PHAR207 PHARMACY PRACTICE
Patient Counselling
PATIENT COUNSELING
• Patient counseling is defined as a face-to-face, interactive meeting
designed to change patient knowledge or behavior.
• It also refers to the process by which the pharmacist listens to his
patients' concerns about medication and provides education appropriate
to the patient's needs.
MEDICATION ERROR
“Medication error is any preventable event that may cause or lead to
inappropriate drug use or patient harm while in the control of healthcare
professionals, patients, or consumers.”
Medication errors can occur at many stages, from the point of prescribing
the medication to the moment the medication is administered to the
patient.
Medication errors can be prevented.
MEDICATION ERROR
• What are the Causes of Medication Errors???
**Polypharmacy
• **Oral Prescriptions
**Drug interactions
• **Communication problem
**Similar drugs
• **Inappropriate drug selection
**Sound-like drugs
• **Incomplete drug use
**Busy working environment
• **Incorrect use of medication
**Lack of computer support
COMPLIANCE
• Compliance is defined as the degree to which the patient's behaviour
conforms to the instructions of the healthcare providers.
• The benefits of patient compliance improve patient disease and clinical
symptoms and reduce the cost of medical treatments.
REASONS FOR NON-COMPLIANCE
Patient Factors;
**Patients may not remember to take their medications. (elderly patients, psychological
diseases, etc.)
**Patients may discontinue or interrupt the drug due to early symptomatic relief
(antibiotics, analgesics, etc.)
**Asymptomatic disease (treatment delays) may be delayed in the treatment given.
**Patients may not understand instructions. (geriatric patients, etc.)
**Patients may not understand the importance of compliance with doses.
REASONS FOR NON-COMPLIANCE
Product factors;
**Complexity of drug regimen (oral antineoplastics)
**Inconsistency of dosage forms (Emend)
**Unpleasant taste (enteral nutrition solutions)
**Cost (chemotherapy drugs)
**Side effects (chemotherapy drugs)
**Potential for abuse (Opioids)
REASONS FOR NON-COMPLIANCE
Pharmacy Factors;
**Lack of patient counselling
**Not giving enough information about drugs
**Lack of time
**Staff shortage
THE PHARMACIST'S ROLE
**Pharmacists can increase patient compliance with patient counselling.
(With Pharmaceutical Care Programs)
**Pharmacist is the best resource to provide Drug information.
**Patient Counseling is one of the most important responsibilities of
pharmacists.
COMMUNICATION
Communication Process
Sender Message Channel Receiver
Feedback
Voice
PATIENT COUNSELING
*** During patient counselling, patients are asked by healthcare
providers open-ended questions that help determine their knowledge
about the disease and medications.
SOOO WHAT SHOULD BE ASKED AND EXPLAINED TO THE
PATIENT?
PATIENT COUNSELING
**WHAT TO ASK AND WHAT TO SAY**
**The brand name or generic name of the drugs used must be asked.
**You should ask about the purpose of the use of previously used drugs.
**The route of use, dosage form, dosage and application schedule of the drug should be
checked. (including treatment period).
**Do you have information about the precautions to be taken during the application?
PATIENT COUNSELING
**You should explain common side effects and How to manage them.
**You should ask that ''Do you have knowledge of techniques for self-
monitoring of drug therapy?'' (fasting blood sugar)
**You should ask that ''Do you have have knowledge of appropriate
storage conditions?''
**You should explain potential drug-drug or drug-food interactions or
contraindications.
PATIENT COUNSELING
**You should ask that ''Do you have any Food Allergies or Drug Allergies?''
**You should ask that Pregnancy status (Does she want to have children
now or in the future?)
**You should ask that Alcohol use and smoking habits.
HOW SHOULD EDUCATION BE GIVEN???
**One-to-One Education.
-Face to face
-Telephone
**Written Education.
- Email
- Brochures
- Reports
- Newsletters
BARRIERS TO EFFECTIVE PATIENT COUNSELING
Barriers to effective patient counselling include physical, psychological,
administrative or time barriers. Such barriers make it difficult to establish
effective communication.
PHYSICAL BARRIERS
***Environmental barriers such as lack of privacy, which creates physical
barriers between patients and doctors/pharmacists, can prevent effective
communication.
***Environmental barriers are examples of physical barriers.
BARRIERS TO EFFECTIVE PATIENT COUNSELING
PSYCHOLOGICAL BARRIERS
• Negative attitudes of physicians and pharmacists are often due to a lack
of confidence or low self-confidence.
• Communication can be a problem for these people
• Physicians or Pharmacists should try to improve their communication
skills through practice.
• A negative attitude is an example of a psychological barrier.
BARRIERS TO EFFECTIVE PATIENT COUNSELING
ADMINISTRATIVE BARRIERS
The administrator thinks that the time that should be spent on
communication can be made by looking after another patient.
So this can be seen as a reason for communicating issues.
BARRIERS TO EFFECTIVE PATIENT COUNSELING
TIME BARRIERS
Time barriers are linked to administrative barriers. Because the management
is responsible for the number of personnel and the distribution of
workloads.
**Time is limited according to Pharmacists and patients.
**Pharmacists say that they cannot spare time for patient counselling due to
the high number of patients.
On the other hand, patients say that they do not have enough time to receive
patient counselling.
BARRIERS TO EFFECTIVE PATIENT COUNSELING
**Interpersonal communication is a fragile process.
**Messages only help the patient when they are received and understood
correctly.
**If messages are incorrect, they may harm the patient and prevent a positive
patient outcome.
**It is important to understand these potential communication barriers so
that a strategy can be developed to minimize or eliminate them.
WAYS TO IMPROVE YOUR PATIENT COUNSELING SKILLS
**Do not jump to conclusions or quick solutions without learning detailed
information.
**Do not move from one subject to another subject until each subject is
completed.
**Guide the interview using a combination of open-ended and closed-ended
questions.
**Keep your goals in mind clearly.
WAYS TO IMPROVE YOUR PATIENT COUNSELING SKILLS
• Try to learn certain (basic) information about the patient
• Please use vary the techniques when interviewing and counselling a
patient who is unable to read, has language proficiency, or has a visual or
hearing impairment.
• Please take as much as brief note during counselling. This condition
should not interrupt the communication with your patient.
WAYS TO IMPROVE YOUR PATIENT COUNSELING SKILLS
Speaking and Listening techniques;
You should stop speaking while the patient is speaking.
You should get rid of distractions.
You should make eye contact to show you're listening.
Listen carefully to what the patient says.
Get feedback to clarify the message.
This shows that you are listening and trying to
understand.
WAYS TO IMPROVE YOUR PATIENT COUNSELING SKILLS
• How to Become a Better Listener????
• ***Take time to listen and give your full attention.
• ***Focus on your target.
• ***Ask questions.
• ***Get feedback.
• Give advice, but do not judge or blame the patient.
PATIENT FOLLOW-UP FORM
COMMUNICATION WITH PRIVATE PATIENTS GROUP
• Elderly Patients
• Patients with Psychological Disorder
• Pediatric Patients
• Patients with Disabilities
CONCLUSION
• The pharmacist must be aware of his role and responsibilities.
• Pharmacists are people who act logically to provide information.
• A Pharmaceutical Care Program is necessary for patients who have poor
patient compliance.
Thank you
