CPS 510 FINAL FINAL TEST 2026
QUESTIONS WITH CORRECT ANSWERS
GRADED A+
◍ Community Pharmacy Studies.
Answer: Document and assess pharmaceutical care - Asheville Diabetes
Project, N.C., 2003 - Diabetes Ten City Challenge (DTCC), 2009
Medication Therapy Management (MTM) - Asheville Asthma MTM
Project, N.C., 2006 - North Carolina State Health Plan MTM study, 2007 &
Minnesota MTM study, 2008 - MTM meta-analysis study in outpatient
settings, 2015 Multiple studies assess the clinical, humanistic, & economic
impact of pharmaceutical care. - Researchers need to continue their work to
further document the effectiveness of the pharmacist's role in ambulatory
care
◍ Why are utilities like "unload/reload" important?.
Answer: They support backup, recovery, and reorganization without altering
database logic.
◍ Pharmacists.
Answer: Advise their patients, physicians, and other health practitioners on:
- the selection, dosages, interactions, and side effects of medications -
monitor the health and progress of their patients to ensure that they are using
their medications safely and effectively. Distribute prescription drugs to
individuals. Compounding —the actual mixing of ingredients to form
medications—is a small but important part of a pharmacist's practice.
◍ Mental Health Parity and Addiction Equity Act of 2008.
Answer: For group health plans of 50 persons or more that provide both
medical and mental health/drug use benefits.... Parity is required for all of
the following: - Financial: co-pays, deductibles, out-of-pocket limits -
, Treatment limits: visit limits, formulary design, medical management
standards - Out-of-network benefits - Plan requirements: criteria for medical
necessity, reason for any denial of payment(cant make it harder to get
mental health care than any other health care)
◍ Prevention.
Answer: Health care professionals deliver preventive services that reduce
chronic disease Preventive services include: blood pressure screening, bone
density testing Primary - prevent condition Secondary - prevent recurrence
(Note that this refers to dealing with individual patient care)
◍ Pharmacy Technicians.
Answer: "An individual working in a pharmacy [setting] who, under the
supervision of a licensed pharmacist, assists in pharmacy activities that do
not require the professional judgment of a pharmacist." State level
requirements for pharmacy technicians vary greatly. - Age minimums,
educational minimums, and training requirements exist. - Currently, many
states regulate pharmacy technicians in some manner (certification,
licensure, or registration). National certification examinations are available
from the Pharmacy Technician Certification Board and the Institute for the
Certification of Pharmacy Technicians. - The certification examinations
cover a broad range of topics related to aspects of pharmacy technician
practice.
◍ Community Health Centers Act.
Answer: Renamed Community Health Centers (CHCs)- FQHCs are
"federally qualified" CHCs that meet additional federal standardsServe
about 20 M patients annually- 2/3 patients uninsured or Medicaid ("Safety
Net")--- high poverty levels, excessive rates of infant mortality- Sliding fee
payments for paying patientsMandated services:- diagnosis, treatment
consultation- laboratory and imaging services- medical and dental services-
pharmaceutical services
◍ Barriers to shifting Pharmacy paradigm...
Answer: 1. Drug focus: dispensing function is primary 2. Service focus:
, services provided distant from the patient and without regard to outcome 3.
Other health care professionals: infringement on others' "turf;" politics 4.
Lack of incentives: compensation based on dispensing productivity rather
than patient care 5. Logistical: pharmacies not designed to do consultations,
disease monitoring, and providing drug information
◍ DSM has evolved with Increasing Numbers of Mental Disorders Classified.
Answer: Growth in number of mental disorders since DSM-I (1952) - DSM
I - in 1952 there were 66 mental disorders - DSM-III (DSM-III-R: 1987)
introduced a multi-axial system allowing more detailed diagnosis - DSM-IV
- in 1994 this approaches 400 mental disorders - DSM-5 released mid-2013:
has ~ same number of disorders as DSM-IV Changed how we think about
mental health - Great examples: ADHD and Post-traumatic stress disorder
(PTSD)
◍ Current Issues Specific to Psychopharmacologic Medication Use/Treatment.
Answer: Polypharmacy within and across therapeutic classes- adverse
events and severe side effects Care continuity and treatment adherence
Safety concerns - Metabolic adverse events with antipsychotic medications
and inadequate monitoring Lack of longitudinal data from which to evaluate
outcomes, safety, and quality of care Concerns specific to children- Increase
in antipsychotic use - Selective serotonin reuptake inhibitors and suicide risk
(cannot stop cold turkey)- Off-label use
◍ Trending: "E-commerce".
