examII clinical communications

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Questions and Answers

Which activity is LEAST aligned with the primary goals of a patient interview when collecting a medication history?

  • Developing a comprehensive therapeutic relationship.
  • Advising on over-the-counter medications to reduce costs. (correct)
  • Identifying potential drug therapy problems.
  • Ensuring an up-to-date and accurate medication list.

A patient mentions experiencing a new symptom after starting a medication. Which open-ended question would be MOST effective in gathering relevant information?

  • Can you describe what you're experiencing? (correct)
  • Did the symptoms improve after taking the medication?
  • Is the medication causing your symptoms?
  • Have you experienced any allergic reactions to the medication?

Which question would be MOST appropriate to gather information related to a patient's adherence to their medication regimen?

  • How often do you forget to take your medications? (correct)
  • What is your attitude toward taking medications?
  • Are you experiencing any side effects from your medications?
  • Do you take your medications as prescribed?

A patient reports experiencing a common adverse effect from their medication. What is the MOST appropriate next step?

<p>Investigate if the patient has experienced the specific side effect. (D)</p>
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If a pharmacist seeks to understand the impact of a patient's medication on their disease-oriented outcome, which question would be most appropriate?

<p>When was the last time you checked your blood pressure at home? (D)</p>
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When assisting a patient to reach their health goals through medication, what should a pharmacist ask to understand better how medications are helping?

<p>Have you noticed any difference in how frequently you (insert goal)? (A)</p>
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Which of the following statements accurately describes a drug therapy problem (DTP)?

<p>A DTP is any undesirable event involving drug therapy that interferes with achieving the desired goals of therapy. (B)</p>
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A patient is prescribed an antibiotic for a viral infection. Which type of drug-related need is MOST likely present?

<p>Indication (D)</p>
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A patient requires a higher dose of their current medication or an additional medication to achieve their therapeutic goal. What type of drug therapy problem is indicated?

<p>Effectiveness (B)</p>
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A patient experiences liver damage as a result of taking acetaminophen at a higher than recommended dose. Which drug therapy issue does this represent?

<p>Safety (A)</p>
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When prioritizing drug therapy problems (DTPs), which factor should be considered FIRST?

<p>The severity of potential harm to the patient (B)</p>
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Which of the following is a core element of motivational interviewing (MI)?

<p>Collaboration (C)</p>
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A pharmacist is helping a patient manage their diabetes. In which scenario is it MOST appropriate to use motivational interviewing?

<p>When the patient expresses ambivalence about adhering to their diet and exercise plan. (D)</p>
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Which communication strategy best exemplifies the reflection technique in motivational interviewing?

<p>Repeating or rephrasing what the patient has said. (C)</p>
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How does ‘expressing empathy’ support effective communication within a motivational interviewing framework?

<p>Acknowledges the difficulties patients face in making changes. (D)</p>
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A patient states, "I know I should exercise more, but it's hard to find the time." Which response best demonstrates the 'develop discrepancy' approach?

<p>&quot;It sounds like you value your health, but exercise is challenging to fit into your current routine.&quot; (B)</p>
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A pharmacist is helping a patient set a health goal. Which SMART goal is best written?

<p>I will reduce my sugar intake by avoiding sugary drinks 5 days a week for the next month. (A)</p>
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A patient consistently takes their medication but not at the prescribed times, leading to suboptimal therapeutic effects. Which term BEST describes this situation?

<p>Adherence (D)</p>
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A patient reports that they stopped taking their medication because they could not afford the refills. Which type of nonadherence does this represent?

<p>Patient Related (A)</p>
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A pharmacist wants to support a patient to self-monitor. Which of the following is MOST important to integrate into the patient's routine?

<p>Integrate new behaviors into current habits (C)</p>
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A pharmacist is interviewing a new patient. Which of the following questions is MOST appropriate for building a therapeutic relationship early in the interview?

<p>What are your expectations from our discussion today? (C)</p>
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A patient has been experiencing persistent heartburn despite using an over-the-counter antacid as needed. Which question would be MOST effective in exploring the indication for their medication use?

