Extra Credit Journal 2

Methods Practice: Data Coding

For an extra credit methods practice I decided to apply some of the inquiry method techniques while working for a professor on campus. I have been doing research with this professor on genetic indicators of health conditions in adults. Most of what we have been doing this semester is coding data received from surveys that were collected last year. This is valuable experience for my field study since I will be coding data from surveys as well.

For this particular methods practice, I decided to not go so fast when coding the surveys so I could look for patterns in the data. I wrote down questions I had about the responses and patterns I saw in them. For example, I found that a lot of the responses on the questionnaire were in relation to medical conditions that I had never heard of. Taking the time to stop and look up each condition when I found it on a questionnaire was extremely helpful. I was able to see that some medical conditions reported on the surveys were actually in the same category as other health conditions (e.g. multiple medical conditions that all have to do with the cardiovascular system). Previous to this, I didn't know that these conditions were related, and with that knowledge, I am more able to analyze the data.

For my own project I plan to implement this slower coding technique every once in a while. It would be impractical to go this slow every time I coded a questionnaire in my research, but doing this periodically will give me insight into the data. I will be able to see patterns that I have not seen before.

Journal 30

Well, seeing as this is my last journal entry for this course, I think it's a good time to reflect on what I have learned. The most valuable lesson I learned from this class was the inquiry based learning method. I is so valuable when researching a topic. Taking information found from research and learning to see it from the perspective of 'but what about this?' is such a valuable tool. I found that it gave continuity to my research. Instead of finding information one day, then starting from scratch the next day finding new information in a different direction, you can begin each new day of research by reviewing the questions that you asked the previous day and keep going in the same direction. Asking questions, developing those questions into better questions, then answering the questions so you can move on to new questions is a great research method.

I also found that keeping a learning journal was very valuable for researching a topic. When I had to actually write down what I had been learning about in my research on this blog it made me continually process the information I was finding. Then when I wanted to use the information later, it was available for me to look back on in an organized way.

I don't mean to discount any of the field preparation I gained from this class because I learned a lot in that area as well. I just didn't come into the class expecting that I would learn these two lessons.

Journal 29

Answers to previous questions:
I took the past couple of days to work on my proposal so I didn't find the answers to the questions from last time. I really want to keep looking into the topic of clinical pharmacists though since that seems like a great solution to adverse drug effects from polypharmacy.

New Information:
I realized a couple of things while answering questions following my presentation on Friday. In my methods section I need to make it more clear what type of sample I will be taking. I am planning on doing a stratified sample from a number of cities in Utah County, but I didn't put that in my project proposal. For compensation I need to make sure I make it clear that I am going to use two dollar bills since I think that would be much more effective than two one dollar bills. In my data analysis section I need to include that my analysis will include linear regression analysis for the quantitative variables (like the relationship between age and number of medications) as well as bar chart analysis for qualitative variables (like the relationship between gender and polypharmacy status). I could also make it more clear what other hypothesis I might test once I have collected my data. I only have two written in my proposal for simplicity, but I could give specifics on the other hypothesis I might want to develop.


Keywords:
presentation, data analysis, compensation, stratified sample, hypothesis

Journal 28

Answers to Previous Questions:
I looked for other  health conditions that were indicators of polypharmacy. A major one that I found was depression. Patients taking antidepressants are much more likely to have polypharmacy. This leads to an interesting subject; how might the presence of an affective (psychological) disorder contribute to polypharmacy. There are a lot of different affective disorders and they probably shouldn't be categorized all as the same type of health condition, but there may be some common themes. This topic seems interesting, but is a bit of a tangent off of my main research topic so I'll hold off for now on investigating it more thoroughly.

New Information:
I found a new article that has an interesting solution to the problem of inappropriate prescribing as a result of polypharmacy. The researchers tested the effect of having a clinical pharmacist (someone with a pharmaceutical degree) involved in the prescribing process for older patients with polypharmacy. Primary care physicians often do not have time to review and adjust the drug regimens of older patients, thus inappropriate prescribing goes unaddressed. In this study, a clinical pharmacist reviewed the drug regimens of older patients with polypharmacy and made recommendations to the physician with changes to inappropriate prescriptions. After one year they found a 23% decrease in inappropriate prescriptions vs. a control group.

Questions from this Information:
How much is this implemented in different health care centers? The article had been cited by over 200 other sources so I assume it has been pretty widely implemented.
How many health care centers have clinical pharmacists available?

Keywords:
Clinical pharmacists, inappropriate prescriptions, affective disorders, indicators of polypharmacy

Journal 27

Answers to previous questions:
I looked through my proposal again and made some adjustments for the final draft. I also found that my references were lacking so I'll need to do some work on that aspect of the proposal before Monday.

New Information Found:
I found a new article that looked at the indicators of polypharmacy. This article was unique because it looked at indicators which lead to a patient who did not currently have polypharmacy developing polypharmacy by the end of the study. Among these indicators were a few health conditions that were positively associated with the development of polypharmacy:

coronary ischaemic diseases (lack of blood supply to the heart)
heart failure
hypertension (high blood pressure)
asthma
osteoarthritis
atrial fibrillation (heart condition)
dementia
esophagus and stomach diseases
depression

These types of findings are important because they give physicians the ability to focus polypharmacy prevention efforts on specific groups. This study was conducted in the Netherlands and their definition of polypharmacy included anyone taking two or more drugs, so it's different in those aspects.

Questions from this information:
Have these findings been replicated in the United States?
Are there more conditions that are indicators of the development of polypharmacy? It would be good to put together a list so I could test my data against it to see if the same condition are indicators of polypharmacy in my population.

Keywords:
indicators of polypharmacy, health conditions, Netherlands