Patient Counseling – Role of Pharmacist

 

Poonam M Kasar, Chetan Sahebrao Salunke, Krishna Pralhad Patil

R.G. Sapkal Institute of Pharmacy, Anjeneri, Nashik.

 

ABSTRACT:

Effective patient counseling makes the patient understand his/her illness, necessary lifestyle modifications and pharmacotherapy in a better way and thus enhance patient compliance. The pharmacist has immense responsibility in counseling the patients. The counseling pharmacist should possess adequate knowledge and should be an effective communicator, making use of the verbal and non-verbal communication skills. The act of assisting a client in seeing everything clearly, potentially from a unique perspective. This might assist the client in focusing on feelings, experiences, or behaviour with the goal of achieving positive change and establishing a trusting connection. Confidentiality is essential for successful counselling.

 

 

INTRODUCTION:

The simple act of asking a patient if he or she would like to speak to a pharmacist has a very positive impact on overall patient satisfaction. And while it doesn't necessarily increase the likelihood that the patient will request to actually speak with the pharmacist, it exhibits a sense of concern from every member of the pharmacy staff. Of course, this small step is merely the tip of the iceberg with regard to the benefit of interactions between pharmacists and staff with their patients.

 

'Patient counseling' by pharmacists is a diverse and ill-defined activity. It may, in practice, range from simply stating the dosage of a drug and giving advice with regard to lifestyle and health promotion issues, for example smoking cessation, cholesterol testing and contraception. A pharmacist must seek to ensure that the patient or his agent understands sufficient information and advice to enable safe and effective use of medicines. This must include seeking to ensure that the directions on the labels of dispensed products are understood.

 

Figure no. 1: Patient Counseling

 

The pharmacist should be prepared and available at all times to give advice on general health matters. Patient counseling is a useful tool in reducing both medication related problems and medication non-adherence. Another benefit of counseling is patient satisfaction. Patients feel counseling is important. Not only does it help them take their medications correctly, many patients feel more confident about using their medications.¹

 

OBJECTIVES:

1.     Patient should recognize the importance of medication for his well being.

2.     A working relationship for continuous interaction and consultation should be established.

3.     Patient understanding of strategies to deal with medication side effects and drug interactions should be improved.

4.     Patient becomes an informed, efficient and active participant in disease treatment and self care management.

5.     The pharmacist should be perceived as a professional who offers pharmaceutical care.

6.     Drug interactions and adverse drug reactions should be prevented.⁷

 

Figure no. 2: Consultation

 

POTENTIAL BENEFITS TO PATIENTS:

1.     Improved therapeutic outcomes and decreased adverse effects.

2.     Improved patient adherence to the treatment plan.

3.     Decreased medication errors and misuse.

4.     Enhanced patient self- management by involving the patient in designing the therapeutic plan.

5.     Potential for decreased health care costs due to appropriate use of medications and prevention of adverse events.²

 

POTENTIAL   BENEFITS TO PHARMACISTS:

1.     Enhanced professional status in the view of patients and other health care providers.

2.     Establishment of an essential component of patient care that cannot be replaced by technicians or automation.

3.     Enhanced job satisfaction through improving patient outcomes.

4.     A value-added service to offer patients.

5.     Revenue generation through payment for counseling services– limited at present but growing.^[2]

 

COMMUNICATION SKILLS:

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.

 

Figure no. 3: Communication  with geriatrics

 

Good communication skills are essential to advance pharmaceutical care. Effective communication is a key component of patient counseling. A pharmacist's communication is an important factor in patient satisfaction, perceptions of overall service quality, and trust. Communication is much more than speaking clearly. It involves listening and understanding. It includes your tone and body language. Much can be said between individuals when no words are even spoken. In the healthcare setting, communication is extremely important.⁸

 

Much of the communication that takes place in the pharmacy is verbal. You spend the day talking on the phone and counseling patients. When you speak, your tone should be pleasant and respectful, your speech clear and not garbled, and your volume at an appropriate level. Non-verbal communication also includes things like facial expression and eye movement. Rolling your eyes at a question shows impatience and lack of respect. It may cause the patient to feel inferior. If your facial expression is pleasant and you are smiling, the patient will likely respond more positively than if you were scowling. Your breathing can also be a type of non-verbal communication. Heavy sighs can signal frustration and impatience. You should be aware of these cues as you communicate. Pay attention to yourself and see if your non-verbal communication says something negative while your verbal communication is positive. Active listening is important to clarify an understanding of what the patient is telling you. Active listening can be accomplished through reflection and clarification. Reflection is listening to the patient and then repeating to them in a nonjudgmental way. This allows both parties to be sure that the same thing is being discussed. Clarification is similar since it requires you to listen to the patient and then summarize what they have said. This is useful to pull out the most important parts of a longer conversation.³

 

Communication during drug therapy must include following points:

1.     Purpose of medication

2.     How medication works

3.     Dose and duration of therapy

4.     Goals of therapy

5.     How effectiveness will be monitored

6.     Adverse reactions and how to deal with them

7.     Drug specific issues.³

 

Figure no. 4: Drug Dispensing

 

COUNSELLING CAN BE DONE ON FOLLOWING TOPICS AS PER THE PATIENTS SITUATION:

·      Counselling on Smoking cessation.