<p>What does your doctor say about your heartburn? (B)</p>
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A patient reports difficulty swallowing their medication. Which follow-up question would BEST explore the effectiveness of the current medication formulation?

<p>Has this medication helped with your condition? (A)</p>
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A patient mentions they sometimes skip doses of their blood pressure medication because they feel fine. What is the MOST appropriate question to assess the safety consequences of this behavior?

<p>Do you know what your blood pressure should be? (D)</p>
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A patient with diabetes is picking up their refill of insulin. Which question BEST targets a disease-oriented outcome related to their medication?

<p>What was your last A1C result? (D)</p>
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Which scenario BEST describes a situation where a pharmacist should prioritize addressing a drug therapy problem (DTP)?

<p>A patient is taking a medication that requires lab monitoring but is not up to date on lab work. (B)</p>
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A patient states, 'My doctor wants me to start exercising, but I hate going to the gym.' Which response BEST reflects the 'express empathy' technique in motivational interviewing?

<p>&quot;I understand that going to the gym can be challenging for many people.&quot; (C)</p>
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A pharmacist is working with a patient to improve their medication adherence. Which approach is MOST consistent with motivational interviewing principles?

<p>Collaboratively exploring the patient's own reasons for wanting to adhere to their medication regimen. (A)</p>
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Which of the following is the BEST example of a 'Specific' component of a SMART goal related to improving medication adherence?

<p>I will take my blood pressure medication every day. (A)</p>
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A patient reports they often forget to refill their prescriptions on time, leading to gaps in their medication therapy. Which type of nonadherence is MOST likely?

<p>Unintentional nonadherence due to forgetfulness. (A)</p>
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When trying to promote positive health behaviors, what is MOST important when tailoring self-monitoring techniques for patients?

<p>Integrating monitoring into the patient’s current routine. (B)</p>
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A pharmacist suspects a patient is experiencing a drug therapy problem. What is the MOST important first step in addressing this issue?

<p>Gathering more information from the patient to fully understand the situation. (C)</p>
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A patient is prescribed a medication they do not need. Which type of drug therapy problem (DTP) is MOST likely?

<p>Unnecessary drug therapy (A)</p>
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A patient is taking a medication which is effective, but experiencing an avoidable side effect. What type of drug therapy problem (DTP) is MOST likely?

<p>Adverse Drug Reaction (D)</p>
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A patient requires additional laboratory monitoring while on amiodarone. What type of drug therapy problem (DTP) is MOST likely?

<p>Needs Additional Monitoring (A)</p>
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A pharmacist is participating in an interprofessional team meeting to discuss a patient's care. What action would BEST exemplify demonstration of respect?

<p>Actively listening to other team members' perspectives and valuing their contributions. (B)</p>
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A clinic is considering implementing a Collaborative Practice Agreement (CPA) with a pharmacist. Which disease state would be MOST appropriate for inclusion in the CPA?

<p>Type 2 diabetes mellitus requiring insulin management. (C)</p>
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A pharmacist is communicating with a physician about a patient's uncontrolled pain. What component of the ISBAR communication model would include the patient's current pain score and recent analgesic use?

<p>Assessment (B)</p>
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Which scenario exemplifies asynchronous telehealth?

<p>A patient sends a secure message to their pharmacist to ask about a medication side effect. (D)</p>
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A study showed a significant increase in statin use and tobacco cessation following pharmacist intervention. What important consideration should be made before widely implementing the study's procedures?

<p>The clinical setting(s) tested within the study (C)</p>
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A pharmacist is interviewing a patient to collect their medication history. What is the PRIMARY reason for collecting this information?

<p>To develop a comprehensive understanding of the patient's medication use and identify potential drug therapy problems (D)</p>
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Which of the following questions is MOST likely to elicit information about a patient's chief complaint during an initial interview?

<p>&quot;What brings you to the clinic today?&quot; (D)</p>
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A patient mentions they have taken a medication in the past for their current condition, but it caused unpleasant side effects. Which question would be MOST appropriate to understand how they feel about retaking this medication?

<p>&quot;How would you feel about taking that medication again?&quot; (A)</p>
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A patient is starting a new medication. Which question is MOST appropriate for gathering information about their personal goals related to their health?

