414 Lec 24-25

Health

 A state of complete physical, mental and social well being

Disease

Objective phenomenon, characterized by altered or abnormal functioning of the body, medical term for change in body or mind

illness

Subjective, includes physical and social state, 

→Response of the person to a disease

Discuss the cultural and contextual factors influencing health and illness.

Social, economic and cultural forces inlfluence the interpertation of what is healthy and pathologic

→Health insurnace, lifestyle drugs 

Explanatory Models

•Perspective and belief about their illness and treatment

•We can better understand patients and family’s perception of their illness

•To understand, ask what, why, and who questions

Szasz and Hollender’s Model of Care- Activity and Passivity Model

•Oldest

•None to little interpersonal communication

•Actice practitioner and passive patient 

•Used in emergency situations

Szasz and Hollender’s Model of Care- Guidance Cooperation Model

•Patient is capable of interpersonal communication 

•Patient can perform independent action but still requires professiona attention

•Like parent and adolescent relationship

Szasz and Hollender’s Model of Care- Mutual Participation Model

•Patient and practitioner are both powerful and interdependent 

•Practitioner has medical experitse, patient ahs personal expertise

•Patients with chronic disease

•Adult to adult relationship

The Consumer Model of Care

•Great patient autonomy in decision making

•Emphasized patients right

•Patient is an informed and skeptical buyer of medical care

•Providers are sellers who respond to needs of the patient

The patient centered Model of care

•Focus is on the whole person versus the both 

•View illness through:

1) Understand patients ideas about what is wrong

2)Eliciting patients feelings about illness

3)Assess how the problem affects the patients daily life

4)Discovering the expectation of the patient regarding treatment

The biopsychosocial model of care

•Chronic disease is major killer (vs acute disease)

•Considers issues such as poverty place of residence, pollution , stress, diet, 

List the different illness phases a patient experiences.

Symptom Experience

Assumption of the sick role

Medical care contact

Dependent patient

Recovery or Rehab

Symptom Experience

•Initial stage of illness

•Physical, cognitive, emotional

Assumption of the sick role

•Individual makes decision

→seeks information advice and relief

→sick individual follows advice of lay referral system 

Medical care contact

•Professional within health care system

Dependent patient

•Decision to transfer control and accept prescribed treatment 

→Now a patient 

Recovery or Rehab

•Decision to relinquish patient role

•Easier in comparison to decisions at other stages

Explain how patient perspectives on health and illness play a role in treatment decisions.

Identity: The label the patient places on the disease and the symptoms associated with it

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Cause: Patients perception of how they got the disease

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Timeline: patients sense of how long the disease will last

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Consequences: Patients expectation of the outcome of the disease

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Cure/control: Patients perception of how the illness can be cured ot controlled 

Passive acceptors

take meds with no questions

Active acceptors

evaluates medications to address their specific worries and concerns

Active modifiers

modify their regimen 

Rejectors

 do not accept or stop taking meds

Health Disparity

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“differences and variations in the health acheivements of individuals and groups”

Health inequity

“Differences in health that are not only unnecessary and avoidable but, in addition, and are considered unfair and unjust”

→Health inequities are rooted in social injustices that make some population groups more likely to have poor health than other groups.

Describe the differences between health disparities and health inequities

•Health disparities: Differences in health outcomes among groups of people

*Male babies are born heavier than female babies*

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•Health inequities: Differences in health that are avoidable, unfair and unjust. Health ineqiuties are affected by social, economic, and environmental conditions 

Health equity

Attainment of the highest level of health for all people. Health equity means efforts to ensure that all people have full and equal access to opportunities that enable them to lead healthy lives.

Describe who is most at risk for health disparities (marginalized, underserved, vulnerable)

•Persons with HIV and other chronic health conditions

•Elderly 

•High risk mothers/children

•Chronic mental illness

•Socioeconomically disadvantaged 

•Racial and ethnic minorty groups

•Unisured/underinsured

•Rural residents

•Homeless/immigrants/refugees

Explain the major causes and areas of health inequities in the US

•Social determinants

•Environmental hazards

•Healthcare access and preventive health services

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Root cause is racism, not race

Describe the areas of health inequities relevant to pharmacists, and what pharmacists can do to address inequity issues

Vaccination Rx Role: Mobile vaccination, in home vaccinations, mass vaccination sites

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Drug related deaths Rx Role: Opiod disposal and misuse screening, admin of MAT to underserved groups

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Heart Disease and Stroke Rx: Patient education, individual counseling, blood pressure screenings, community outreach

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Obesity Rx Role: Help with weight management resources, screening for meds

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Asthma Rx Role: How to use inhalers, education on risk/triggers to prevent death

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Adolescent Pregnancy Rx Role: Counseling on contraceptives and other options

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Cigarette Rx role: Smoking cessation campaigns 

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Diabetes rx role: checking blood sugar, med adherence, MTM