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57 Cards in this Set
- Front
- Back
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Compliance (adherence)
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the extent to which a patients begavior coincides with a prescribed medical regimen in either a curative or preventive situation. This includes medications, diet, exercise, and any other therapy involved in treatment.
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Non-compliance due to communication (patient)
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lack of: comprehension of importance, effectiveness, or instructions, little medical supervision, low satisfaction with health care professional, perception of health care professional as unfriendly or overbearing
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Non-compliance due to patient difficulties
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physical disabilites, pschological difficulties, fear, concurrent self-administration of other medications(OTCs, herbs, street drugs, alcohol, prescriptions)
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Non-compliance due to therapy
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multiple drugs, frequency of administration, duration of therapy, adverse effects, administration difficulties, asymptomatic, cost
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Non-compliance due to health care system
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poor relationship with patient, provides prescription without confidence in effectiveness, unwillingness to educate
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Steps to prevent non-compliance DDDA
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detection: persistent therapeutic problem, refulls missed, missed clinic appts., ask questions, determine the reason, develop a plan, assess a success DDDA
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Improving compliance
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educate, simplify the medication regimen, labeling, explicit directions, packaging, dosage forms, compliance aids
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Past Medication History PMH
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disease, sugeriees, medical procedures
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Family History FH
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1rst degree relatives, disease states, cause of death
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Social History SH
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tobacco use, alcohol use, recreational drug use, living status
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Allergies
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offending agents, type or response or reaction
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Medications
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prescription: current (name, Rx number, physician, pharmacy name and #), Past Meds: just list, Compliance Issues: shows basic understanding of current meds, length of therapy, does, quantity, etc.
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OTC's
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may have to prompt patient, ask what they take for headache, constipation, pain/fever, cough/cold, GI upset, etc
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Other info needed
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ADR's other than allergies, home rememdies, herbal products, diet restrictions/deficiencies, fluid intake
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Basic Patient Data Required for Patient Profile by OH Law
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-full patient name and gender
-complete address and # -birth date -drug allergies -disease state / chronic? -OTC's, devices |
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Basic Prescription Date Required for Patient Profile by OH Law
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-date filled
-Rx number -prescriber -drug, strength, dosage form -quantity -sig -price dispensing RPh initials |
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Profile Utilization
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-source of 3rd party info
-tax/insurance info -aids in ident. script by patient name -accounting/filing info -aids in delivery instruct. -inventory control -simulataneous script, label, profile info |
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Disadvantages/Limitations of Profiles
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-limited to the patients knowledge of diagnosis
-must be updated continuously -not all OTC's on record -poly-pharmacy |
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Epidemiology
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the study of the distribution and determinants of disease frequency in human populations
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Objectives
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1. identify etiology
2. determine the extent of dx in community 3. study history and prognosis of dx 4. evaluate new preventitive and therapeutic measures 5. provide foundation for developing public policy and reg. decisions |
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Primary Prevention
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someone who is healthy and well and keep them from getting sick ex. vaccine ULTIMATE GOAL
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Secondary Prevention
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denotes the id of people who have already developed a disease and caught it at an early stage ex. figure out diabetes early
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Population base approach for prevention
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look for groups of people prone to certain disease
ex. older:heart disease, stroke, cancer younger: accidents, suicide, homicide |
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High-risk approach for prevention
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look for people who are at high risk for certain diseases ex. obese; heart disease
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sensitivity
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how sensitive the test is at detecting the disease (true positives) #disease w/ + test / # with disease
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specificity
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if the test is negative and the person does not have the disease # w/o disease (-) / # w/o disease
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Incidence
NEW CASES |
# of NEW cases per unit of time / # of people in population at risk
*used for screening purposes, new case impact, change in disease pattern |
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Prevalence
ALL CASES |
# of people w/ disease per unit of time / # of people in population at risk
*used for provision of service, treatment allocations, hospital bed usage, planning facilities |
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Human Disease
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results from an interaction of hose, agent, and enviroment
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Endemic