<p>&quot;What concerns do you have about taking medications?&quot; (C)</p>
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A pharmacist is reviewing a patient's medication list. Which question is MOST pertinent to gather information about potential allergic reactions or drug intolerances?

<p>&quot;What happens when you take that medication?&quot; (C)</p>
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What is the MOST important aspect of defining a drug therapy problem (DTP)?

<p>Detailing both the condition and the medication related to the problem. (B)</p>
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Which of the following drug therapy problems (DTPs) should be prioritized FIRST?

<p>A patient prescribed a medication known to cause a life-threatening arrhythmia who has a history of long QT syndrome. (C)</p>
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What is the central focus of motivational interviewing (MI)?

<p>Collaboratively working with patients to explore their ambivalence about change. (C)</p>
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Which element is MOST characteristic of the 'evocation' principle in motivational interviewing?

<p>Drawing out the patient’s own motivations and reasons for change. (D)</p>
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A patient says, 'I'm not sure if I can make these lifestyle changes, it seems like too much.' Which response best reflects the 'support self-efficacy' concept of motivational interviewing?

<p>&quot;It's okay to feel overwhelmed. We can take small steps and build on your successes.&quot; (C)</p>
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Which of these options align with a time-based component of a SMART goal focused on improving medication adherence?

<p>&quot;I will refill my prescription within 3 days of running out of medication.&quot; (D)</p>
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A patient understands how to take their medication but still takes it incorrectly due to forgetfulness. Which type of nonadherence is MOST likely?

<p>Unintentional nonadherence (A)</p>
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Which approach is MOST important to incorporate into a new self-monitoring technique to help promote positive health behaviors?

<p>Integrating the new self-monitoring behaviors into current habits. (C)</p>
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A pharmacist and physician have different viewpoints regarding a patient's treatment plan. Which behavior is MOST appropriate for demonstrating respect in this situation?

<p>Actively listening to and acknowledging the physician's perspective. (B)</p>
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A healthcare clinic is considering implementing a Collaborative Practice Agreement (CPA). Which element refers to defined activities delegated to the pharmacist?

<p>A CPA describes the formal relationship between the provider and the pharmacist. (C)</p>
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In the ISBAR communication model, which component includes objective data such as vital signs, lab results, and current medications?

<p>Background (B)</p>
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Which scenario BEST exemplifies asynchronous telehealth?

<p>A patient sends a secure message to their provider through an online portal. (A)</p>
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A study shows that pharmacist interventions significantly increased statin use and tobacco cessation rates. What consideration is MOST relevant before wide implementation?

<p>The population included in the study and the generalizability of the results. (B)</p>
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Which of the following features is MOST indicative that telehealth would be appropriate?

<p>A patient requesting a dermatology consultation. (B)</p>
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Which piece of information would be placed in the 'Objective' section of a SOAP note?

<p>Blood pressure reading of 140/90 mmHg. (A)</p>
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Flashcards

Purpose of patient interview?

To ensure an accurate medication list, assess needs, identify problems, and develop a therapeutic relationship.

Key interview components?

Includes chief complaint, history of present illness, past medical history, and medication history.

Types of drug therapy problems?

Unnecessary drug therapy, needs additional therapy, ineffective drug, dosage issues, adverse reactions, adherence problems.

Prioritizing drug therapy problems?

Severity of potential harm, patient's perception of risk/urgency, and rate at which harm might occur.

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Key elements of motivational interviewing?

Collaboration, evocation, and autonomy.

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When to use motivational interviewing?

Obesity, diabetes, hypertension, medication adherence, psychiatric illness, substance abuse, etc.

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Communication strategies for motivational interviewing?

Open-ended questions, reflections, express empathy, develop discrepancy, summarize, affirmations, roll with resistance.

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SMART goals?

Specific, measurable, attainable, relevant, and time-based.

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Compliance?

Extent behavior matches recommendations; implies patient passivity.

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Adherence?

Patient's willingness to follow regimen, active participation.

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Concordance?

Agreement after negotiation, respects beliefs and wishes.

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Reasons for less-than-optimal adherence?

Patient-related, provider-related, health system-related.

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Behaviors of collaborative partnerships?

