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pop health final > new material (50% of the test) > Flashcards

new material (50% of the test) Flashcards

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1
Q

What are health seeking behaviors formed around?

A

-socioeconomic status, cultural influence, and personal relationships

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2
Q

How does social structure (aka socioeconomic status) influence health seeking?

A

SES is a strong predictor of health differences in people. People that are of higher social status and health are seen to live longer and have more full filled lives. People that have toxic lives are seen to have lower SES most of the time.

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3
Q

How does culture influence health seeking? is this at the individual or population level?

A

both the population level and the individual level

  • fast food culture
  • health literacy
  • access to knowledge and technology
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4
Q

how do personal relationships influence health seeking?

A

positive and supportive relationships buffer the effects of stress and promote positive health outcomes

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5
Q

what happens to the life expectancy of some who lives an isolated life?

A

their life chances lower

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6
Q

what is a category A bioterrorism attack?

A

this is a risk to national security due to high transmission/decimation and high morality rates with the potential to cause social disruption and public panic that requires special action

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7
Q

What is a category B bioterrorism attack?

A

a moderate attack that is easy to disseminate. there are low morbidity rates and enhancement by the CDC

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8
Q

What is a category C bioterrorism attack?

A

emergin pathogens that could be engineered for mass spread because they are easily available and produced to have high morbidity rates and a major health impact

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9
Q

What are the two liability protection issues involved in pharmacy volunteer work?

A

The volunteer service act and the title 31 emergency management

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10
Q

what is the volunteer service act?

A

a law giving immunity for volunteers serving without being paid for state or non profit organizations

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11
Q

what is title 31 emergency management?

A

state officer immunity grated for workers when the governor declares a “state of emergency” for the state, unless they cause willfull misconduct, gross neglegance, or bad faith. then they will get in trouble

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12
Q

what are the three federal resources for pharmacy disaster assistance?

A

Healthcare ready website
NCPDP
strategic national stockpile

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13
Q

describe the health care ready website

A

this website maps the opened and closed pharmacies in the areas affects by the disaster and monitors international disasters that may effect medicine delivery to the US

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14
Q

describe the NCPDP. what does it stand for?

A

National Council for Prescription Drug Programs
-this is guidance for the pharmacy at getting resources in a declared emergency, AND for healthcare workers that need information regarding claims and processing patients

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15
Q

describe the strategic national stockpile

A

these are 12-hour push packs to supplement and re-supply state and local public health agencies in the even of a national emergency anywhere at any time in the territory of the US

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16
Q

what are all the roles that a pharmacist can assume during a drug disaster

A

a volunteer for mass dispensing OR a POD

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17
Q

what is a POD

A

a site used as a distribution site for medicine and medical supplies to healthy people in an area of risk during a large-scale public health emergency

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18
Q

what pathogens are in a category C bioterrorism attack?

A

hantavirus and nipah virus

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19
Q

What three years were considered to be the “waves or opioid overdose”?

A

1990s
2010
2013

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20
Q

describe the opioid overdose in the 1990s

A

there was a large increase in the prescribing of opioids and there were deaths related to prescription opioids and that has continues to increase since 1999

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21
Q

describe the opioid overdose in 2010

A

heroin was the cause of many deaths

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22
Q

describe the opioid overdose in 2013

A

increase in overdose regarding synthetically made (illegally made) opioids from things such at fentanyl patches in combination with heroin, counterfeit pills, and cocaine

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23
Q

what patient population is targeted in the MTF survey? what does MTF mean?

A

MTF means monitoring the future and it targeted students in 8th, 10th, and 12th grade in hundreds of schools across the country.

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24
Q

what was found the the MTF survey?

