Pharmacist Patient Counselling

Patient Counselling

• Involves providing information, advice, and assistance to help patients use their medications correctly

Importance of Patient Counselling

• Counseling patients about their medications is an important responsibility for pharmacists
• It presents an excellent learning opportunity for students
• Pharmacists are often the primary healthcare providers focusing on patient medication education
• They explain how to take medications, what to expect, and potential side effects and drug interactions
• Many pharmacists are trained in counseling methods like the one developed by the Indian Health Service (IHS)

Benefits of Patient Counselling

• Pharmacists can provide effective doses and relevant information to patients
• Pharmacists have a significant role in counseling patients with chronic illnesses
• It helps prevent drug interactions and adverse drug reactions
• Aids in building a therapeutic alliance with patients to achieve mutually understood therapy goals
• Patients become informed, efficient, and active participants in their treatment and self-care
• Pharmacists are seen as professionals offering pharmaceutical care

Stages of Patient Counselling

Introduction (Counselling Content)

• Introduce yourself
• Review the patient's medication record
• Explain the purpose and importance of counseling
• Obtain the patient's medication history, including allergies and previous incidents
• Gather drug-related information, such as allergies and herbal use
• Assess the patient's understanding of the reasons for their therapy
• Address any actual or potential concerns or problems of importance to the patient

Present Patient Condition

• Personal assessment includes the patient's name and age
• Assess the patient's mental ability to understand warnings
• Assess the patient's sensory and physical status
• Evaluate the patient's cognitive abilities
• Determine the patient's willingness to use medication
• Clinical assessment involves understanding how the patient uses the medication
• Determine the patient's attitude toward medication
• Identify possible barriers to adherence
• Evaluate the patient's willingness to adhere to the treatment plan

Closing the Counselling Session

• Confirm the patient's understanding through feedback
• Summarize key points
• Allow the patient to express any concerns
• Assist the patient in planning follow-up actions

Barriers to Effective Counseling

• Effective patient counseling in community pharmacy can be challenging due to various barriers

Pharmacist-Related Barriers

• Lack of knowledge about the patient
• Lack of knowledge about the patient's disease condition
• Lack of confidence or skill
• Negative attitude and beliefs
• Age difference
• Religious difference

Patient-Related Barriers

• Lack of trust
• Lack of knowledge of non-verbal communication
• Cultural or religious beliefs
• Poor listening skills
• Lack of time
• Information overload
• Physical or mental status issues
• Emotional factors

System-Related Barriers

• Shortage of pharmacists in a pharmacy
• Lack of time
• Pharmacists not able to access the patient's full medication history
• Poor communication between pharmacists and physicians

Strategies to Overcome Communication Barriers

• Use appropriate body language
• Motivate the receiver
• Choose a good time and place to communicate with the patient
• Use clear language that the patient understands
• Communicate one thing at a time
• Respect the patient's desire not to communicate
• Confirm that the patient has understood you correctly
• Communicate in a location free from distractions
• Acknowledge any emotional responses the patient has

Patient Counselling Points for Chronic Diseases/Disorders

• Applies to Hypertension, Diabetes, Asthma, Tuberculosis, Chronic Obstructive Pulmonary Disease, and AIDS

Hypertension

• A clinical condition with elevated blood pressure in blood vessels, potentially leading to hemorrhage and other conditions
• Can be managed through pharmacological and non-pharmacological approaches

Diabetes

• A metabolic disorder characterized by hyperglycemia resulting from defects in insulin secretion or action
• Chronic hyperglycemia can damage multiple organ systems
• Management involves pharmacological and non-pharmacological approaches;

Asthma

• Airways narrow, swell, and produce extra mucus, leading to breathing difficulties
• Management includes pharmacological and non-pharmacological approaches

Tuberculosis

• A potentially fatal contagious disease affecting the lungs, caused by Mycobacterium tuberculosis
• Management involves pharmacological and non-pharmacological approaches

COPD (Chronic Obstructive Pulmonary Disease)

• Marked by airflow obstruction, lung hyperinflation, and extra-pulmonary manifestations
• Management includes pharmacological and non-pharmacological approaches

AIDS (Acquired Immune Deficiency Syndrome)

• Caused by HIV, which destroys immune cells
• Management includes pharmacological and non-pharmacological approaches

Patient Package Inserts (PPI)

• A patient-oriented package insert is used in the United States and the European Union (Patient Information Leaflets)
• It is a non-technical document with specific information about the drug, its usage, and potential safety concerns

Importance and Benefits of PPIs

• Conveys knowledge about medicines and subjective benefit/risk perception
• Provides information for safe and effective use
• Offers essential drug information for both over-the-counter and prescription medications
• Increases patient awareness of medication-related issues, promotes safe medication use, and aids in treatment plan success

Scenarios of PPI Use

• The primary source of drug information is a package insert (PI)
• Contains information based on regulatory guidelines for safe and effective drug use
• Also known as a prescription drug label or prescribing information
• A good PI contains approved, essential, and accurate drug information
• Written in non-promotional, accurate language
• In India, the regulatory authority is the Ministry of Health and Family Welfare
• Pharmaceutical companies submit full prescribing information that complies with Schedule D, 1940 Act
• The application is approved, and the information is included with the drug in the package
• The United States-Food and Drug Administration and European Medicines Agency regulate the content and format of drug product labeling

Patient Information Leaflets (PILs)

• A technical document included in medicine packages with written information about the medication
• OR
• Leaflets with specific information on medical conditions, doses, and side effects
• Patient medication information leaflets (PMIL) are important information sources for patients
• Studies are ongoing to determine if patients read and are satisfied with PMILs