Ajman University College of Pharmacy PHA100 Patient-Centered Communication PDF

Ajman University College of Pharmacy PHA100 PHARMACY & COMMUNICATION SKILLS COMMUNICATION III PATIENT-CENTERED COMMUNICATIONS DR. NADIR KHEIR 8/29/2019 Principles of PC-2020-AU-NK  LEARNIN...

Ajman University College of Pharmacy PHA100 PHARMACY & COMMUNICATION SKILLS COMMUNICATION III PATIENT-CENTERED COMMUNICATIONS DR. NADIR KHEIR 8/29/2019 Principles of PC-2020-AU-NK  LEARNING OUTCOMES By the end of this lecture, you will be able to: 1.Discuss principles of good communication with patients 2.Discuss factors affecting communication 3.Explain the meaning of patient-centered communication 4.Explain the meaning of special populations in health care 5.List the most important special populations in health care and explain why they fit in this category 6.Explain how to deliver patient-centered care to patients categorized as special populations  Managing a team Discussing a Discussing a patient’s patient’s case case Consulting Making an a patient intervention  PRINCIPLES OF COMMUNICATIONS IN PHARMACY Counseling patients regarding their medications is an important responsibility for pharmacists Using: active listening (focusing on the patient), eye contact (being attentive, but not staring), being aware of your own body language (facing the patient and giving them your undivided attention), recognizing and interpreting nonverbal cues from the patient (comparing their nonverbal behaviors to their verbal  COMMUNICATION: EMPOWERING PATIENTS Effective medication counseling can empower patients to be active partners in their care Patients who are engaged in their health have enhanced care experiences, better outcomes and reduced overall healthcare costs Establishing a therapeutic relationship promotes understanding and empowering self-management Here the patient gives authority to the provider and the provider gives information and commitment Education involves assessing the patient’s understanding, the ability to use the prescribed medications correctly, and attitudes toward the health-related issues and associated pharmacotherapy  FACTORS THAT AFFECT COMMUNICATIONS There are many factors that can influence communication Your personality Your understanding of the personality of others Your culture and beliefs Your beliefs about the interaction you are having, and your desired outcome HOW KNOWLEDGE AFFECT COMMUNICATIONS? Knowledge is important in a pharmacist’s daily work Educating patients is one of the main roles of a pharmacist However, can knowledge affect communication? How? Imagine a situation where a pharmacist wishes to introduce a new medicine to a physician: how should this be done? Imagine a pharmacist wishes to educate a patient about a medicine. How should this be done? AN EXAMPLE AN EXAMPLE: CONTINUED AN EXAMPLE: CONTINUED SO: WHAT DO YOU THINK? WHAT IS YOUR EVALUATION OF WHAT HAPPENED? Discuss this communication scenario  PITFALLS IN COMMUNICATION: OVER LOAD OF INFORMATION Communication is a highly complex area It deals with not only the transmission of content but also interpersonal relationships, social processes, ability to ‘read’ the other person, and empathy Lecturing a patient will not ensure optimum delivery and receipt of the message It is not only about what you do or say, but HOW you do and say!  PATIENT-CENTERED COMMUNICATIONS The principles of patient-centered communication: 1.Eliciting and understanding patient perspectives (e.g., concerns, ideas, expectations, needs, feelings, and functioning) 2.Understanding the patient within his or her unique psychosocial and cultural contexts 3.Reaching a shared understanding of patient problems and the treatments that are concordant with patient value  PATIENT-CENTERED COMMUNICATIONS The Four Habits Model is a framework for patient- centered communication It contains 23 clinician communication behaviors organized into four “habits”: A.invest in the beginning, B.elicit the patient’s perspective, C.demonstrate empathy, D.invest in the end  GENERAL SKILLS IN PATIENT-CENTERED COMMUNICATIONS Skills Details Openness Demonstrated by making oneself available, not only with time but also by behavior: acknowledge the patient and make him/her feel welcome Identifying a patient by name in a warm greeting, offering a smile, being attentive, and maintaining friendly eye contact to build rapport Active Attentive body language listening Using verbal and nonverbal encouragement, paraphrasing to confirm understanding Keeping questions to a minimum to demonstrate to a genuine interest in the patient Questions designed to collect patient perspectives should be open-ended questions Speaking Slow down and speak in plain, non-medical language plainly Allow time for patients and families to ask questions by asking “What questions do you have?” Check the understanding of a patient by asking them to restate it in their