Pharmacy Ethics: Patient Communication

Ethical Considerations in Professional Communication

• Ethical communication is a type of communication based on certain ethical values such as honesty, conciseness, and responsibility for one's words and resulting actions.
• Fundamentals of ethical communication: • Be truthful and honest: 100% openness and transparency are fundamental to all business relationships. • Active listening: proactively listen to the speaker, ask questions to clarify, and avoid interrupting. • Speak non-judgmentally: eliminate unnecessary conflict and promote understanding. • Speak from your own experience: provide support for your arguments with tangible experiences. • Consider the receiver's preferred communication channel: use the preferred communication method to effectively communicate. • Strive to understand: seek to fully understand what is being said before responding. • Respect privacy and confidentiality: take responsibility for actions that result from one's words. • Avoid a negative tone: maintain a courteous, professional, and tactful tone.

Code of Ethics for Pharmacists

• Adopted by the American Pharmaceutical Association on October 27, 1994
• Key principles: • Respect the covenantal relationship between the patient and pharmacist • Promote the good of every patient in a caring, compassionate, and confidential manner • Respect the autonomy and dignity of each patient • Act with honesty and integrity in professional relationships • Maintain professional competence • Respect the values and abilities of colleagues and other health professionals • Serve individual, community, and societal needs • Seek justice in the distribution of health resources

Ethical Decision-Making

• Steps involved in ethical decision-making: • Identify the problem or issue • Gather relevant information • Consider alternative solutions • Evaluate the consequences of each alternative • Choose the best course of action • Implement the decision • Monitor and evaluate the outcome

Ethical Issues in Community Pharmacy Practice

• Conscientious objection: the right to refuse to dispense a drug based on personal beliefs
• Prescribing of Pharmacy Only Medicines (POM): the sale of certain medications without a doctor's prescription
• Extemporaneous pharmaceutical preparations: products dispensed immediately after preparation without concerns for quality, stability, bioavailability, efficacy, and safety
• Product recalls: the removal of defective products from use and the dissemination of safety alerts
• Supply, import, and export of drugs: controlled by permits and licenses, with a high level of ethics required to prevent misuse
• Marketing of pharmaceutical products: ensuring ethical principles are maintained when promoting products
• Advertising: regulations regarding direct-to-consumer advertising and the provision of free samples

Pharmacist Relationship with Patients, Physicians, and Drugs

• The pharmacist-client relationship is influenced by: • The personality of the pharmacist • The location of the pharmacy • The socioeconomic level of the client • The sex and age of the client • The client's health problem and its severity

• Types of pharmacies: • Small neighborhood pharmacy: personalized service, limited storage space, and strong relationships with neighborhood physicians • Rural pharmacy: fewer staff members, more spacious, but not necessarily more organized, with a focus on local consumption patterns • Big central location pharmacy: big in supplies and personnel, but not necessarily in space, with a focus on aesthetics and cleanliness

• Clients' health problems and the pharmacist: • Clients prefer to discuss health problems with a pharmacist rather than a physician • Pharmacists' advice is free and requires no waiting time or rituals • Pharmacists are careful not to handle cases involving high fever, bleeding, or infected wounds

• Physicians vs pharmacists: • Professional jealousy and competition between pharmacists and physicians • Pharmacists are the medication experts, while physicians are the medical experts • Both recognize their work is complementary to each other

• OTC vs prescription drugs: • Over-the-counter (OTC) drugs are available without a prescription • Prescription drugs require a written prescription from a physician • OTC drugs are considered safe if warnings and directions are followed • Prescription medications are usually more potent than OTC drugs### Weight Loss Supplements

• Raspberry ketones come from red raspberries and reduce fat storage and increase metabolism, but may cause feelings of jitteriness and increased blood pressure and heart rate.

• Mechanism of action of raspberry ketones: reduce fat storage and increase metabolism.

• Side effects of raspberry ketones: feel jittery, increased blood pressure, and heart rate.

Other Weight Loss Supplements

• Chromium helps improve calorie burn and decreases appetite, but may cause watery stools, constipation, nausea, vomiting, and headaches.
• Mechanism of action of chromium: improve calorie burn and decrease appetite.
• Side effects of chromium: watery stools, constipation, nausea, vomiting, and headaches.

Prescription Drugs and Weight Loss

• Saxenda (liraglutide) is an injectable medication that decreases appetite and increases feelings of fullness by acting as a GLP-1 agonist.
• Mechanism of action of Saxenda: decrease appetite and increase feelings of fullness.
• Side effects of Saxenda: uncomfortable gastrointestinal disorders, especially when first taking the drug, and low blood sugar.
• Contrave (naltrexone hydrochloride and bupropion hydrochloride) affects the central nervous system to increase the number of calories burned and reduce appetite.
• Mechanism of action of Contrave: affects the central nervous system to increase calorie burn and reduce appetite.
• Side effects of Contrave: uncomfortable gastrointestinal disorders, insomnia, and dry mouth, and may cause suicidal thoughts or actions, particularly when first taking it.

OTC Misuse

• Only 16% of patients read the entire product label, and if they read them, they do not follow the directions on the label.
• OTC drugs can be harmful if misused.
• OTC drugs can change the effect of prescription medications.
• OTC drugs can mask symptoms of a disease.
• OTC drugs can lead to overdose.

Safe Use of OTC Drugs

• Patients should consult a doctor or pharmacist before purchasing an OTC product, especially in cases of pregnancy or breastfeeding.
• Patients should read the label carefully.
• Patients should not take medicines with the same active ingredient.
• Patients should remember that herbal supplements are not the same as OTC medicines.
• Patients should always check the expiration date.

This quiz covers ethical considerations in professional communication for pharmacists, including understanding general and specific ethical principles and applying them to patient cases. It's based on lectures 10 & 11 by Dr. Maria Maged.