BCACP Patient-Centered Care 3 — Questions and Answers
Question 1: Which framework BEST describes the integration of evidence-based medicine with patient values and clinical expertise?
- The biomedical model
- The pharmacokinetic model
- Evidence-based practice incorporating patient preferences (Correct answer)
- The population health model
Correct answer: Evidence-based practice incorporating patient preferences
Evidence-based practice integrates the best available research, clinical expertise, and individual patient values to guide care decisions.
Question 2: A patient with type 2 diabetes has an A1C of 9.2% and states he does not want insulin. The BCACP pharmacist should:
- Initiate insulin anyway to meet the guideline target
- Explore the patient's concerns about insulin and discuss non-insulin intensification options (Correct answer)
- Accept the A1C as the patient's preferred level
- Refer the patient back to the physician without further discussion
Correct answer: Explore the patient's concerns about insulin and discuss non-insulin intensification options
Exploring insulin concerns and presenting alternatives honors patient autonomy while working toward glycemic targets within the shared decision-making framework.
Question 3: Health literacy is BEST defined as:
- A patient's ability to read medical textbooks
- The capacity to obtain, process, and understand health information needed to make decisions (Correct answer)
- A patient's agreement with provider recommendations
- The level of formal education a patient has completed
Correct answer: The capacity to obtain, process, and understand health information needed to make decisions
Health literacy encompasses not only reading ability but also the cognitive and social skills needed to access and apply health information.
Question 4: A pharmacist identifies a low-income patient who cannot afford their prescribed antihypertensive. The MOST appropriate next step is:
- Advise the patient to skip doses to extend the supply
- Assess eligibility for patient assistance programs or lower-cost therapeutic alternatives (Correct answer)
- Document the issue and defer to the physician
- Recommend the patient purchase only half the prescribed quantity
Correct answer: Assess eligibility for patient assistance programs or lower-cost therapeutic alternatives
Identifying cost assistance programs or therapeutically equivalent lower-cost alternatives directly addresses a modifiable adherence barrier.
Question 5: In motivational interviewing, the spirit of MI is BEST characterized by:
- Directing the patient toward the clinician's preferred behavior change
- Confronting the patient about unhealthy choices
- Partnership, acceptance, compassion, and evocation of the patient's own motivation (Correct answer)
- Providing persuasive arguments for why behavior change is necessary
Correct answer: Partnership, acceptance, compassion, and evocation of the patient's own motivation
The spirit of MI is embodied in its four elements: partnership, acceptance (including autonomy), compassion, and evocation of the patient's intrinsic motivation.
Question 6: A patient reports taking their antihypertensive medication 'most of the time.' The BEST follow-up question is:
- 'Why aren't you taking it every day?'
- 'Can you tell me what a typical day looks like when you do and don't take your medication?' (Correct answer)
- 'Don't you understand how dangerous high blood pressure is?'
- 'Should I tell your doctor you're non-compliant?'
Correct answer: 'Can you tell me what a typical day looks like when you do and don't take your medication?'
Open-ended, non-judgmental questions about daily routines reveal patterns and practical barriers to adherence without creating defensiveness.
Question 7: Which of the following BEST represents a patient-centered goal for a 65-year-old with heart failure?
- Reduce BNP to within normal limits
- Maintain the patient's ability to walk to the mailbox daily without dyspnea (Correct answer)
- Achieve a target ejection fraction above 50%
- Reduce hospitalizations by 30% at the population level
Correct answer: Maintain the patient's ability to walk to the mailbox daily without dyspnea
Patient-centered goals reflect what matters to the individual patient in terms of function and quality of life, not only clinical biomarkers.
BCACP Patient-Centered Care 3
Which framework BEST describes the integration of evidence-based medicine with patient values and clinical expertise?