine stimulates dopamine release, pleasurable feelings, repease administration, tolerance develops.
Reward Path-Nicotine enters brain; stimulates nicotine receptros, dopamine is released, happy
Withdrawl:
-Irratable
-Anxiety
-Difficulty concentrating
-Restlessness/Impatience
-Depressed mood/Depression
-Insomnia
-Impaired performance
-Increased appetite/weight gain
-Cravings |
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Term
| Parts of tobacco dependence |
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Definition
Physiological-addiction; medication
Behavioral-habit; behavior change problem |
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Term
| How can nicotine users self titrate? |
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Definition
Smoking/Dipping more frequently
Smoking more intensely
Obstructing vents on low nicotine brand cigarettes |
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Term
| Drug interactions with smoking |
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Definition
Have decreased effect due to CYP1A2:
-Bendamustine;Caffeine;Clozapine;Erlontinib;Flucoxamine;Olanzapine;Ropinirole;Racrine;Theophylline;Irinotecan
Incread effect:Clopidogrel
Hormonal Contraceptives |
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Term
Clinical Practice Guidelines for trating tobacco use and dependence?
Updated? |
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Definition
Updated May 2008
Sponsered by US departemnt of Public health, Health and Human Resources |
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Term
| Why should pharmacists address tobacco use with their patients and why is it important for a phamracist to be aware of a patients smoking status? |
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Definition
-Users should be encouraged to quit by health care professionals
-Screening for tobacco use and providing tobacco cessation counseling are positively associated wtih patient satisfaction |
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Term
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Definition
Ask
Advise
Assess
Assist
Arrange |
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Term
Resiness to quit tobacco use?
Stages
How pharmacist assesses it? |
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Definition
Stage 1 Not ready to quit in the month
2. Ready to quit in the next month
3. Recent quitter w. in the last 6 months
4. Former tobacco user. Quit >6 months ago
Do you ever plan to quit; benefits of now rather than later; what would have to change for you to have to quit sooner |
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Term
| Cognitive/Behaviorial Strategies that can help patients at differnt stages of readiness to quit. |
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Definition
Review commitment to quit, distractivve thinking, positive self talk, relaxation through imagery, mental rehearsal and visualization
Ex. Thinking about cigs doesn't mean you have to smoke one. When you are craving remind yourself that the urge will go away. As soon as you get up in the morning look in the mirror and say I am proud...
Behavioral:
Control your environment
Substrates for smoking (gum, candy)
Take a walk, breaking, self masssage
Actively work to reduce stress |
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Term
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Definition
Helps patients understand when and why they sue tobacco
Identifies activities or situations that trigger use
Can be used to develop coping strategies. |
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Term
| 3 Steps of brief tobacco counseling. |
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Definition
Ask-about use
Advise-to quit
Refer-to other resources (assist/arrange) |
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Term
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Definition
Tobacco cessation counseling provided via telephone
Staffed by trained specialists
Up to 4-6 personalized sessions
Some state quit-lines offer pharmaoctherapeutic (reduced cost)
Up to 30% success rate |
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Term
| Pharmacotherapies used in nicotine addiction |
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Definition
Patch
Gum
Lozenge
Inhaler
Nasal Spray
Bupropion
Vareniciline |
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Term
| Primary, Secondary, Tertiary Prevention |
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Definition
Primary-Before disease, to avoid. Most cost effective.
Ex. Immunization, Health Education, Counseling.
Secondary-Detecting disease early. Co-morbidity/pre-clinical disease. Can often affect history of disease or its progression to maximize well being.
Ex. Screening for hypertension, cholesterol, diabetes, breast cancer, colon cnacer, etc.
Tertiary- Involves care of the established disease.
Treatment for prevention of complications. Examples: MTM, physical therapy rehab, mental health outreach |
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Term
| Pharmacists Role in disease prevention and health promotion |
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Definition
Perform patient risk assessment and screening; support compliance and adherence to medication and behavorial therapies
-Deliever patient education on disease prevention and disease management strategies. |
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Term
What is disease management, why is it important, why should pharmacists be involved in disease management activities.
Examples of preventative and disease management pharmacy services |
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Definition
Evaluative approach to health care delivery that attempts to imporove outsomes for patients with a specific disease while optimizing the overall use of health care resources.,
Examples of services:Diabetes, osteoporosis, CD, Skin damage, weight management, glaucoma, mmunizations, asthaa allergy, etc.