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habitual presence of a disease within a given geographic region (usual occurance)
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Epidemic
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occurrence of an illness of similar nature in a community or region tha tis in excess of what is expected
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Pandemic
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world wide epidemic
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Incubation Period
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the intercal from receipt of infection to the time of onset of clinical illness
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Attack Rate
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# of people at risk who develop illness / # of people at risk
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Cohort Study Design
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BEST WAY, start with healthy subjects-follow to determine risk of disease with exposure or nonexposure ADV. determines true risk, multiple disease with multiple risk factors can be assessed DISADV. expensive, time consuming, problem w/ rare diseases
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Relative Risk
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likelihood of occurrence of the target event in those exposed and those not exposed incidence in exposed group / incidence in unexposed group
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Attributable Risk
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portion of risk that can be attributed to the exposed factor incidence of exposed-incidence of unexposed
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Case-Control Study Design
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NOT NEARLY AS GOOD AS COHORT, know the outcome in the beginning, use case and controls and determine exposure to risk factors ADV. less expensive, easier, can look at rare disease DISADV. estimate of risk, can not observe multiple disease/risk factors
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Odds Ratio
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an estimate of relative risk using a case-control method for study design
odds of exposure for cases / odds of exposure for controls |
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Cross-Sectional Design
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prevalence study (point in time study)
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Experimental Study Design
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classic controlled clinical trial ex. drug A versus drug B for treatment of a particular disease
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Medicare Part D costs
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-monthly premium - $33
-yearly deductable $250 -25% copay for next $2000 -if exceed this you pay all for the next $2850 -after this you only pay %5 copay *break even pt about $850 |
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Can have additional financial assistance if:
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1. income is less the $14,255 for single, or $19,245 couple
AND 2. ur assets cannot exceed $11,500 single, or $23,00 couple |
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5 purposes for stat. analysis
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1. describe gen. characteristics of groups
2. test cause-effect relationship between two or more variables 3. determine the correlation between two or more variables 4. compare differences between means of different groups or factors 5. compare differences in distribution or frequency of occurence |
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descriptive stats.
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describe, summarize, and reduce to a manageable form the properties of a mass of data, these are usually descriptors of properties or populations ex. mean, median, mode, etc
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inferential stats.
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statistics that are used to make judgements about a population from data obtained through a sample. They are used to make ESTIMATES about true population parameters or characteristics. *has to be intervel or ratio level data
ex. ANOVA, t-test |
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Nominal scale of measurement
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-#'s used to identify groups
-categorization, labels -count obects / people in categories -catergories are not ordered |
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Ordinal scale of measurement
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-assign #'s to objects that are rank ordered
-# indicate order only -researcher does no know the distance between numbers |
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Interval scale of measurement
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-actual defined units of measurement
-research knows order and distance between #'s -distance between #'s is equal -NO absolute zero |
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Ratio scale of measurement
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-actual defined limits of measurement
-researcher knows order and distance between #'s -distance between #'s is equal -there IS an absolute zero |
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Validity
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-measuring what it is supposed to be measuring
*internal validity-extent to which results are true for sample studied *external validity-extent to which results are true for population, generalizability |
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Reliability
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refers to dependability, stability, consistency, predictability, and accuracy of study results ex. instrument is reliable if it produces same results over and over
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Measure of central tendency
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mode, median, mean
-nominal: MODE -ordinal:mode and MEDIAN -interval:mode, median, MEAN -ratio:mode, median, MEAN |
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Variability
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how scattered data is
range, standard deviation, variance, standard error of mean |
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Central Limit Theorem
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regardless of the shape of the parent population, the distribution of the sample means will approach a normal distribution if the sample size is large enough, if sample is greater than 30 can assume it is normally distributed
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Correlations
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-association between two variables
-values range from -1 to 1 -magnitude is indicated by # -direction indicated by +- -when nominal direction indicated in words |
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Strength of Correlation
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.7 + = very strong
.5-.69 = strong .3-.49 = mod. strong .1-.29 = weak 0-.9 = almost no association |
