Pharmacology 4E03: Social Pharmacology

COORDINATOR RENEE LABIRIS Ext 75657

Pharmacology 4E03 2013-2014 Course Outline


 

Pharmacology 4E03 Outline
 
The overall objectives of this course are to provide you with an opportunity to explore the dimensions of drug use/abuse in society. By now you have completed a number of courses in pharmacology and I will assume that you have a good understanding of pharmacodynamics and pharmacokinetics. This course will include a variety of drug classes but the focus of discussion will not be on their mechanisms of action but on the context in which they are used or abused.
As a general working model, we would consider the use of drugs from the perspectives of: the Consumers (patients/buyers), the Prescribers (generally physicians), the Providers (manufacturers), the Regulators (usually Governmental agencies) and the Dispensers. Each group brings to the situation, biases and attitudes that colour the utility of the product. Efficacy, a term that you have struggled through in earlier courses, takes on newer meanings as we begin to consider effectiveness in the world beyond the laboratory. Further, the notion of what constitutes "evidence" varies depending on the perspective chosen and I expect that we will have heated and illuminating discussions on that issue.

Much of the discussion will involve the general principles of pharmacoepidemiology. This is a relatively new term which has aroused mixed emotions. Some have argued that it is "an affront to good English usage" noting that "at 20 letters, it is awkward, pompous and longer than any other specialized title in medicine" (1). Nevertheless it has become a legitimate field dealing the "application of epidemiologic knowledge, methods and reasoning to the study of the effects (beneficial and adverse) and uses of drugs in human populations" (2) Epidemiologists as a whole are concerned with the who, the where and the how of disease distributions.

Pharmacoepidemiology began with a focus on one particular source of disease and illness viz drugs. It has become broader now and is seen to be a bridge science incorporating elements from pharmacology, therapeutics, epidemiology, statistics, economics and anthropology, and may be better called Social Pharmacology.

Given that the scope is broad, it would be impossible to cover all aspects. I have been deliberately selective in the content issues to provide you with a flavour of the field. I expect that by the end of this 12 week course you would be introduced to the terms and concepts listed below:

  1. Terms commonly used in epidemiology (eg incidence/prevalence/relative risks/odd ratios/specificity/sensitivity etc.)
  2. Epidemiological approaches: particularly relative advantages/disadvantages of diverse study designs, data collection.
  3. Pharmacovigilance
  4. Evidence: in Science and the Law
  5. Economic Evaluation of Drugs (Pharmacoeconomics)
  6. Drug Utilisation in a cross-cultural context

The above issues have been incorporated into the body of several paper problems that have been specifically written for the course.

Evaluation will comprise the following:

  1. Tutorial Participation which will be evaluated at the end of every tutorial using prescribed forms. Active participation demands that the student be responsible, bring in new information, communicate that information effectively, critically evaluate the information that she/he brings as well as that provided by others, and finally be able to assess their own performance appropriately. The forms to be used will provide descriptors for evaluating each of the above qualities.

  2. Submission of a Written Summary of discussions. This MUST be handed in within ONE WEEK after the completion of a given problem. The format of this submission would be as follows:

    1. A listing of issues Generated / Learning tasks defined / Attainment of Course Objectives.
    2. A brief description (ONE page maximum) of what the student learned from the problem. This would take the form of a brief summary of her/his current knowledge on that topic.
    3. A more detailed analysis of ONE of the major issues that arose in the discussion.
    4. Students will be randomly selected to present their analysis of a major issue that arose in the discussion of a problem.
  3. Pharmacoepidemiology Essay. At the end of the course students are required to submit an essay on a pharmacoepidemiology topic. This exercise provides students an opportunity to explore an area of pharmacoepidemiology in more depth than what is covered in class. This could include a discussion of prescribing patterns, the design of a system to improve drug utilization in a specific environment, an assessment of the impact of a specific law or economic event had on drug therapy, economic evaluation of a specific drug therapy. Essays should adequately address methodological issues that arise within the topic. The objective(s) should be clearly defined and a logical and persuasive discussion with adequate referencing should be given. The essays will be evaluated by:

    1. Letter of Intent - One page outline of the topic selected by the student. Topic must be approved.
    2. Essay - 10 to 15 pages in length, double-spaced, excluding references. Students are encouraged to explore challenging issues. A certain percentage of the marks will be allotted for difficulty level.
    3. Oral Presentation - The student will prepare a 10 minute presentation of their topic and should be prepared to respond to questions from their colleagues.

The allocation of marks will be as follows:

Class Participation 15%
Written Summaries 15%
Oral Presentation of an issue arising from a problem 10%
Letter of Intent 5%
Essay 45%
Oral Presentation 10%

 

ACADEMIC DISHONESTY consists of misrepresentation by deception or by other fraudulent means and can result in serious consequences, e.g. the grade of zero on an assignment, loss of credit with a notation on the transcript (notation reads: "Grade of F assigned for academic dishonesty"), and/or suspension or expulsion from the university.

It is your responsibility to understand what constitutes academic dishonesty. For information on the various kinds of academic dishonesty please refer to the Academic Integrity Policy specifically Appendix 3.

The following illustrates only three forms of academic dishonesty:

  1. Plagiarism, e.g. the submission of work that is not one's own or for which other credit has been obtained.
  2. Improper collaboration in group work.
  3. Copying or using unauthorized aids in tests and examinations.

REFERENCES:

(1) Shapiro. S. (1990) Am. J. Epidemiol 131:379

(2) Porta, MS and Hartzema AG (1991) Chapter 1 in Pharmacoepidemiology 2nd Edition, edited by Hartzema, Porta, Tilson , Harvey Whitney Books.

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