Pharmacy Outcomes Exam 3 :(

Describe contexts where measurement of health-related quality of life is relevant

HRQoL is relevant in clinical trials, treatment evaluations, chronic disease management, and health policy decision-making.

What is the difference between generic and disease-specific quality of life instruments?

Generic instruments measure overall health (e.g., SF-36, EQ-5D), while disease-specific instruments focus on issues related to a particular condition.

What domains are measured by SF-36 and EQ-5D?

SF-36: physical functioning, bodily pain, general health, vitality, social functioning, role limitations, and mental health.
EQ-5D: mobility, self-care, usual activities, pain/discomfort, and anxiety/depression.

What is reliability in the context of QoL instruments?

Reliability refers to stability over time, internal consistency among items, and equivalence across different forms or raters.

What is validity in QoL instruments?

Validity includes content validity (relevance of items), criterion validity (correlation with a gold standard), and construct validity (logical relationships with other measures).

How do utility and health status measures differ?

Utility measures quantify preferences for health states (e.g., QALYs), while health status measures describe health without incorporating preferences.

What are patient-reported outcomes?

Outcomes reported directly by the patient about their health, quality of life, or treatment satisfaction.

What are the steps in conducting a decision analysis?

Define the problem, identify alternatives, determine probabilities, estimate outcomes, assign values, and calculate expected values.

What are advantages and disadvantages of decision analysis?

Advantages: structured framework, supports decision-making.
Disadvantages: relies on assumptions, may oversimplify reality.

How do you calculate average outcomes and costs in decision analysis?

Multiply the probability of each outcome by its cost or value and sum the results.

When is Markov modeling appropriate?

When analyzing chronic conditions with recurring events over time and transitions between health states.

What types of retrospective databases are used in outcomes research?

Health surveys, SEER, insurance claims, and electronic medical records (EMR).

How do you choose a database for pharmacoeconomic research?

Based on availability of relevant data/variables (e.g., diagnoses, costs, utilization)

How do retrospective database studies compare to RCTs?

Retrospective studies are less expensive, faster, and real-world; RCTs offer high internal validity

What are examples of pharmacy services?

Medication therapy management, immunizations, disease state management.

What are outcomes of pharmacy services?

Improved adherence, reduced hospitalizations, better disease control.

What are sources of economic value from pharmacy services?

Cost savings, increased revenue, improved patient outcomes, reduced adverse events.

What is deprescribing and what are its outcomes in older adults?

Systematic process of discontinuing inappropriate meds. Outcomes: fewer adverse events, better quality of life.

What is the AMCP Value Dossier?

A document submitted by pharmaceutical companies to provide evidence of value to payers and formulary committees.

What are performance-based coverage agreements?

Contracts where payment depends on a drug meeting specific performance outcomes

How do performance-based agreements differ from commercial agreements?

Performance-based: linked to outcomes.
Commercial: focus on price, volume, or market share.