Lecture 2.pdf

Importance of Sociology & Psychology to Pharmacy 1  Objectives The students should be able to: 1. Describe the need to study social and behavioral sciences in pharmacy practice. 2. Explain the relationship between social factors...

Importance of Sociology & Psychology to Pharmacy 1  Objectives The students should be able to: 1. Describe the need to study social and behavioral sciences in pharmacy practice. 2. Explain the relationship between social factors and people's experience of health and illness. Introduction 3  Extended role of pharmacist Advise patients on minor illnesses Advise patients on sensible and effective ways of using medicines. Provision of domiciliary services to housebound/isolated patients. Participation in continuing education of community health care practitioners. 4  Extended role of pharmacist Advise prescribers on economic and effective prescribing and on the effects of medicines. Monitoring and reporting adverse drug reactions and interactions. Advising general practitioners on the administration and handling of complex substances. Diagnostic testing, e.g. measurement of blood pressure and blood glucose and cholesterol levels. 5  Extended role of pharmacist Health education and promotion. Supervision of supply and safekeeping of medicines in residential homes. Keep records of prescribed and purchased medication. Registration of elderly patients. 6  Levels of Organization and the Disciplines Involved in Pharmaceutical Education Biosphere Society/Nation Culture/subculture Humanistic and Social pharmacy social sciences Community Small group/family Person Clinical pharmacy Organ Cell Chemistry/Biology Natural sciences Molecule Atom Sorensen EW, Mount JK, Christensen ST. The concept of social pharmacy. 7  Society? Sociology?  Introduction Society A collection of people sharing common traditions, institutions, territories, activities & interests Sociology The scientific study of society, including the study of development, structure & functioning of human society, and patterns of social relationships, social action & culture  Sociology based assumptions Human behaviour is conditioned by our social environment. How people act, think, and behave is a result of the way in which they have been 'brought up’.  “Norms” It is not sufficient to understand or explain people's actions solely through the behaviour of the individual or individuals concerned. It is necessary to take a wider social perspective and understand the social forces that influence, or interact with the individual to understand society. 10  Social pharmacy It is a discipline which deals with the role of medicines from social, scientific and humanistic perspectives. It is supported by an understanding of theories of social and behavioural sciences and basically, “consists of all the social factors that influence medicine use, such as medicine- related beliefs, regulations, policy, attitudes, medicine information, ethics and behaviour.” 11 Levels of society Structural level Individual level 12 Psychology? PHCL 436 13  Introduction Psychology The study of the human mind & its functions as it relates to human behavior, cognition (thought) & experience  Introduction Pharmaceutical Psychology The study of people’s beliefs & behavior in relation to the activities of the modern day pharmacist, from experiences with health promotion & disease diagnosis in the pharmacy; to beliefs & behaviors relating to prescribing, reviewing & dispensing of pharmacologically active compounds by pharmacists.  Introduction Cognitive Pharmacy Involves pharmacy relevant thoughts & beliefs Cognitive Pharmacy Services Structured attempts to change patients’ behavior through the practice of pharmacy Why Study Social & Cognitive Pharmacy? Limitation of “biology’’ in explaining all health behaviors and outcomes Biomedical Bio-psychosocial Model of Health Model of Health Focuses on biological Acknowledges a complex factors that influence interaction of biological, health & disease psychological & social factors in influencing health & disease  Why Study Social & Cognitive Pharmacy? Social & cognitive pharmacy are concerned with the application of psychosocial knowledge to impact patients’ health & illness-related behavior within the context of practice.  Example Not all individuals will respond to symptoms in the same way. Not everyone has faith in orthodox medicine, and the need to seek treatment is not necessarily a top priority for everyone and may compete with other factors such as work and family commitments, or difficulties of transport and mobility. 