Courtney Carlson BUS 345-01

This week we talked about ethical guidelines and regulations when it comes to human subjects volunteering in research. When it comes to research there tends to be a vague area as to what needs to be disclosed and what does not. In the past, research has gone through trials and tribulations as patients are either pleased or not with their outcomes in a research trial. Misuse of volunteerism knowledge dates all the way back to Nazi Germany. In this time research experiments took place in concentration camps where vile tests were done on "volunteers" that left them most often in harms way. As war crimes were later reviewed, boards decided that there had to be regulations put in place in order to ensure the safety of research volunteers so that law suits and criminal trials would not have to occur. The Nuremberg Code was put into place that stated ten rules to follow in terms of mostly consent and qualifications to run the trial. Then the Belmont report came out to further explai...

Three Interesting Things: 1.) I find it interesting that when researchers are looking for volunteers, they disclose all sorts of information to them in order to make sure that they have all the information they need to make their decision. This interests me because if physicians and pharmacists did this during their regular practice than they would deal with less medical errors and more efficient adherence of patients. Why is there a difference in information given if research and practice are similarly on the same level. 2.) I find that the IRB kind of relates or has similarities of a jury. They are people who cannot have connection to subjects or the conditions at hand because it will skew their review. They are all culturally diverse and full of people with totally different backgrounds. It gives a more honest review in the end as well as make the trial more efficient. 3.) I think that it is interesting that the Code of Federal Regulations uses the word reasonable so often; reaso...

This week we talked about the opioid epidemic in the United States. When it comes to this crisis there is much to take into consideration. The crisis is not new and has been around for years. The crisis has come in three waves starting with the 1990's where opioid prescription numbers started to increase and this followed with a rise in overdose deaths. The second wave, in 2010, marked the rise of heroin induced deaths due to the fact that those addicted to prescriptions had to find a more readily available alternative. The third wave of 2013 was due to the fact that over dose deaths were most commonly due to synthetic opioids like fentanyl. When it comes to opioids, they have a range of uses but are mostly used for pain relief. Opioids have three levels; opiates, semi-synthetic, and synthetic. Each level is a further breakdown or derivative of the earlier. Opiates come directly from the juice of the Papaver Somniferum plant and are used to raise the pain threshold and reduce the p...

Three Interesting Things: 1.) I think it is interesting that some patients avoid treating their pain with opioids because of the negative connotation given by the media surrounding these drugs. Although, yes, they can be addictive there are ways to manage the intake so that you can both treat your pain and not become addicted. 2.) I think that the fact that patients could have to sign a narcotic contract to ensure that they will not go to fill the prescription at another pharmacy. I think that this is an excessive way to do this but I also feel that this is the only way to keep patients honest because of people within these situations these people cannot control their need. 3.) I think that it is interesting that this article brings up the topic of having pharmacists be more intuned with their work and be more educating for their patients. We have talked about often how pharmacists should have more of a comforting position with their patients and be able to have empathy for them. ...

1.) What are A of C codes? (Sept 26) 2.) Why are some classes of medical devices exempt from the 510 K versus others? (October 3) 3.) Would adding a in house pharmacist to every doctors office be more cost effective? (October 10) 4.) Would implementing pharmacists as part of a care team cause them to have to do more schooling? (November 5) 5.) Are MTM consultations covered by insurance? (November 7) 6.) How does pharmacoeconomics change the industry? (October 8)

When it comes to retail pharmacies, they play a key role in the medicinal care industry. They are the individuals who see the most volume of patients compared to physicians. In a given week in the US nearly 275 million people visit the pharmacy to fill a prescription. This high traffic of patients puts pressure on the pharmacists to perform up to par. The industry is making their best efforts to move their work towards value based rather than volume based and this is based on the three pillars/triple aim; lowering cost of care per capita; improving the overall patient experience, and improving the overall health of the population. Much scrutiny that the retail pharmacists face is in terms of medication adherence and non adherence. When the patient chose to not follow drug regimens, not refill prescriptions, or stretch out there prescriptions, the pharmacists are the people catching most of the blame. They are the ones that are meant to give the patient all the information they need to ...

This week we learned about the overall communication between patient and pharmacist. This communication line is extremely important in the sense that the patients ultimate quality of care is at stake. When it comes to patients, they each have their own distinct condition as well as personality that goes with it. Some patients are very involved in the knowledge of their condition and chose to learn as much as they can. On the other hand there are individuals who are oblivious or could care less and would rather just listen to instructions. When it comes to providers, there are not enough of them to go around. In this day and age there are a increasing number of conditions arising that ever before. These conditions call for more physicians and pharmacists in order to keep up with the rising demand. On top of this the education of a pharmacist is changing. They used to be focused on drug interaction but are now more focused on disease treatment. This means that there is an inconsistency t...

Three Interesting Things: 1.) I think that MTM is super helpful and that there should be a scaling or set of regulations put in place where patients conditions are categorized. Out of these categories, patients should then be obligated by physician request to have a MTM appointment with pharmacists in order to better there condition journey. This could be a one time or multi-scheduled event. 2.) Hospitalizations and expenditures increase in the non MTM groups and decrease for the  in MTM groups, This shows that the patients who have more information about their conditions and medications are better equipped. They still go to the pharmacy the same number of times but they do not see as many hospital trips and their costs are decreased. 3.) I think it is interesting that they talked about implementing MTM but at different level. This means that the more complex conditions will receive a more complex MTM consultation while the lower level ones will be more basic. This can help in l...

Three Interesting Things: 1.) I think that it is interesting that the pharmacy professions is being compared to the fast food industry. Patients now want their encounter to be brief and efficient rather than informative. Having this lack of communication makes pharmacists look like they do not know what they are doing. this also shows that pharmacists are not using the education they worked so hard to receive. 2.) I think that it is interesting that the deliberative pharmacist is the one that patients saw as the most expertise. This pharmacist is one that makes it seem that they are friends or family members that are making the suggestion. This lack of professionalism can make it seem that the pharmacists profession is not as vigorous and that the treatment is not as important. 3.) I also think it is interesting that there is no universal standards for electronic data capture and formatting. With the amount of medical errors occurring as well as lack of adherence of drugs, this misc...

This week we learned about private and public insurance. Coming into the week I did not know much about either of these topics because they did not apply much to me as a child. Now that I am quickly approaching the time in my life where I will have to chose to be on my employers insurance or stay on my guardians until I am 26, I need to be more aware of what insurance actually means to me. Dr. Shcherbakova started off her private insurance conversation by asking us why do we have insurance. At first when this question went through my head I just thought "well because we just do in order to afford healthcare costs". I am sure I am not the only one that felt like it was hard to describe exactly why we need it because, well, we have most likely always had it and never really knew we did. There is much that goes into insurance that I was not aware of. In terms of private insurance I found it interesting that the reason we have it is due to risk. Risk is uncertainty of an event...