Answer: 1. Mail-order model; full-service - Rx from unaffiliated physician
filled and mailed to patient - Other services and products available on
website 2. Information and counseling - Services other than dispensing (for
a fee) - Information, counseling 3. Remote Prescribing and dispensing-
"Patient" may complete medical survey online - "Physician" reviews survey,
and prescribes Rx desired - Fees for survey, physician, Rx, and shipping -
Fraud, ethical and safety concerns; especially outside of U.S
◍ Cultural Influences on Health - Specific Health Practices used to Promote
Healing & Include.....
, Answer: Prayer Rituals Complementary and alternative medicine (CAM) -
Folk remedies - Herbs - Alternative health practitioners
◍ Common Health Behavior Models.
Answer: Locus of Control Model Health Belief Model Theory of Reasoned
Action/Theory of Planned Behavior Social Cognitive Theory
Transtheoretical Model of Change These models have some overlap, differ
by model constructs None of them are perfect...
◍ Reactions to Reimbursement Methods.
Answer: Capitated payments using diagnostic-related groups (DRGs)-
complete shift in risk from fee-for-service for capitation- huge shift in how
pharmacy is handled!!Inpatient-Prospective Payment System- move some
surgeries to outpatient setting- only covers acute phaseValue-Based
Purchasing- Measure prescribed processes of care- Outcomes measured (e.g.
mortality post hospitalization)
◍ Practice Environment.
Answer: Number of primary care providers has increased dramatically
Largest increase has been in "physician extenders": - nurse practitioners and
physician assistants. - increase in primary care physicians is the result of
foreign medical graduates. - Trend toward more specialists in US and less
primary care does have implications for the future of the practice of
pharmacy. Pharmacists may have an increased role in meeting the needs of
patients by fulfilling their responsibilities to provide patient-centered care
and, in states where it is allowed, through their expanded responsibilities in
collaborative drug therapy management.
◍ Patients and the Health Care Environment - Longer life expectancies.
Answer: Health care needs have shifted towards managing chronic disease
& disability - Improved public health measures - Better technology
(including drugs) - Longer life expectancies Longer life expectancy and
chronic diseases means patients are living longer with multiple morbidities -
patients need help navigating the health care system
◍ Activities of Daily Living (ADLs).
QUESTIONS WITH CORRECT ANSWERS
GRADED A+
◍ Community Pharmacy Studies.
Answer: Document and assess pharmaceutical care - Asheville Diabetes
Project, N.C., 2003 - Diabetes Ten City Challenge (DTCC), 2009
Medication Therapy Management (MTM) - Asheville Asthma MTM
Project, N.C., 2006 - North Carolina State Health Plan MTM study, 2007 &
Minnesota MTM study, 2008 - MTM meta-analysis study in outpatient
settings, 2015 Multiple studies assess the clinical, humanistic, & economic
impact of pharmaceutical care. - Researchers need to continue their work to
further document the effectiveness of the pharmacist's role in ambulatory
care
◍ Why are utilities like "unload/reload" important?.
Answer: They support backup, recovery, and reorganization without altering
database logic.
◍ Pharmacists.
Answer: Advise their patients, physicians, and other health practitioners on:
- the selection, dosages, interactions, and side effects of medications -
monitor the health and progress of their patients to ensure that they are using
their medications safely and effectively. Distribute prescription drugs to
individuals. Compounding —the actual mixing of ingredients to form
medications—is a small but important part of a pharmacist's practice.
◍ Mental Health Parity and Addiction Equity Act of 2008.
Answer: For group health plans of 50 persons or more that provide both
medical and mental health/drug use benefits.... Parity is required for all of
the following: - Financial: co-pays, deductibles, out-of-pocket limits -
, Treatment limits: visit limits, formulary design, medical management
standards - Out-of-network benefits - Plan requirements: criteria for medical
necessity, reason for any denial of payment(cant make it harder to get
mental health care than any other health care)
◍ Prevention.
Answer: Health care professionals deliver preventive services that reduce
chronic disease Preventive services include: blood pressure screening, bone
density testing Primary - prevent condition Secondary - prevent recurrence
(Note that this refers to dealing with individual patient care)
◍ Pharmacy Technicians.
Answer: "An individual working in a pharmacy [setting] who, under the
supervision of a licensed pharmacist, assists in pharmacy activities that do
not require the professional judgment of a pharmacist." State level
requirements for pharmacy technicians vary greatly. - Age minimums,
educational minimums, and training requirements exist. - Currently, many
states regulate pharmacy technicians in some manner (certification,
licensure, or registration). National certification examinations are available
from the Pharmacy Technician Certification Board and the Institute for the
Certification of Pharmacy Technicians. - The certification examinations
cover a broad range of topics related to aspects of pharmacy technician
practice.
