The document discusses effective communication skills for dispensers at rural drug vendors. It covers several case studies where patients misunderstood or did not follow treatment instructions correctly due to poor communication. The document emphasizes using plain language, focusing on key messages, checking for understanding through teach back methods, and effectively soliciting questions from patients. It also discusses barriers to communication like the environment and patient factors. Good listening skills, questioning techniques, and strategies to improve communication between dispensers and prescribers are presented. The importance of collaboration and addressing issues rather than personalities to achieve positive outcomes is highlighted.
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Doctor patient communication @Mustafa Kemal UniversityDainius Jakučionis
Lecture I gave at Mustafa Kemal University in Turkey, Antakya. Main topic is about doctor patient communication, which could help to increase health outcomes. Important subject about patient-centered communication and approach.
The process of curing a patient requires an approach which involves considerations beyond treating a disease. It requires several skills in a doctor along with technical expertise. Studies have shown that good communication skills in a doctor improve patient’s overall satisfaction.
Keys: To Avoid MEDICO-LEGAL LITIGATION : by Communicating Effectively Wi...Lifecare Centre
The main key to good DOCTOR--PATIENT RAPPORT is good communication
If the doctor effectively uses empathy, they can gain trust in confidence of the patient, which create of bond of friendship.
These patient develop full faith in the ability, & the sincerity of the doctor.
Then only they tend to accept the unfavorable outcome without any ill feelings and develop no malice towards the Doctor.
It’s great when you can build a good rapport with patients and everything runs smoothly, but unfortunately, there are patients who can make your work more challenging than it already is.
A talk I gave in Al-Zaem Al-Azhary university on Thursday, 15/5/2014
Outline:
What do we mean by breaking bad news (BBN)?
Which news is bad? really bad? Like really, really bad !
Why should we care about BBN?
Ethical
Professional
Legal
BBN as part of the Communication Cycle/Pathway
Practical approaches to BBN:
SPIKES
ABCDE
BREAKS
The Do Not's in BBN
The process of curing a patient requires an approach which involves considerations beyond treating a disease. It requires several skills in a doctor along with technical expertise. Studies have shown that good communication skills in a doctor improve patient’s overall satisfaction.
Keys: To Avoid MEDICO-LEGAL LITIGATION : by Communicating Effectively Wi...Lifecare Centre
The main key to good DOCTOR--PATIENT RAPPORT is good communication
If the doctor effectively uses empathy, they can gain trust in confidence of the patient, which create of bond of friendship.
These patient develop full faith in the ability, & the sincerity of the doctor.
Then only they tend to accept the unfavorable outcome without any ill feelings and develop no malice towards the Doctor.
It’s great when you can build a good rapport with patients and everything runs smoothly, but unfortunately, there are patients who can make your work more challenging than it already is.
A talk I gave in Al-Zaem Al-Azhary university on Thursday, 15/5/2014
Outline:
What do we mean by breaking bad news (BBN)?
Which news is bad? really bad? Like really, really bad !
Why should we care about BBN?
Ethical
Professional
Legal
BBN as part of the Communication Cycle/Pathway
Practical approaches to BBN:
SPIKES
ABCDE
BREAKS
The Do Not's in BBN
Sales Skills and a little bit more. For many years, I have been successful winning new business, and major accounts.
Here are some really good pointers, some you know, others you may not. Happy Hunting.
To those who would like to have a copy of this slide, just email me at martzmonette@yahoo.com and please tell me why would you want this presentation. Thank you very much and GOD BLESS YOU
The Art of Interviewing is part of our 'This Is How We Do It Series'. This is for you if you want to undertake interviews that give you rich insight into what people actually do, not just what they say they do. This presentation will also help you plan, conduct and capture interviews as well as give you some insights into different interview techniques.
Recorded webinar: http://slidesha.re/1nOR5i5
Subscribe: http://ksmartin.com/subscribe
Purchase the book: http://bit.ly/TOObk
This webinar features content from Karen's workshop and talk at the Lean Enterprise Institute and Lean Frontiers Coaching Summit, held on July 29 & 30, 2014 in Long Beach, California.
Both the workshop and talk focus on learning how to break the "telling" habit as a leader or improvement coach, and how to use the right questions at the right time to develop people more effectively and get better work results.
