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.