Term
| What is shared decision-making? |
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Definition
The process of discussing and exploring the benefits, harms, and risks of each health care option. This can be achieved through meaningful dialogue and gaining
understanding of what is important to the
patient. |
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Term
| What are the two patient-centered approaches to medical decision-making? |
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Definition
Shared decision making
Motivational interviewing |
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Term
| Which should be used for a pt who is ambivalent about change: shared decision-making or MI? |
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Definition
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Term
| What are the components of the SHARE approach? |
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Definition
Seek your pt's participation
Help them explore & compare tx options
Assess their values/preferences
Reach a decision with the patient
Evaluate their decision |
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Term
| At what point in SHARE do we use teach-back to ensure understanding and look for signs of uncertainty? |
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Definition
| H-help them explore options |
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Term
| In what part of SHARE do we assess potential barriers and ways to overcome? |
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Definition
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Term
| At what point during SHARE do we listen actively and ask open-ended questions? |
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Definition
| Assess their values/preferences |
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Term
| What is complementary medicine? |
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Definition
| The use of non-mainstream practice along with conventional (Western) medicine |
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Term
| What is alternative medicine? |
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Definition
| The use of non-mainstream practice in place of conventional (Western) medicine |
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Term
| What is integrative medicine? |
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Definition
| Bringing together complementary and conventional medicine in a coordinated way |
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Term
| What percent of adults and children use non-mainstream medical practices? |
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Definition
| 30% of adults, 12% of children |
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Term
| What are the top 3 complementary approaches used by adults? |
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Definition
| Natural products (supplements), deep breathing, yoga/tai chi/qi gong |
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Term
| When and where was ayurvedic medicine established? |
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Definition
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Term
| What is a key concept of Ayurvedic medicine? |
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Definition
| Universal interconnectedness, body constitution and life forces |
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Term
| What is a common example of Traditional Chinese Medicine (TCM)? |
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Definition
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Term
| When and where was homeopathy developed? |
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Definition
|
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Term
| What are 2 key concepts of homeopathic medicine? |
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Definition
"Like cures like"
Minimum dose |
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Term
| What are the criteria for a dietary supplement, according to the Dietary Supplement Health and Education Act? |
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Definition
- Is intended to supplement the diet
– Contains one or more dietary ingredients (including vitamins, minerals, herbs or other botanicals, amino acids, and certain other substance) or their constituents
– Is intended to be taken by mouth, in forms such as tablet, capsule, powder, softgel, gelcap, or liquid
– Is labeled as being a dietary supplement |
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Term
| What is St. John's wort used to treat? |
|
Definition
| mental disorders, nerve pain, malaria, and topical balm for wounds, burns, and insect bites. |
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|
Term
|
Definition
cyclosporine, Indinavir, digoxin, SSRIs,
oral contraceptives, Coumadin, TCAs and
benzodiazepines |
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Term
| What is Saw Palmetto used for? |
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Definition
| BPH (should not be taken w/ other meds for BPH) |
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Term
| Adverse fx of saw palmetto? |
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Definition
Slows blood clotting (risk of bleeding w/ coumadin)
Reduces effectiveness of hormonal therapies (OCPs, estrogen) |
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Term
| What effect can melatonin have on blood sugar? |
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Definition
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Term
|
Definition
| vaginal atrophy, Alzheimer’s disease, improve athletic performance, sexual dysfunction, SLE, Sjogren’s syndrome, osteoporosis, fibromyalgia, IBD, Parkinson’s disease, weight loss |
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Term
| Pts taking what meds should avoid chasteberry? |
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Definition
OCPs, HRT, hormone sensitive
conditions, or dopamine-related medication (antipsychotics, Parkinson’s disease treatments) |
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Term
| What drug's level increases when taken w/ grapefruit juice and why? |
|
Definition
Statins
Grapefruit blocks enzyme that breaks them down |
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Term
| What drug's level decreases when taken w/ grapefruit juice and why? |
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Definition
Fexofenadine
Grapefruit blocks the transporter used to take it up into the body |
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Term
| What effect does ginseng have on CYP3A4 |
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Definition
|
|
Term
| What effect does goldenseal have on 3A4 and 2D6? |
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Definition
|
|
Term
| St. John's wort effect on CYP450 |
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Definition
|
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Term
| examples of drugs with a narrow therapeutic range? |
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Definition
| Carbamazepine, levothyroxine, warfarin, digoxin, cyclosporine, phenytoin |
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Term
| What drugs besides statins and fexofenadine are affected by grapefruit juice? |
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Definition
| Buspirone, nifedipine, amiodarone, cyclosporine, budesonide |
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Term
| What are the WHO five dimensions of medication adherence? |
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Definition
Social and economic factors
Patient-related factors (readiness to change)
Comorbid conditions
Therapy-related factors (complexity of tx)
Health care system factors (Provider influence) |
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Term
| How do we define medication error? |
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Definition
| any preventable event that may cause or lead to inappropriate medication use or patient harm while the medication is in the control of the health care professional, patient, or consumer |
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Term
| How many medication errors are there each year? |
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Definition
|
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Term
| What has FDA done to prevent med errors? |
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Definition
Label barcodes
Rejecting 1/3 of drug names that would be confusing |
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Term
| How many pts develop a hospital-acquired infection? |
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Definition
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Term
| What processes are implemented to improve performance? |
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Definition
DMAIC (Define, Measure, Analyze, Improve, Control)
PDSA (Plan, Do, Study Act) |
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Term
| Public reporting of med errors? |
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Definition
American Recovery and Revision Act of
2009 |
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Term
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Definition
| a written statement of a person's wishes regarding medical treatment, often including a living will, made to ensure those wishes are carried out should the person be unable to communicate them to a doctor. |
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Term
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Definition
| A living will is a written document that helps you tell doctors how you want to be treated if you are dying or permanently unconscious and cannot make your own decisions about emergency treatment. |
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Term
| Durable power of attorney |
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Definition
| A durable power of attorney for health care is a legal document naming a healthcare proxy, someone to make medical decisions for you at times when you are unable to do so |
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Term
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Definition
| tells medical staff in a hospital or nursing facility that you do not want them to try to return your heart to a normal rhythm if it stops or is beating unsustainably using CPR or other life-support measures |
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Term
|
Definition
Physician/Medical Orders for Life Sustaining Treatment
provide guidance about your medical care preferences in the form of a doctor's orders. |
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