Communication is the transfer of information meaningful to those involved. Interactive communication is a process that facilitates a dialogue to provide multiple opportunities to accurately interpret meaning and respond appropriately. An interactive model is similar to a discussion rather than a lecture.
For example, using an interactive model, a patient may be asked what they know about their medications. As the patient describes aspects of his or her medication therapy, the pharmacist can then respond to fill in knowledge gaps, correct misinformation and verify patient understanding, thus eliminating or minimizing misunderstandings.
Interactive communications are effective for many interpersonal situations, but are especially useful when working with patients to assure appropriate use of medications.
Patient counseling is a process wherein pharmacist implements face-to-face interaction with the patient to provide information, orally or in written form, on directions of use & advice on side effects to help them to use their medications appropriately
Patient counselling ,steps of patient ppunseling,communication skill in patie...MerrinJoseph1
Dr.Merrin,Joseph,Department of pharmacy practice,Community Pharmacy , Pharm D Second year, patient counseling,definition,outcome/scope of patient counseling,steps in patient counseling,communication skill in patient couseling,verbal skills and non-verbal skills.
1.Definition and benefits of patient counselling
2.Stages of patient counselling - Introduction, counselling content, counselling process and closing the counselling session
3.Barriers to effective counseling - Types and strategies to overcome the barriers
Patient Counselling is needed for
Better patient understanding to their illness and role of medication.
Improve medication adherence.
Improve dosage regimen adherence.
More effective Drug treatment.
Reduce incidence of adverse drug effect and unnecessary healthcare cost.
ADR reporting.
Improve quality of life for patient.
Raising image of Pharmacist & its profession.
PH 5.1 communicate with patient on all aspects of drug use
PH 5.2 Communicate with patient on proper use of drug /delivery device & storage of medicine PH 5.3 Communicate the patient to motivate adherence to treatment in chronic diseases PH 5.5 Communicate with patient regarding cost of treatment
Introduction: Medication adherence is defined by the World Health Organisation as “The degree to which the person's behaviour corresponds with the agreed recommendations from a health care provider
Factor Affecting Non-Adherance:Poor adherence or non-adherence to medical treatment severely compromises patient outcomes and increases patient mortality.
Non-adherence is a very common phenomenon in all patients with drug-taking behaviour.
The complexity of adherence is the result of an interplay of a range of factors, including patient views and attributes, illness characteristics, social contexts, access, and service issues.
Non-adherence: Non-adherence is the failure or refusal to comply with advice and can imply disobedience on the part of patient
5 step Factors: Social/economic and Economic Factors
Provider-patient/health care system factors
Condition-related factors
Therapy-related factors
Patient-related factors
Behavioural Factors:
Life style (smoking, alcohol, coffee use) Psychological and personality factors: anxiety, depression, coping style
Biological factors:
Gender, age, and genetic predisposition
Social and cultural factors:
Educational level, living situation, price of medication, policies.
Information Factors:
Have you received enough information? Satisfaction with the last visit?
Awareness factors:
Severity of the complaints (Baseline) quality of life,
Locus of control about patient adherence:
internal and external, stability and control about the cause of the complaints: internal and external, stability and controllability.
Stages to Overcome This Barrier
what is patient counselling, objective of patient counselling, steps in patient counselling, patient counselling contents, process, conclusion, communicative skill for effective counselling, verbal communication, non verbal communications
GraphRAG is All You need? LLM & Knowledge GraphGuy Korland
Guy Korland, CEO and Co-founder of FalkorDB, will review two articles on the integration of language models with knowledge graphs.
1. Unifying Large Language Models and Knowledge Graphs: A Roadmap.
https://arxiv.org/abs/2306.08302
2. Microsoft Research's GraphRAG paper and a review paper on various uses of knowledge graphs:
https://www.microsoft.com/en-us/research/blog/graphrag-unlocking-llm-discovery-on-narrative-private-data/
Essentials of Automations: Optimizing FME Workflows with ParametersSafe Software
Are you looking to streamline your workflows and boost your projects’ efficiency? Do you find yourself searching for ways to add flexibility and control over your FME workflows? If so, you’re in the right place.
Join us for an insightful dive into the world of FME parameters, a critical element in optimizing workflow efficiency. This webinar marks the beginning of our three-part “Essentials of Automation” series. This first webinar is designed to equip you with the knowledge and skills to utilize parameters effectively: enhancing the flexibility, maintainability, and user control of your FME projects.
