DOC-20240710-WA0005..pdf

Patient Counseling Patient Counseling  Patient Counseling Communication between health care providers and patients serves two functions: It establishes an ongoing relationship between the health care provider and the patient. It provides an exchange of information that will allow th...

Patient Counseling Patient Counseling  Patient Counseling Communication between health care providers and patients serves two functions: It establishes an ongoing relationship between the health care provider and the patient. It provides an exchange of information that will allow the health care provider to assess a patient’s health condition, manage treatment, and evaluate effects on quality of life Interpersonal communication involves the following components: Generation of a message by an individual Transmission of the message from one individual to another Reception of the message Interpretation of the message  Patient Counseling Numerous communication barriers exist in the pharmacy patient-care setting and can affect interpersonal communication. They include but are not limited to the following: Environmental barriers (pharmacy counter, noise, crowds, lack of privacy) Personal (low self-confidence, shyness, internal monologue, lack of objectivity, cultural differences) Patient barriers (inaccurate perception of the pharmacist’s role, the health care system, or the patient’s medical condition) Administrative and financial barriers (high prescription volume, few support staff members, staff members not paid to talk) Lack of time  Patient Counseling Vulnerable populations include the following: Elderly people (age 65 or older) Immigrant populations Low-income individuals People with chronic mental or physical health conditions Pharmacists should develop appropriate visual or written materials for patients with low health literacy Limiting written information given to patients, using plain (or lay) language in written and verbal communication, and using the teach-back method to confirm patient understanding of shared information  Patient Counseling The following are key points to consider When opening the interview, always introduce yourself and state the purpose of the interview. Ask permission of the patient to speak about his or her health care in front of others (family members, friends, etc.). Appear professional, interested, confident, and relaxed to put the patient at ease during the interview. Establish and maintain a rapport with the patient by being personal. If necessary, take notes, but do not lose focus on the patient  Patient Counseling Control the flow of information by asking only one question at a time. Politely redirect the patient to the line of questioning if he or she veers off topic. Give the patient ample time to recall information. Gently prod, but do not waste time if the patient cannot remember. The use of open-ended questions is very helpful when gathering patient information When closing the interview, summarize to the patient the information you have gathered and explain the plan. Ask the patient if he or she has any questions  Patient Counseling Medication History A comprehensive medication history should be conducted as follows: Allergies: What, when, where, outcomes Current prescription medications: Drug name, purpose, dose and frequency, duration, assessment of effects Past medication usage: Drug name, purpose, time period of use, reason for discontinuation Adverse drug effects: Medication, type of effect Use of OTC drugs, dietary supplements, and vitamins: Drug name, purpose, dose and frequency, duration, assessment of effects Other substances (tobacco, alcohol, illicit drugs): Amount, frequency, duration Adherence: Missed doses, reasons for nonadherence  Patient Counseling Three Prime Questions,” are listed below along with the information each question is designed to cover: “What did the doctor tell you the medicine is for?” Name of medication, purpose of medication “How did the doctor tell you to take the medication?” Dosing schedule, additional instructions, length of therapy, storage “What did the doctor tell you to expect?” Expected outcomes, precautions, possible side effects  Patient Counseling Active Listening and Empathy Following are tips for effective listening: Stop talking. Eliminate distractions. Establish appropriate eye contact. Read nonverbal cues. Listen to how something is said. Provide feedback.  Patient Counseling Assertiveness is the direct expression of ideas, opinions, and desires Assertive behavior can be characterized by the following: Directly expressing ideas, opinions, and desires Showing respect for self and others Being willing to openly and honestly communicate feelings, opinions, and needs Not violating the rights of others  Patient Counseling Several problem-solving techniques have been identified to aid the pharmacist when interacting with individuals in a difficult situation Fogging: Acknowledging possible truth from someone while ignoring any implied judgments about oneself: Patient: “$90! That’s outrageous! You’re trying to rip me off.” Pharmacist: “Yes, this is an expensive medication. If you would like, I can call your doctor and discuss some less expensive alternatives.” Being a broken record: Using calm repetition (if any error in prescription) Patient: “The doctor wrote this; you have to fill it!” Pharmacist: “I cannot fill this prescription as it is written.” (Repeated over and over.) Patient Counseling Using negative inquiry: Actively prompting feedback to use the information Patient: “That is impossible! I can’t give myself an insulin shot.” Pharmacist: “What is it about giving yourself an insulin shot that bothers you?” Disarming anger: Offering an honest contract to someone who is exhibiting a lot of anger (writing it down is often helpful): Patient: “You gave me the wrong prescription! How could you do this? Do you know what I would have done to you if I would have taken the wrong medicine?” Pharmacist: “I didn’t realize that an error occurred. Please start from the beginning, and I will write down all of the details.”  Patient Counseling Culture is defined as a complex pattern of shared meanings, beliefs, and behaviors that are learned and acquired by a group of people during the course of history Ethnocentrism is the belief that one’s own culture is superior while expressing contempt for another culture. Prejudice is a preconceived judgment or opinion of another person that is based on direct or indirect experiences. Stereotypes are fixed perceptions of a particular group or culture that reject the existence of individuality within that group or culture