own words, not just repeat it, to ensure the message is understood BEST PRACTICES FOR PATIENT-CENTERED COMMUNICATION  EXAMPLES OF HOW TO BECOME PATIENT-CENTERED COMMUNICATOR Visual aids and demonstration devices can promote patient understanding Opening pill bottles can emphasize the medication color, size, and shape to the patient For injectable medications: showing patients the exact marking on the measuring devices to ensure accurate dosing The direct observation of drug-use can also reveal accurate usage and strengthen teaching of important points Patient-friendly written resources as an adjunct to verbal communication can also help improve patient awareness Combining and using verbal, written and video should be used to emphasize important points TIPS FOR GOOD PATIENT INTERVIEWS  SPECIAL POPULATIONS Also known as ‘vulnerable’ populations These are patients who experience greater risk factors, worse access to care, and increased morbidity and mortality compared with the general population Usually also have poor health literacy Examples: chronic health conditions, racial and ethnic minorities, the economically disadvantaged Also, the elderly and children  CHRONICALLY ILL AND DISABLED PATIENTS Patients with chronic diseases are at risk of poor health outcomes Many with multiple conditions and multiple medicines Because of their health, chronically ill and disabled people may have difficulty accessing care They are at high risk to face special challenges in obtaining services Reasons: age, frailty, inability to communicate effectively, experience discrimination How should this reflect on a pharmacist’s communication skills?  LOW-INCOME INDIVIDUALS Low-income individuals are more likely to have multiple health issues, with heavy impact on their well-being They are more likely to be from racial and ethnic minority groups They may be less likely to have insurance or options for financial coverage As a result, they usually have less interaction with the healthcare system How should this reflect on a pharmacist’s communication skills?  THE VERY YOUNG AND VERY OLD Children have developing organs, low immunity, and spend more time outdoors Children respond different to medicines and interventions than adults and cannot just be viewed as “small adults” in the healthcare setting Also, older adults are more vulnerable to health issues since they also have low immunity and often numerous medical conditions Old people don’t always receive the care recommended for them, such as preventive care How should this reflect on a pharmacist’s communication skills?  PATIENTS WITH LOW LITERACY AND/OR HEALTH LITERACY SKILLS Presents challenges in: Reading prescription bottles Failing to attend appointments Understanding informed consent documents Understanding discharge instructions Following diagnostic test instructions Reading health education materials Adhering to drug therapy (poor adherence)  WHAT IS THE AIM? WHAT IS THE CHALLENGE? Pharmacists need to ensure that the medications prescribed/dispensed/bought are: (1) appropriate, (2) effective, (3) safe), and (are taken by the patient as prescribed What then is the problem with vulnerable or special populations?! How should this reflect on a pharmacist’s communication skills?  Fear Drug Lack of interactions confidence Hearing Affordability Toxicity/ADRs Biological Comprehension Mental problems impairment  SO, WHAT TO DO? 1. Imagine these scenarios: You are a clinical pharmacist, and today you meet this elderly man who is now being discharged from the cardiac rehabilitation section after surviving a heart attack He is accompanied by his wife and daughter He will be on half a dozen medications that you will dispense Does he fit as ‘vulnerable’? Why? What are the possible issues that you need to consider? How to ensure to provide patient-centered care?  SO, WHAT TO DO? 2. Imagine these scenarios: A man in his 40s comes to the pharmacy, with a sheet of paper on which there was a drug name written He does not speak Arabic or English He looked tired, wearing a workers overall that is old and dirty He tries to tell you he works in a nearby construction site and he needs this medicine You read the sheet of paper, and you read [please give antibiotic for cough] Does he fit as ‘vulnerable’? Why? What are the possible issues that you need to consider? What would you do?  ALWAYS 1. Keep it short and simple 2. Only tell patients what they need to know, not what is nice to know 3. Use the “teach back” strategy 4. Because everyone has different learning styles, verbal messages should be reinforced with written information and pictures whenever possible 5. Everyone learns better if information is reinforced in multiple ways. Provide easy-to-understand information for ALL patients  Verbal communications LET US TRY TO LEARN BY APPLYING AND PLAYING ROLES ! Empathy Body language Teaching back Active listening Eye contact