2. What is Counselling?
Counselling involves giving patients
information and guidance on their
medicines and allowing them to make
informed decisions.
Guidance; is the help given to an
individual to enable him/her make
whatever adjustments or
readjustments necessary in order that
he may achieve individually and
socially desirable satisfaction in all of
his activities.
3.
4. Aims of counselling patients
The aims of counselling patients are to:
◦ Encourage patients to identify any problems
they perceive with medicines and also any
solutions to these problems.
◦ Encourage patients to develop their own action
plan for taking/using medicines correctly.
◦ Gain an understanding of the patient’s
perspective.
◦ Respect the patient’s beliefs and be non-
judgemental of their use (or non-use) of
medicines.
If patients do not take their medicines
correctly, they will not benefit from them.
5. Why should we Counsel
Patients?
Provide advice on the side-effects they may
experience from their medication.
Advice on how to use their medicine the first
time they receive it.
Important to check they are using it properly on
subsequent visits to the pharmacy.
Medicines may interact with other drugs the
patient is taking, and also with certain foods or
drinks.
Many patients are receiving substandard
care because they find their medicines difficult
to take or hard to remember, because they
don’t have anyone to talk to about their
medicines, or because they have complicated
6. Importance of patient counseling
Reducing medication errors
Increasing patients’ understanding and
management of their medical condition
Minimizing incidence of adverse drug
reactions and drug–drug interactions
Improving patient outcomes and satisfaction
with care
Improves compliance and adherence
Reduces health care cost
It is a psychological therapy.
It enables patients/clients release stres
s and anxiety
7. Opportunities for Counselling
Pharmacists and pharmacy
technicians should take a prominent
and proactive role in counselling.
The main opportunity for counselling
is at the end of the dispensing
process, or when a medicine is being
sold.
8. Qualities of a good counsellor
Knowledgeable about the product
being dispensed or sold
Excellent communication skills
(good listener, non-judgemental,
accept client’s feelings, pay attention)
Should solve the problem for the
patient.
Patience
Flexibility
Warmth
9. Qualities of a good counsellor
Tact (be polite in what you say or do)
Sensitivity
Empathetic with patients/clients
Confidentiality
Personal integrity
11. Information/advice to include
when Counselling
Name, strength, and dosage form.
How to take or use the medicine
When to take or use the medicine
How much to take or use
How long to continue to take it
What to expect,
◦ e.g. immediate relief, no effect for several days
Why the medicine is being taken or used
What to do if something goes wrong,
◦ e.g. if a dose is missed
How to recognise side-effects and minimise their incidence
Lifestyle changes which need to be made
Potential precautions, contraindications, drug-drug
interactions including non-prescription and herbal drugs
Dietary changes which need to be made
Proper storage
Prescription refill information
12. Information/advice to include
when Counselling
Don’t break an enteric coated tablet f
or easy swallowing
With medications in suspension form,
“Shake the Bottle” has to be followed.
How to remove medicine from the pa
ck and use e.g. blister, strip pack.
How to fit in the dropper assembly an
d use.
To specify whether the medicine is for
internal or external use
13. Consideration of the Medicine
Consider counselling if the drug has:
◦ A narrow therapeutic index
◦ The potential to interact with another drug
or food
◦ The potential to cause side-effects
◦ Special storage conditions
Counselling should also be done if it
is recommended by a reference
source, such as the BNF.
14. Consideration of the Patient
(1)
Is the patient known at the pharmacy,
and had previous problems with drug
therapy?
What counselling have they previously
received?
What are the patient’s comprehension
levels?
What level of support do they have or
need?
How old is the patient?
Are they pregnant or breastfeeding?
Do they have any disabilities?
Are they known to be poorly compliant?
15. Consideration of the Patient
(2)
When a patient who has brought in a
prescription wants to also buy an ‘over-the-
counter’ medicine that you know will interact
with the medicine on prescription
◦ E.g. a patient on warfarin who wants to buy
aspirin
If a patient brings in a prescription for more
than one medicine and asks for one or more
of them not to be dispensed
◦ Indicates poor compliance
If a patient wants to buy an OTC medicine
to relieve the side-effects of a prescription
medicine
◦ E.g a patient taking diclofenac who wants to buy
something to treat indigestion
16. Consideration of the Patient
(3)
Patients with terminal illness and rel
atives of patients e.g. HIV/AIDS and c
ancer
Patients who are on medication for t
he rest of their life.
Family planning clients
Women with abortions
Weak personalities
Addicted clients
17. Aids to Counselling
Patient Information Leaflets (PILs)
◦ In the UK we must give a leaflet out with
every medicine dispensed
◦ If these are not available, consider writing
your own information leaflets on how to use
ear drops, eye drops, pessaries,
suppositories, inhalers etc
Placebo devices
◦ E.g. placebo inhalers
◦ Useful for demonstrating correct inhaler
technique to patients, and for checking that
patients are using them correctly on
subsequent visits
18. Stages in the Counselling
Process
The following steps should be
followed:
1. Introduction
2. Process content
3. Conclusion
19. 1.Introduction
Review the patient’s record
Obtain drug related information such as
allergies, use of herbals etc.
Assess the patients understanding of the
reasons for therapy
Assess any actual and/or potential
concerns or problems of importance to the
patient.
20. 2.Process Content
Medication information exchange
◦ Use language that the patient
understands
◦ Use appropriate counseling aids
◦ Present facts and concepts in simple
words and in logical order
◦ Use open ended questions
21. 3. Conclusion
Check patient understanding
(feedback)
Summarize by emphasizing key
points
Give opportunity to the patient to put
forward any concept
Help the patient to plain follow-up
22. Summary of counseling process
There are six elements to the counseling p
rocess in pharmacy practice. They are easy
to remember with the memory aid GATHER
G: Greet the patient/client
A: Ask the patient/client about him/herself
T: Tell patient/client about proper use of m
edicines
H: Help patient/client to understand the in
structions
E: Explain how to use the medicine
R: Return for follow up.
23. Barriers to effective
counseling
Physical barriers for example uncomf
ortable sitting arrangement
Difference in social and cultural backg
round for example beliefs
Non verbal communication for exampl
e showing signs of disgust
Barriers caused by patients/clients e.g
. lack of interest in being counseled
Lack of trust and confidence between
counselor and client.
Language barrier
24. Conclusion
Counselling is an important part of the role of a
pharmacy staff which benefits the patient
Counselling must be structured, and the key
information should be given so it is easily understood
Counselling should be used to reinforce the label and
compliance and warn against the potential for
interactions
Some groups need special counselling
◦ Elderly, parents of ill children etc
Sometimes the amount of information given has to be
limited to avoid confusion
Patient understanding must be checked
Counselling is NOT a lecture
◦ Patients must be given the chance to ask questions
