Case Study #2

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Case Study

CASE #1 Application of Evidence Based Medicine and Analysis of Data

Acute otitis media (AOM) is a fairly prevalent condition amongst infants as nearly 4 out of 5 children experience AOM by the age of 3. The Direct Medical costs associated with the treatment of AOM are nearly $3 billion each year. Evidence based treatment is imperative in being able to provide the most appropriate treatment for AOM.

Case Description
A young mother brings in her 18 month old daughter for treatment for AOM. You are a student on rotation in the Howard University Hospital pharmacy. You note that the patient has a prescription written for Clindamycin to be taken three times daily. In addition, the physician has written a prescription for aspirin as needed for the mild, nonsevere bilateral pain being experienced by the patient.

Part A. Your preceptor/supervisor asks you to review treatment guidelines and the other evidence based medicine sources to establish what is the appropriate treatment for the patient to treat the infection and pain. Please utilize the EBM process that you have learned about in class to provide a 1 page summary (paragraphs not bullet points) of your findings. In your explanation, provide a PICO based question. You should cite at least three references in your explanation, and part of your explanation should refer to the appropriate guidelines. In addition, you should provide the level of evidence for your recommendation (30 points)

Part B
From your experience with the mother and her 18 month old daughter diagnosed with severe asthma you realize that there is a need to develop a physician intervention to educate physicians at the Howard university hospital on appropriate treatment of mild bilateral AOM. Briefly in 1 page (paragraphs not bullet points) describe how you would design such a study. Be sure to include the following:

• Research question
• Study design,
• Rationale for selecting the study design,
• Study population
• Study variables
o Dependent
o Independent
o Confounders/Covariates

(20 points)

Part C
You are a pharmacist working in the corporate office of a chain pharmacy. You have been tasked with increasing the number of immunizations provided by your pharmacy. In order to accomplish this, you ultimately want to find out want to find out what types of factors help to predict the types of patients that are most likely to receive immunizations at a pharmacy. In particular, you are interested in evaluating whether or not patients that have a professional relationship with their pharmacists are more likely to use immunizations. However you also realize that demographic information such as age, gender, and ethnicity may also impact whether or not patients receive an immunization at a pharmacy. In addition there are other types of variables that you would like to evaluate the impact of. You will realize that it will be helpful to characterize your population with regards to each of these characteristics and also find out how these other characteristics relate to the receipt of immunizations in a pharmacy. Please conduct the appropriate univariate, bivariate, and multivariate analysis and write an abbreviated manuscript/report that should contain the following. (50 points)
i. Background (1/2 page double spaced )
ii. Research purpose (1/4 page double spaced)
iii. Methodology (1 page double spaced)
a. Study population, study design, data source
b. Analysis plan: dependent and independent variables, confounding variables, statistical analysis used, software used
iv. Results: (1 page double spaced summary of results; 1 page double spaced with 1 figure and 1 table)

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