A

there is a large increase in vaping across the country

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25
what substance had the highest rate of use in the MTF survey
alcohol
26
what substance came second int he MTF survey for the highest use?
vaping
27
what were the findings in the MTF survey in regards to increase and decrease in specific drug usages?
increased vaping use, and decreased use of drugs in every other category
28
what patient population was targeted in the NSDUH study?
ages 12 years old and up
29
what does NSDUH stand for?
National Survey of Drug Use and Health
30
what did the NSDUH find in their survey in regards to marijuana use?
there is increases marijuana use since 2007
31
what did illicit drug users say they started with in NSDUH?
marijuana
32
when did people start smoking weed according to NSDUH?
teenage years
33
what has happened to underage drinking according to NSDUH?
it has decreased
34
what has happened to drinking and driving according to NSDUH?
it has decreased
35
according to NSDUH, when is drug use at its highest?
late teens early twenties
36
what has happened to drug use according to NSDUH for people in their 50s and early 60s?
it has increased (the hippies!)
37
what has happened to cocaine use over the past decade according to NSDUH?
it has decreased
38
what has happened to methanphetamine use according to NSDUH over the past decade?
it has increased
39
what is the substance with the highest rate of dependance or abuse? second?
``` highest = alcohol second = weed ```
40
what percentage of the population needs treatment for drug/alcohol abuse? what percentage got it? how many people were left untreated?
8.6%, only 0.9% were treated leaving 20.2 million people untreated in 2013
41
what is NAS? what is NOW?
NAS is neonates at risk for substance abuse because of their mothers NOW is neonates at risk for opioid withdrawl symptoms ONLY
42
how common are NAS/NOWS?
1 baby is born in the NAS/NOW category every 15 minutes
43
What are potential problems associated with NAS/NOW babies?
low birth weight and respiratory complications
44
What pays for the medical costs of NAS/NOW babies? How much did it pay?
medicaid 82% in 2014
45
what long term complications are associated with weed used according to MTF?
psychiatric issues, higher prevelance of lifetime drug abuse problems, cogniative issues, physical illness, and lifetime alcohol use problems at age 50
46
what is drug diversion by heathcare providers?
a heathcare provider stealing drugs for their own use
47
how does drug diversion by healthcare workers affect patient care?
- healthcare workers become impaired | - there are outbreaks of Hepatitis C or bacterial pathogens when tampering with injectable opioids
48
what class of drugs is most commonly diverted by health care workers?
opioids
49
what drug is most associated with outbreaks in drug diversion?
fentanyl
50
What are ways that healthcare providers get to steal these opioids without being noticed?
they steal unopened vials they take the syringes in the sharps container they take small hits out of vials meant for the patient, which results in the patient not getting the right dose (the diluted dose)
51
what should you do if you notice that a health professional is participating in drug diversion?
- assess the patient to make sure they're okay - alert public health officials when you think that needles are being used - call the police/alert law enforcement
52
What is the yield for every dollar invested in drug addiction treatment in regards to theft, and other crimes? what about in regards to healthcare costs?
$4-$7 back in crime and theft, 12-1 ratio of return in health care costs
53
how much does it cost to treat substance abuse vs how much does it cost to put someone in prison?
$4,700 to treat someone for substance abuse but $24,000 to put someone in prison. the cost of treating them is much more efficient than sending them to jail
54
What is the USPSTF?
The US Preventative Services Task Force - reviews all evidence on specific preventative services and provides evidence-based recommendations and focuses on screening, behavioral counseling, and preventative recommendations.
55
What does the USPSTF do if there are gaps in the research?
it calls for more research to fill the gaps and reports to congress
56
How does the Affordable Care Act incorporate USPSTF recommendations?
It requires health insurance plans to offer free-of charge preventative services that the USPSTF recommends that have an evidence rating of A or B.
57
Does a patient have to meet a deductible to access the services by the Affordable Care Act?
no
58
What is a Grade A recommendation by the USPSTF mean?
service is recommended with a high certainty of substantial benefit
59
What is a Grade B recommendation by the USPSTF mean?
service is recommended because there is high certainty of moderate benefit OR because there is moderate certainty to have moderate-substantial benefit
60
What is a Grade C recommendation by the USPSTF mean?
selective providing/offering of the service is recommended and clinicians should use professional judgement on an individual patient basis -there is moderate certainty of at least a small benefit
61
What is a Grade D recommendation by the USPSTF mean?
service is NOT recommended and there is a moderate to high certainty of no benefit or the harms outweigh the risks
62
What is a I statement made by the USPSTF mean?
this means that the current evidence is insufficient to make a recommendation
63
What are other governmental agencies besides the USPSTF that can make recommendations?
CDC, WHO, and disease-specific associations
64
What should you do when the USPSTF and the clinical standard recommendations differ?
the physician should approach it in a way that has the greatest benefit to the patient
65
How does medication counseling fit into the Pharmacist Patient Care Process?
within the patient education/self-management portion. also communication is int he center
66
Why should we counsel patients on their medications?
- reduces our liability (failure to warn patients about things has resulted in law suits) - OBRA '90 legally binds us to offer - Alabama state law requires us to offer the patient counseling
67
How should we counsel the patient?
Use motivational counseling (which requires some practice and training) and ask open ended questions
68
What are the general steps in regards to counseling the patient?
1) establish a relationship and make sure their language needs are met 2) assess the patient's knowledge and needs 3) provide the information with visual aids or a demonstration 4) verify understanding by making them repeat to you what you said
69
What are the three prime questions we should use when counseling a patient?
- What did you prescriber tell you this was for? - How did you prescriber tell you to take this medication? - What outcome did your prescriber tell you to expect?
70
What are examples of pharmacist barriers that prevent effective counseling?
-body movements, volume and tone, bad listening to the patient, and the righting reflex
71
What are examples of patient barriers that prevent effective counseling?
language, literacy, disabilities, negative past experiences
72
What are examples of environmental barriers that prevent effective counseling?
an intimidating counseling room/area, lack of privacy, and noise
73
Why is the term adherence preferred over compliance?
Compliance indicated "obedience" to healthcare instructions where adherence is patient-centered and focuses more upon what the patient had agreed to do that the health care professional has suggested
74
What are the consequences of non-adherence?
better adherence = better outcomes = lower health care costs overall that are better than the development of a new drug
75
what percentage of hospitalizations does non-adherence cause?
1/3
76
how many deaths does nonadherence cause in the US each year?
125,000
77
How much money does non adherence cost to our healthcare system each year?
$300 billion
78
what are key factors that contribute to non adherence?
SES, our health care system, medical conditions, therapy-related things, and patient-related things
79
what is the difference between intentional and non intentional non adherence?
intentional is deliberate and non intentional is primarily due to the lack of capability and resources
80
What is directly observed therapy?
this is physically watching them take their medication
81
what is indirectly observed therapy?
not watching them take their medications but monitoring their plasma levels
82
What are some approaches to approving therapy?
- address the financial barriers - address the physical barriers - help patients remember their medications

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