Patient Counselling Techniques by Dr. Shabana Naz Shah

Dr. Shabana Naz Shah
PhD. In Pharmaceutical Chemistry
Sr. Manager Technical Services
Martin Dow Limited

 (Bartlett) is a planned learning experience using a
combination of methods such as teaching, counseling
and behaviour modification techniques that influence
patients knowledge and health behaviour.
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 Patient counselling is one of the major duty of a
pharmacist other then dispensing of drug.
 It is refers to the process of providing information,
advise and assistance to help patient to use their
medication appropriately.
3

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.
4

In an attempt to provide patient education, there are
many different things to consider.
Health professional information and Health Literacy.
Critical Thinking.
Knowledge Generation.
Knowledge Dissemination Activities.
Health Consumer Information and Health Literacy.
Readability.
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 To provide information directed at
encouraging safe & appropriate use of
medication, thereby enhancing therapeutic
outcomes.
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1. Patient should recognize the importance of
medication for his well being.
2. A. working relationship and a foundation for
continuous interaction and consultation
should be established.
3. Patient’s understanding of strategies to deal
with medications should be improved.
4. Should ensure better patient compliance.
7

5. Patient becomes an informed, efficient and
active participant in disease treatment and
self care management.
6. The pharmacist should be perceived as a
professional who offers pharmaceutical care.
7. Drug interactions and adverse drug reactions
should be prevented.
8

 Counselling process uses following:
◦ 1.Verbal communication.
 Language.
 Tone
 Volume.
 Speed
2.Non-verbal communication.
Proximity.
Eye contact.
Facial expression.
9

 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.
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Effective patients counseling aims to produce the
following results:
Better patients understanding of their illness and the role of
medication in its treatment.
Improved medication adherence.
More effective drug treatment.
Reduced incidence of adverse effects and unnecessary
healthcare costs.
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Improved quality of life for the patient.
Better coping strategies to deal with medication related adverse
effects.
Improved professional rapport between the patient and
pharmacist.
12

 Be a good listener.
 Be flexible.
 Be empathetic.
 Be Non-judgemental.
 Be tolerant.
 Communicate confidently.
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 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.
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 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.
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 Stage III: Medication education, during which
the pharmacist provides comprehensive
information regarding the proper use of
medicines in a collaborative, interactive
learning experience.
 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.
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 Recognizing the need for counseling.
 Assessing and prioritizing the needs.
 Specifying the assessment method to be used.
 Implementing.
 Assessing the success of the process.
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 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.
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 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.
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 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
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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.
 Expected duration of treatment.
 Expected benefits of treatment.
 Possible adverse effects.
 Possible medication or dietary interactions
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 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.
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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.
Administrative barriers.
Negative attitude.
Poor patient perception of the pharmacist
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 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.
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 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.
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 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
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 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
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 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.
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 Name of the medication.
 How to take the medication.
 Warning about medication.
 Storage of medication.
 Sundry items.
 Purpose and outcome of treatment.
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 Satisfaction of having fulfilled his/her professional
duty.
 Serving patients and their well being.
 Improves patients compliance.
 Pharmacy is seen as “Professional” or “Caring”
pharmacy.
 Formation of trusting relationship with patients.
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 Medication Cards.
 Patient information leaflets.
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Patient Counselling Techniques by Dr. Shabana Naz Shah

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