Pharmacy 514 Self Care MTM CTerriff Jan

8/9/2019 Pharmacy 514 Self Care MTM CTerriff Jan

1/43

Pharmacy 514

PharmacotherapyColleen M Terrif, PharmD, MPH, AAHIVP

Clinical Associate Proessor

W! Colle"e o Pharmacy

Deaconess Hospital an# $oc%&oo#

prin" '(15


2/43

)*+ecties

D-rin" the therape-tics e.am P/1st-#ents &ill0

1 De2ne sel3care an# the #riers an#scope o sel3care

' Cate"orie the top 5 con#itions, inran%in" or#er, &here sel3me#icationis -se#

tate the three 67 8DA re"-late#9-estions &hich m-st *e -l2lle# inor#er to chan"e a me#ication rom

$. to )TC


3/43


4/43

What is el3Care;

Care ta%en *y in#ii#-als to&ar#s theiro&n health an# &ell3*ein"

Incl-#es care e.ten#e# to others0 Chil#ren, amily

8rien#s, nei"h*orhoo#s, comm-nity

In#epen#ent

$eliance on one


5/43

What is Health;

!niersity o Washin"ton 6'((=7 >Wellness Wheel< ?)nline@ Aaila*le rom0http0&&&&ashin"tone#-proostst-#entliehealthan#&ellnessima"esHealthBWellnessWheel+p"6Accesse# '1 March, '(117


6/43

el Care Inoles

Improin" an#or maintainin" health Preention

Dia"nosis

Treatment0 Minor ailments

on"3term con#itions

Transition care0 Post illness or hospital, reha*ilitation

#ischar"e

Ima"e rom0 McEay Pharmacy Aaila*le rom0 http0&&&mc%aypharmacycompa"esin#e.asp;titleFMinorBailments


7/43

Pop-lation Care3 HealthPyrami#


8/43

Care Contin--m

The Self-Care Continuum

Pure SelfCareIn#ii#-alresponsi*ility

Pure MedicalCareA*#icate#

responsi*ility

Dailychoic

esiestyl

e

el3mana"e#ailments

on"3term

con#ition

s

Comp-lsory

psychiatric careMinor

ailments

Ac-te

con#itions

Ma+or

tra-ma

lthy living Minor aliments Long-term conditions In-hospital c


9/43

el3Care In#-stry

-pplies, pro#-cts Me#ications0

Vitamins

Gat-ral pro#-cts Gon3prescription me#ications

Testin"

Accessi*le healthcare proi#ers6pharmacists7


10/43

el3Me#ication )ptions

1 Gonprescription me#ications Who re"-lates;

'4( million people -se 6'(1' #ata7

1(' *illion in al-e 6ann-al sain"s7 tohealthcare system

Cons-mers spent ' *illion in '(1(

oer3the3co-nterJ 6)TC7

*ehin#3the3co-nterJ 6KTC7

' G-tritional Dietary -pplements Vitamin, mineral, her*, amino aci#

'L *illion in '(1(


11/43

el3Me#ication )ptions

Gat-ral pro#-cts an# homeopathicreme#ies0

Incl-#in" complementary an#alternatie me#icine 6CAM7

4 *illion in '((=

4 Alcohol, to*acco, street #r-"s;;

Ima"e rom0 astsi#e Mar%etplace Aaila*le rom0http0&&&eastsi#emar%etcomcontent#eptnat-ralhtml


12/43

Impact o el Care

Pain

Co-"hcol#

Aller"ysin-s

Heart*-rn

Ko&els

Inections

%in

(N 1(N '(N (N 4(N 5(N :(N =(N L(N O(N

2002 Non! Survey" #0$ %S & ' ()C in # months


13/43

Driers o el3Care

ro&th o a"in" pop-lation $estricte# access to prescri*ers thr- HM)


14/43

A"in" Pop-lation

=' million Q :5 *y '((

8astest3"ro&in"0 R L5

Heay prescription an#non3prescription -se

Me#s are accessi*le, orcon#itions common toel#erly

aety concerns

Ima"e rom0 Cana#ian eriatricsociety t-#ent ite Aaila*le

rom0http0cana#ian"eriatricscast-#ents


15/43

.amples o el Care

Dia*etic CH8 6heart ail-re7

eere aller"y

8emale0 chil#3*earin"