Pharmacits b/c they are acessible, trused, DM sercices can increases compliance and improve treatment outcomes; point of care testing devices are often accessible and avaoilable. (lipid, a1c) |
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Term
| Mandatory components of DM programs |
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Definition
Contimuum of Care
Focus on patient health related outcomes
Optimizes economic outcomes
Use of clinical practice guidelines
Focus on chronic diseases
Implements continuous quality imporvement
Feedback to health care providers
Expanded role of pharmacists in drug therapy monitoring. |
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Term
| Steps in creating a DM program |
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Definition
Selection of disease state
Collection of baseline cost and utilization data
development of protocols
Health professional education
Data collection and management
Interventions on high risk patients involving multiple health professionals
Education of health professionals on benchmarking with peers
Reassessment/Evaluation of DM program. |
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Term
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Definition
69.4% of managed care organizations
Pharmacy Benetits Managers (PBMs) and pharmaceutical companies
Community pharmacists (52% chians and 40% independents) |
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Term
| What is a needs assessment? |
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Definition
Process of assessing and defining needs, opporitunites, and resources
Can ascents:
Gaps in services
Willingness of community
Help reach problems
Helps identify target pop |
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Term
| Process evaluation of the intervention |
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Definition
Used to evaluate the process by which the program is being implemented
-often overlooked
-should begin early
-Audit/peer/accredication/attendance/feedback/tracking |
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Term
| Impact evaluation of the health promotion interventions |
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Definition
Second level of evaluations
Immediat impact of program
Effectiveness of objectives;behvaiors
Exampines particpants rather than program. knowledge/awareness/etc. |
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Term
| Outcome evaluation of the intervention |
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Definition
Third level of evaluation
Changes in goals and health benefits
Long term; requires large pop samples
Centered upon morality and morbitidiy incidence prevalence of conditions affected by program; change indisease over time in the county region state |
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Term
| Dissemination; what a plan can help to do in a research project |
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Definition
You must be aware of goals and consequences in diseminating results: public policy changed; lines of injury may be pursued/abondoned; findings could help people to better understnad the implications in relation to practical decision making.
-Development is a key part of the collaborative research planning process
-Can help to:
Better focus your project
-Identify key audiences
-Identify key messages |
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Term
| Why is health literacy important to consider for dissemination? |
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Definition
Health literacy is "the degree to which individuals have the capacity to obtain, process, and understand basic health information and serviced needed to make appropriate health decisions"
-Health literacy includes both the ability to access necessary health information and the capability of correctly using that information |
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Term
Focus of interprofessional education
Challenges/Advantages |
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Definition
Teaching and learning of students from different professions together during their professional training to promote collaboration in practice.
Challenges:
-Professional program hierarchies
-Unclear structure boundries and roles within the team
-Inter-program scheduling
-Change is slow
-Difficult to maintain
Advantages:Promotes collab. practice;
MTM
Communication among professionals
Focus on long term care outcomes
Patient care improved; reduced medical errors. |
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Term
| Potential barriers and challenges pharmacists face now and in the future to providing innovative pharmaceutical care and preventive care services. Understand ways to overcome these challenges or barriers. |
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Definition
Barriers
-Educational prep
-Role ambiguity and incrongruient expecatations
-Authority
-Power
-Ego
-Status
-Autonomy
-Personal characteristics of members
-Inter program scheduling
-Cost
Overcome
-Institutional Support
*A prepared workplace:
-Redesign curriculum
-Restructure clinical training
-Develop interprofessional teams
-Communicate across professions
-Use evidence based practices |
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Term
| Drug therapy reliance/Future challenges |
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Definition
RX volume increasing 4-5% annualy
RX cost expected to double to $446 billion by 2015
Incidence of chronic disease states increasing
10/100 patients are in the hospital due to medication related problems. |
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Term
| Role of collaborative practice in role as a future pharmacist; examples of these collaborative practice activities. |
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Definition
Multidisiciplinary approach to patient care; both join to make joint decisions
Assessing patient response to therapy
Counseling and educating a patient on medications.
Assisting physician to imporove med management and continuity of care; modifying continuing and monitoring a patients drug recommendation.
Ordering, performing, and interpreting med-related lab tests. |
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Term
| MTM; examples related to practicing pharmacist today. |
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Definition
"A distinct service or group of sercives that optimize therapeutic outcomes for individual patients"
Independent of, but can occur in conjuction with, the provision of a medication product.
Components
-Medication therapy review
-Personal med record
-Med action plan
-Intervention and or referral
-Documentation/follow up |
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