◍ Community Health Centers Act.
Answer: Renamed Community Health Centers (CHCs)- FQHCs are
"federally qualified" CHCs that meet additional federal standardsServe
about 20 M patients annually- 2/3 patients uninsured or Medicaid ("Safety
Net")--- high poverty levels, excessive rates of infant mortality- Sliding fee
payments for paying patientsMandated services:- diagnosis, treatment
consultation- laboratory and imaging services- medical and dental services-
pharmaceutical services
◍ Barriers to shifting Pharmacy paradigm...
Answer: 1. Drug focus: dispensing function is primary 2. Service focus:
, services provided distant from the patient and without regard to outcome 3.
Other health care professionals: infringement on others' "turf;" politics 4.
Lack of incentives: compensation based on dispensing productivity rather
than patient care 5. Logistical: pharmacies not designed to do consultations,
disease monitoring, and providing drug information
◍ DSM has evolved with Increasing Numbers of Mental Disorders Classified.
Answer: Growth in number of mental disorders since DSM-I (1952) - DSM
I - in 1952 there were 66 mental disorders - DSM-III (DSM-III-R: 1987)
introduced a multi-axial system allowing more detailed diagnosis - DSM-IV
- in 1994 this approaches 400 mental disorders - DSM-5 released mid-2013:
has ~ same number of disorders as DSM-IV Changed how we think about
mental health - Great examples: ADHD and Post-traumatic stress disorder
(PTSD)
◍ Current Issues Specific to Psychopharmacologic Medication Use/Treatment.
Answer: Polypharmacy within and across therapeutic classes- adverse
events and severe side effects Care continuity and treatment adherence
Safety concerns - Metabolic adverse events with antipsychotic medications
and inadequate monitoring Lack of longitudinal data from which to evaluate
outcomes, safety, and quality of care Concerns specific to children- Increase
in antipsychotic use - Selective serotonin reuptake inhibitors and suicide risk
(cannot stop cold turkey)- Off-label use
◍ Trending: "E-commerce".
Answer: 1. Mail-order model; full-service - Rx from unaffiliated physician
filled and mailed to patient - Other services and products available on
website 2. Information and counseling - Services other than dispensing (for
a fee) - Information, counseling 3. Remote Prescribing and dispensing-
"Patient" may complete medical survey online - "Physician" reviews survey,
and prescribes Rx desired - Fees for survey, physician, Rx, and shipping -
Fraud, ethical and safety concerns; especially outside of U.S
◍ Cultural Influences on Health - Specific Health Practices used to Promote
Healing & Include.....
, Answer: Prayer Rituals Complementary and alternative medicine (CAM) -
Folk remedies - Herbs - Alternative health practitioners
◍ Common Health Behavior Models.
Answer: Locus of Control Model Health Belief Model Theory of Reasoned
Action/Theory of Planned Behavior Social Cognitive Theory
Transtheoretical Model of Change These models have some overlap, differ
by model constructs None of them are perfect...
◍ Reactions to Reimbursement Methods.
Answer: Capitated payments using diagnostic-related groups (DRGs)-
complete shift in risk from fee-for-service for capitation- huge shift in how
pharmacy is handled!!Inpatient-Prospective Payment System- move some
surgeries to outpatient setting- only covers acute phaseValue-Based
Purchasing- Measure prescribed processes of care- Outcomes measured (e.g.
mortality post hospitalization)
◍ Practice Environment.
Answer: Number of primary care providers has increased dramatically
Largest increase has been in "physician extenders": - nurse practitioners and
physician assistants. - increase in primary care physicians is the result of
foreign medical graduates. - Trend toward more specialists in US and less
primary care does have implications for the future of the practice of
pharmacy. Pharmacists may have an increased role in meeting the needs of
patients by fulfilling their responsibilities to provide patient-centered care
and, in states where it is allowed, through their expanded responsibilities in
collaborative drug therapy management.
◍ Patients and the Health Care Environment - Longer life expectancies.
Answer: Health care needs have shifted towards managing chronic disease
& disability - Improved public health measures - Better technology
(including drugs) - Longer life expectancies Longer life expectancy and
chronic diseases means patients are living longer with multiple morbidities -
patients need help navigating the health care system
◍ Activities of Daily Living (ADLs).