Athlete

mo%er

Arthritis


16/43

en#er Iss-es

ap &i#ens &ith a"e0 )erall0 5(05(

:53:O0 114 emales01(( males

Q L50 '=( emales01(( males More &omen report health pro*lems

than men

pecial nee#s0 Pre"nancy

Kreast3ee#in"

Contraception

l h i i l


17/43

$ole o Pharmacist in el3Care

isten As% 9-estions

When to recommen#

What to recommen# When to reer

Co-nter misconceptions, misinormation

#-cation, proision o inormation0 Ver*al

Written

)ther reso-rces 6ie &e*site recommen#ations7

Ima"e rom0 APhA Aaila*le rom0


18/43

Internet Pharmacies

Kene2ts0 cost, conenience $is%s0 co-ntereit, contaminate# an#

-nsae me#icationsS lac% o

cons-ltation, s-perision GAPK0

Inormation0 K-yin" Me#icine )nline &&&na*pnetpro"ramscons-mer3protection

*-yin"3me#icine3online

Cre#entialin"0 VIPP 6Veri2e# InternetPharmacy Practice ites7

$ecommen#e#0 BBBBBB pharmacies
http://www.nabp.net/programs/consumer-protection/buying-medicine-onlinehttp://www.nabp.net/programs/consumer-protection/buying-medicine-onlinehttp://www.nabp.net/programs/consumer-protection/buying-medicine-onlinehttp://www.nabp.net/programs/consumer-protection/buying-medicine-online


19/43

We*3Kase# Dr-"Inormation

$e"-lation; ac% o 9-ality control

Inacc-rate inormation har# to #iferentiate

H-"e n-m*ers an# #iersity o sites

Pop-lar topics0 Diseaseme#ical pro*lems 6search e.ample0

BBBBBBB7

Treatmentproce#-res .ercise2tness

Ge& to health ino3 ocial Me#ia0 8ace*oo%, /o-T-*e, T&itter, My pace


20/43

$. to )TC &itch

When me# "oes "eneric $. mar%et share Pharmace-tical in#-stry loo%in" to improe sales

)TC #ose may *e less than $.

)TC me#s not coere# -n#er most ins-rance

plans May sae cons-mers an# mana"e# care

8DA re"-late#S m-st hae all 0 Can the patient a#e9-ately sel3#ia"nose the clinical

con#ition; Can this con#ition *e sel3treate# s-ccess-lly;

Is this )TC sae an# efectie or cons-mer -se -n#erthe con#itions o act-al -se;


21/43

$. to )TC e.amplesIngredient *rand name %se

ansopraole Preaci# '43H$

$D,heart*-rn

enor"estrel Plan K )netep

Contraception

)mepraole Ue"eri#)TC

$D,heart*-rn

I*-proen,phenylephrine

A#ilCon"estion$elie

Pain, nasalcon"estion

8e.oena#ine Alle"ra Aller"ies


22/43

Kehin#3the3Co-nter 6KTC7 r#class o me#ications3 Pharmacist onlyJ

Proi#es access to me#ications thatre9-ire sae"-ar#s or -se

Pharmacists ass-re appropriate selection,

#osa"e, an# screen or potentialinteractions

.amples0

Pse-#oephe#rine, Plan K yrin"es

WA0 Prescriptie a-thority 6protocol7

A##itional reso-rce0 &&&-spharmacistcomcontent#cons-ltByo-


23/43

KTC 8actors to Consi#er

Pharmacist proi#e necessary co-nselin" Hae appropriate inrastr-ct-re to protect

cons-mer priacy

Cost iss-es thical consi#erationscontroersies0

Access to clean syrin"es ers-s #r-"paraphernalia

$eli"io-s o*+ections ers-s amily plannin"

Decon"estant ers-s meth prec-rsor

Ima"e rom0 .aminer Aaila*le rom0 http0&&&e.aminercomarticlepresi#ent3o*ama3si"ne#3into3la&3a3ne&33

l


24/43

ae !se3 $ole oPharmacist

Actiely inole# in helpin" patients ns-re that patients are a*le to rea#

an# -n#erstan# la*elin"