·      Counselling on Alcohol Use Disorder.

·      Counselling on the Use of Prescription opiods.

·      Counselling on Lifestyle Modification.

·      Counselling on Support Options for Regular Exercise and Diet Changes.

·      Counselling on Sleep Hygiene and Lifestyle Modification to Improve Mood.

·      Counselling on Sexual Health and Contraception.

·      Counselling on Support Options for Domestic Violence.

·      Counselling for Patient with Memory Loss and Cognitive Impairment.

·      Counselling for Patient with Chronic Disease and Terminal Illness.

·      Counselling for   Patients   Following disfigure Injuries or Surgery.

·      Counselling on Sudden Infant Death Syndrome.

·      Counselling on Pregnancy Loss.

·      Communication with Transgender and Gender-diverse Patient.

·      Communication with Patient with Disabilities.

·      Communication on complementary Alternative Medicine.⁵

 

Patient Counselling Obstacles:

A.             Emotional Considerations:

Patients with a changed state of mind due to dread of illness, out-of-pocket expenses, work and business interruptions, and so on. Other factors include uncertainty about what to expect with this new illness or symptom, reliance on providers to provide the best treatment and on family to help with dayto-day tasks, fear of change and death, pain and discomfort, lack of privacy in physical examinations, loss of identity as a healthy person (which sounds strange but is mostly true). People are more likely to trust or respond favorably to another individual when they receive social support.¹

 

B.    The Pharmacy Setting:

Many community pharmacies do not have a dedicated room for private counselling and discussion between the pharmacist and the patient In addition to a lack of privacy, pharmacists frequently face other obstacles to meaningful engagement with their patients, such as

·      A lack of supportive people.

·      A significant workload and backlog

·      People who are waiting for their medicines to be filled or for pharmacist assistance.

·      Incoming phone calls and coworker requests for information or assistance.

·      Interns and other employees, as well as

·      Inadequate computer hardware, software, and services

·      Getting ready for new consultation role.¹

 

Barriers to Communication among Pharmacists:

Nervous movements or "fidgeting," crossed arms or legs, turning or leaning away from the patient, failure to maintain eye contact, and obvious distractedness are examples of inappropriate nonverbal behaviors that pharmacists who are uncomfortable interacting with patients or who have had little training in patient interaction may engage in. Pharmacists have also mentioned the following impediments to successful communication:

·       Lack of time.

·       Financial concerns.

·       Poor communication skills or a lack of confidence in those skills.

·       Lack of information of current drugs or medical history, as well as the patient's failure to value the counselling session or pharmacist expertise. The patient's lack of appreciation for the usefulness of a pharmacist consultation can be overcome by publicizing the service and personally giving the consultation to each patient with a brief discussion of the process' importance in enhancing patient medication therapy outcome⁴.

 

Figure no. 5: Drug Information

 

 

ROLE OF PHARMACIST VS ROLE OF PATIENT^6,9:

 

CONCLUSION:

Prescribing and patient counseling is mammoth task. Pharmacists or other health professionals are the core of patient counseling process as today’s doctors are busy enough to give adequate time to educate patients about their health and disease progression, compliance and mitigation. Pharmacists have to play versatile role from prescribing to compliance. A proper patient counseling leads to improve patient compliance and hence the therapeutic outcomes and quality of life. Moreover, the patient counseling by pharmacists also enables chronic care patients to have patience.

 

REFERENCE:

1.   Rayal T, Jauhari R, Roy P, Roy J. A Brief Review about Patient Counselling. Journal of Applied Pharmaceutical Sciences and Research. 2022 Jun 1; 5(1): 9-16.

2.   Mohiuddin AK. Patient counseling: a complete guide for compliance. Journal of Applied Pharmaceutical Sciences and Research. 2018: 1-0.

3.   Pharmacist in Patient Counselling | Namdeo Shinde - Academia.edu

4.   https://ijcrr.com/uploads/2173_pdf. pdf

5.   Patient communication and counseling - Knowledge @ AMBOSS

6.   The Role of Pharmacists in Patient Counselling for OTC Medication: A Cross-sectional Study (researchgate.net)

7.   Adepu R, Nagavi BG. Attitudes and behaviors of practicing community pharmacists towards patient counselling. Indian journal of pharmaceutical sciences. 2009 May; 71(3): 285.

8.   Adepu R, Nagavi BG. Attitudes and behaviors of practicing community pharmacists towards patient counselling. Indian journal of pharmaceutical sciences. 2009 May; 71(3): 285.

9.   Al Aqeel S, Abanmy N, AlShaya H, Almeshari A. Interventions for improving pharmacist-led patient counselling in the community setting: a systematic review. Systematic reviews. 2018 Dec; 7(1): 1-3.

 

 

Received on 25.04.2023           Modified on 28.05.2023

Accepted on 23.06.2023   ©Asian Pharma Press All Right Reserved