Summarize results, similar agendas, nonhierarchical relationships, respect

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Benefits of pharmacist involvement?

Reduced medication errors and overall costs, improved adherence and A1C control ect.

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What is a collaborative practice agreement (CPA)?

A CPA is a formal relationship & is recommended by organizations.

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Appropriate CPA disease states?

Chronic illnesses such as hypertension and diabetes.

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ISBAR?

Introduction, Situation, Background, Assessment, Recommendation.

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Synchronous telehealth?

Real-time communication like phone and video

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Asynchronous telehealth?

Communication not in real-time, secure messaging

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Benefits of telehealth services?

Improved access, provider effeciency and overall care.

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Patient Interview Components

Chief Complaint, History of Present Illness, Past Medical History, Medication History, and Social History

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What is a Drug Therapy Problem (DTP)?

Any undesirable event involving drug therapy that interferes with achieving desired goals.

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Unnecessary Drug Therapy

Duplicate therapy or no current medical indication

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Effectiveness Problem

Better drug available, dose adjustment, or additional monitoring required.

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Adverse Drug Reaction

Side effect or allergy

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Non-Adherence

The patient does not take the medication as prescribed.

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Motivational Interviewing

Used for obesity, diabetes, and medication adherence. Promotes collaboration, autonomy, and a patient-centered approach.

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Purpose of Patient Counseling

To educate patient about the medication.

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Required Counseling Content

Name, route, special directions, storage, and common side effects.

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Prime Counseling Question: Purpose

What did your doctor tell you the medication is for?

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Prime Counseling Question: Use

What did your doctor tell you to take it?

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Prime Counseling Question: Expectations

What did your doctor tell you to expect?

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Medication Errors in Children

Administration errors are the most common errors and 1–3 minute interventions increase safety

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How to speak to Children

Four stages of cognitive development

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Impact of Age on Communications.

Educational level and vision

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Communication Barriers

Altered cognition or speech

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Attitudes in Healthcare

Identify and accommodate stereotypes

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Environmental Barriers

Light, noise, physical layout, technology and location of pharmacy

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Chief Complaint

A patient's description of their primary reason for seeking medical care.

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History of Present Illness

Detailed account of the development of the patient's current illness.

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Past Medical History

Summarized record of a patient's previous illnesses, surgeries, hospitalizations, and treatments.

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Medication History

Complete record of all medications a patient is currently taking, including prescription, over-the-counter, and herbal remedies.

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Medication Experience

Patient's beliefs, concerns, and goals related to their medication therapy.

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Vital Signs

Objective measurements such as blood pressure, heart rate, and lab results.

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Allergic Reactions

Record of any adverse reactions or intolerances a patient has experienced with medications.

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Social History

Information about a patient's use of tobacco, alcohol, and illicit drugs.

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Lifestyle

Information on a patient's typical food intake, exercise habits, and lifestyle.

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Needs Additional Drug Therapy

A type of drug therapy problem where a patient needs to be on a certain drug, but is not.

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Surrogate Outcome

Asking the patient if they have had a blood pressure check at home or elsewhere.

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Patient Medication Goals

Assessing if a patients medications are helping them reach their medical goals.

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Eliciting DTPs

Question to elicit information on effectiveness, safety, indication or adherence

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Unintentional non-adherence

Non adherence because of misunderstanding and memory relating to a medication.

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Patient Chart

A form filled with patient background information that helps determine a proper plan of action

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Study Notes

Here are the updated notes.

  • Action is required if common or severe side effects occur

Safety

  • Common Side Effects

  • Teach patients how to manage side effects

  • For very young patients, counsel parents only

  • Encourage children to respond, and understand that those Under 7 express actions vs time

  • Be aware of children's cognitive abilities at different ages, for example, children aged 2-7 cannot relate cause and effect

  • Children aged 7-12, can relate diseases and the effects

  • Communicate using internal, educational, tone, and stress levels of those that are patients, using proper communication style

  • Be understanding of hearing or memory issues in older patients when trying to communicate

Managing Communications

  • Always remember and listen when communication, remember their norms and literacy skills, while having proper tone
  • Be understanding of hearing issues & memory loss, and focus on them

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