Proi#e a##itional inormation, i nee#e# Help patients aoi# #r-"3interactions

Warn 6an# e#-cate a*o-t &hat to #o7a*o-t possi*le si#e efects an# aller"icreactions

Disc-ss stora"e an# han#lin"


25/43

Me#ical iteracy

Illiteracy0 '( #iferent %in#s $ea#&rite

8-nctional

Healthme#ical

listersecom'(1'(4(4'(3types3o3illiteracy

$eco"nition an# cope

!na*le to rea#-n#erstan# ho& to ta%e me#s As% them to rea# the #irections on pill *ottle

&&&acpinternistor"archies'((((4illiteracyhtm

Chan e ho& o- comm-nicate

l C
http://listverse.com/2012/04/04/20-types-of-illiteracy/http://listverse.com/2012/04/04/20-types-of-illiteracy/http://www.acpinternist.org/archives/2000/04/illiteracy.htmhttp://www.acpinternist.org/archives/2000/04/illiteracy.htmhttp://www.acpinternist.org/archives/2000/04/illiteracy.htmhttp://www.acpinternist.org/archives/2000/04/illiteracy.htmhttp://listverse.com/2012/04/04/20-types-of-illiteracy/http://listverse.com/2012/04/04/20-types-of-illiteracy/


26/43

tora"e o el3CarePro#-cts

Temperat-re H-mi#ity

i"ht

.piration #ate

Ima"e rom0 -ic% an# imple Aaila*le rom0 http0&&&9-ic%an#simplecom#iet3&ei"ht3losshealthme#icine33 3 3


27/43

tora"e o )TCs

Closet + ,itchenCainet *athroom MedicineCainet

Anal"esicsAntaci#s

Anti*iotic topicalAntihistaminesAntipyreticsAntiseptics

Decon"estantsHy#rocortisone topical

A#hesie *an#a"esA#hesie &raps, tape

Alcohol &ipesCali*rate# meas-rin"spoonDental 8loss

Disinectant8eminine care pro#-ctsa-e pa#s

ThermometerToothpasteMo-th&ash


28/43

Dr-" Interactions

Dr-"3#r-"0 Antaci#s an# certain anti*iotics,

antiirals

Dr-"3oo#*eera"e0 Aspirin an# "arlic 6*lee#in" ris%7 Alcohol

Dr-"3#isease state0 ee e.ample

e" GAID3CH8, I, renal

Dr-" inormation so-rces


29/43

I We Don


30/43

Me#ications Ca-sin"A#mission

Prospectie, o*serational st-#y, !E 1L,L'( patients R 1: years o a"e

1,''5 a#missions

:5N #irectly relate# in L(N o cases

Me#ian ) L #aysS (15N atality

Most common me#s0 Aspirin

Di-retics

Wararin

GAID

Pirmohame# M et al 6'((47 >A#erse #r-" reactions as ca-se o a#mission to hospital0 prospectie analysis o 1L,L'(< 3


31/43

Aller"ies to In"re#ients

Actie or inactie in"re#ients ortin" o-t an# appropriate

#oc-mentation0

Tr-e aller"y Intolerancesi#e efect

Mana"ement0 preention, treatment

Ima"e rom0 piPen Aaila*le rom0 http0&&&epipencoma*o-t3epipen

I ti I #i t


32/43

Inactie In"re#ient.amples

Aspartame Kenal%oni-m chlori#e

l-ten 6search actiity7

actose Propylene "lycol

accharin

-l2tes /ello& tartraine


33/43

TerriYsms

/o- can treat anythin" &ith a #r-"J /o- can ca-se anythin" &ith a #r-"J

8or eery recommen#ation hae 'alternaties rea#y

)ptions 6sel3care70 Gone el3care therapy

$eer


34/43

Patient3Pharmacist

Cons-ltation


35/43

MTM

1 Descri*e the serice as ace3to3acepatient assessment an# interentionto i#entiy an# resole #r-" therapypro*lems

' 8orm-latin" a me#ication treatmentplan to optimie the response tome#ications an# achiee patients

Pharmacy 514 Self Care MTM CTerriff Jan

Documents

Transcript of Pharmacy 514 Self Care MTM CTerriff Jan