19  Relevance of Sociology to Pharmacy Social factors influence peoples’ health (either in a health-promoting or damaging way) Sociology can help pharmacists gain better understanding of why people experience health differently according to their social, economic or political situations. Relevance of Sociology to Pharmacy Sociology Psychology Ability to influence beliefs & behaviors Effective Pharmacist Social Determinants of Health  Health, Illness and Disease Health: a state of complete physical ,mental and social well being not merely the absent of diseases or infirmity. Illness: is the response of the person to a disease it is abnormal process in which the person’s level of functioning is changed Disease :medical term, meaning there is a pathologic change in the structure of function of the body or mind. 23  Social Determinants of Health WHO Definition The conditions in which people are born, grow, live, work and age, including the health system These are shaped by distribution of money, power & resources at global, national & local levels, which are themselves influenced by policy choices Are mostly responsible for health inequities (unfair and avoidable differences in health status) seen within and between countries Social Determinants of Health In November 2008, Professor Sir Michael Marmot was asked by the then Secretary of State for Health to chair an independent review to propose the most effective evidence-based strategies for reducing health inequalities in England from 2010.  Fair Society - Healthy Life Reducing health inequalities would require action on six policy objectives: Give every child the best start in life Enable all children, young people and adults to maximise their capabilities and have control over their lives Create fair employment and good work for all Ensure healthy standard of living for all Create and develop healthy and sustainable places and communities Strengthen the role and impact of ill-health prevention. 26  Social Determinants of Health Neighborhood conditions& communities Lifetime & Gender generational factors Working Education conditions Income & Race & racism wealth  Social Determinants of Health Neighborhood conditions Water/air quality Housing factors (overcrowding, exposure to dust) Access to food Access to an environment to exercise Quality of local services (transportation, medical care) Social relations (trust & understanding)  Social Determinants of Health Working conditions Physical nature of work Noise levels Exposure to hazardous chemicals Long working hours/shift-work Stressful jobs Earnings & benefits Unemployment  Social Determinants of Health Education Literacy level Employment opportunities Healthier work conditions & higher pay Income & Wealth Increased income associated with better education quality, childhood circumstances, working conditions  Social Determinants of Health Race, Racism Living in an area in accordance to race resulting in neighborhood inadequate resources Long term stress from ethnic bias Stress Can lead to progression or development of disease Can lead to uptake of risky health behaviors  Social Determinants of Health Lifetime & generational factors Childhood experiences Health & wellbeing of pregnant mothers Aging & deteriorating social ties Gender differences Women on average live longer than men Men more involved in risky employment, unhealthy behavior as well as higher stress level  Health Outcomes Data Health according to the WHO A state of complete physical, social and mental well-being, and not merely the absence of disease Emphasis on certain prerequisite for health: Peace Adequate economic resources Food & shelter Stable eco-system Sustainable resource use  Health Outcomes Data Health statistics may be expressed based on: Socioeconomic classification Gender Geographic region Ethnicity Examples of health statistics: Life expectancy Mortality rates Self-reported health  Life Expectancy in KSA (WHO) http://gamapserver.who.int/gho/interactive_charts/mbd/life_expectancy/atlas.html  Mortality Rate in KSA (WHO) http://gamapserver.who.int/mapLibrary/Files/Maps/Global_Death_rates_2012.png  Commonly Investigated Health Behaviors Smoking Alcohol consumption Obesity Sexual health Taking medication Blood glucose monitoring  Conclusion “Pharmacists are among a range of primary care health professionals who do not see deal with social determinants of health inequalities as core business.” Marmont et al 2010  Conclusion The genesis of social pharmacy No other health profession has been challenged with changes as profound and momentous as the profession of pharmacy in recent history. A shift from the product to the patient “Curriculum with less knowledge of science and more knowledge of patient and well being” Questions??  References Donyai, Parastou. Social and cognitive pharmacy: theory and case studies. London: Pharmaceutical Press;2012. Chapter 1 Social and Behavioral Aspects of Pharmaceutical Care, Second Edition. Chapter 1