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by: Gaurav

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1 : Patient medication counselling Techniques & Communication Skills Prepared By: Gaurav Bhatia Pharm D[P.B]
2 : Patient counselling. Patient counselling may be defined as providing medication information orally or in written form to the patients or their representative or providing proper directions of use, advice on side effects, storage, diet and life style modifications.
3 : GOAL. To provide information directed at encouraging safe & appropriate use of medication,thereby enhancing therapeutic outcomes.
4 : Functions. Better patient understanding of their illness & the role of medications in its treatment. Improved medication adherence More effective drug treatment Reduced incidence of adverse effects & unnecessary health care costs Improved quality of life for the patient Better coping strategies to deal with medication related adverse effects Improved professional rapport between the patient & pharmacist
5 : Communication. Communication is the transfer of information meaningful to those involved. It is the process in which messages are generated and sent by one person and received and translated by another person. Empathy: It is the ability to see & feel what the world is like for another person.
6 : Contd… Counselling process uses following:- 1.Verbal communication. Language, Tone, Volume, Speed 2.Non-verbal communication. Proximity, Eye contact, Facial expression
7 : Qualities of a good counsellor. Be a good listener. Be flexible. Be empathetic. Be Non-judgemental. Be tolerant. Communicate confidently.
8 : Communication during drug therapy. Purpose of medication How medication works Dose and duration of therapy Goals of therapy How effectiveness will be monitored Adverse effects and how to deal with them Drug specific issues
9 : Techniques of counselling. Stage I: Medication information transfer, during which there is a monologue by the pharmacist providing basic, brief information about the safe and proper use of medicine.  Stage II: Medication information exchange, during which the pharmacist answers questions and provides detailed information adapted to the patients’ situation.  Stage III: Medication education, during which the pharmacist provides comprehensive information regarding the proper use of medicines in a collaborative, interactive learning experience.  
10 : CONTD… Stage IV: Medication counseling, during which the pharmacist and patient have a detailed discussion intending to give the patient guidance that enhances problem-solving skills and assists with proper management of medical conditions and effective use of medication.
11 : Stages in the counselling process. Recognizing the need for counseling Assessing and prioritizing the needs Specifying the assessment method to be used Implementing Assessing the success of the process
12 : When it is necessary. During an ambulatory clinic visit On admission, beginning with the medication history inter-view Counselling throughout an inpatient stay Immediately, prior to discharge or at discharge
13 : Primary Steps. Identifying the patients Introducing yourself Adopting suitable physical position to enable counselling to take place comfortably & effectively If multiple medications, organising the drugs in a logical sequence Utilising other counselling aids when appropriate
14 : Procedure. Patients with serious or unstable disease states Patients receiving specific medications Patients treated with complex drug regimens Patients whose established medications have been altered Elderly or Paediatric patients Patients with language or reading difficulties Patients identified as non-intentional non-compliers
15 : Steps during Patient counselling. Preparing for the session Opening the session Counselling content Name and description of the medication Reason why it has been prescribed or How it works How to take the medication Exected duration of treatment Exected benefits of treatment Possible adverse effects Possible medication or dietary interactions
16 : Contd… Advice on correct storage Minimum time duration required to show therapeutic benefit What to do if a dose is missed Special monitoring requirements Closing the session.
17 : Barriers of Patient counselling. Lack of time. Lack of knowledge about drugs & patient’s history. Lack of confidence. Poor communication skills. Language barriers. Lack of awareness by the patient of the need for counselling & its availability. Physical barriers. Economic considerations & Poor patient perception of the pharmacist.
18 : Contd… Administrative barriers Negative attitude Poor patient perception of the pharmacist
19 : Steps to becoming a counselling pharmacist. Evaluate your own values & priorities. Evaluate barriers to patient counselling. Arrange for removal or reduction of barriers where possible. Arrange for counselling aids. Prepare staff,physician & patients. Prepare for each counselling session. Progress into counselling insteps. Remember to tailor counselling. Arrange for practice. Self-evaluation.
20 : False assumptions about patient understanding and medication adherence. Do not assume that previous physicians have already discussed with patients the medications they prescribe. Do not assume patients understand all information given. Do not assume that if patients understand what is required, they are able to take medication correctly. Do not assume that patients don’t take medication because they don’t care or not motivated. Do not assume that once patients have problems they will contact you.
21 : Medication Counseling Tips. Establish relationship – show interest in patient (verbal & nonverbal) Verify patient's name and prescriber's name Why the patient is being prescribed the medication (if known) or the medication’s use, expected benefits and action Open the medication containers and show patient what the medication looks like, or demonstrate use How to take the medication When to take and how long to take the medication What to do if a dose is missed Any special precautions to follow
22 : Contd… Foods, alcoholic beverages or OTC’s to be avoided How the patient will know the medication is working How to store the medication If the prescription can be refilled, and if so, when Verify the patients’ knowledge and understanding Ask the patient if they have any questions Document the interaction
23 : Patients who should always be counselled. Confused patients, and their caregivers Patients who are sight or hearing impaired Patients with poor literacy Patients whose profile shows a change in medications or dosing New patients, or those receiving a medication for the first time, Children, and parents receiving medication Patients receiving medication with special storage requirements, complicated directions, significant side effects
24 : Counselling Aids. Medication Cards. Patient information leaflets. Flesch Reading Ease[FRE] formula FRE=206.84 – 0.85W – 1.02S
25 : THANK YOU!@
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