Here’s what you’ll gain:
- Essentials of FME Parameters: Understand the pivotal role of parameters, including Reader/Writer, Transformer, User, and FME Flow categories. Discover how they are the key to unlocking automation and optimization within your workflows.
- Practical Applications in FME Form: Delve into key user parameter types including choice, connections, and file URLs. Allow users to control how a workflow runs, making your workflows more reusable. Learn to import values and deliver the best user experience for your workflows while enhancing accuracy.
- Optimization Strategies in FME Flow: Explore the creation and strategic deployment of parameters in FME Flow, including the use of deployment and geometry parameters, to maximize workflow efficiency.
- Pro Tips for Success: Gain insights on parameterizing connections and leveraging new features like Conditional Visibility for clarity and simplicity.
We’ll wrap up with a glimpse into future webinars, followed by a Q&A session to address your specific questions surrounding this topic.
Don’t miss this opportunity to elevate your FME expertise and drive your projects to new heights of efficiency.
UiPath Test Automation using UiPath Test Suite series, part 3DianaGray10
Welcome to UiPath Test Automation using UiPath Test Suite series part 3. In this session, we will cover desktop automation along with UI automation.
Topics covered:
UI automation Introduction,
UI automation Sample
Desktop automation flow
Pradeep Chinnala, Senior Consultant Automation Developer @WonderBotz and UiPath MVP
Deepak Rai, Automation Practice Lead, Boundaryless Group and UiPath MVP
Smart TV Buyer Insights Survey 2024 by 91mobiles.pdf91mobiles
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Securing your Kubernetes cluster_ a step-by-step guide to success !KatiaHIMEUR1
Today, after several years of existence, an extremely active community and an ultra-dynamic ecosystem, Kubernetes has established itself as the de facto standard in container orchestration. Thanks to a wide range of managed services, it has never been so easy to set up a ready-to-use Kubernetes cluster.
However, this ease of use means that the subject of security in Kubernetes is often left for later, or even neglected. This exposes companies to significant risks.
In this talk, I'll show you step-by-step how to secure your Kubernetes cluster for greater peace of mind and reliability.
UiPath Test Automation using UiPath Test Suite series, part 4DianaGray10
Welcome to UiPath Test Automation using UiPath Test Suite series part 4. In this session, we will cover Test Manager overview along with SAP heatmap.
The UiPath Test Manager overview with SAP heatmap webinar offers a concise yet comprehensive exploration of the role of a Test Manager within SAP environments, coupled with the utilization of heatmaps for effective testing strategies.
Participants will gain insights into the responsibilities, challenges, and best practices associated with test management in SAP projects. Additionally, the webinar delves into the significance of heatmaps as a visual aid for identifying testing priorities, areas of risk, and resource allocation within SAP landscapes. Through this session, attendees can expect to enhance their understanding of test management principles while learning practical approaches to optimize testing processes in SAP environments using heatmap visualization techniques
What will you get from this session?
1. Insights into SAP testing best practices
2. Heatmap utilization for testing
3. Optimization of testing processes
4. Demo
Topics covered:
Execution from the test manager
Orchestrator execution result
Defect reporting
SAP heatmap example with demo
Speaker:
Deepak Rai, Automation Practice Lead, Boundaryless Group and UiPath MVP
Elevating Tactical DDD Patterns Through Object CalisthenicsDorra BARTAGUIZ
After immersing yourself in the blue book and its red counterpart, attending DDD-focused conferences, and applying tactical patterns, you're left with a crucial question: How do I ensure my design is effective? Tactical patterns within Domain-Driven Design (DDD) serve as guiding principles for creating clear and manageable domain models. However, achieving success with these patterns requires additional guidance. Interestingly, we've observed that a set of constraints initially designed for training purposes remarkably aligns with effective pattern implementation, offering a more ‘mechanical’ approach. Let's explore together how Object Calisthenics can elevate the design of your tactical DDD patterns, offering concrete help for those venturing into DDD for the first time!
Builder.ai Founder Sachin Dev Duggal's Strategic Approach to Create an Innova...Ramesh Iyer
In today's fast-changing business world, Companies that adapt and embrace new ideas often need help to keep up with the competition. However, fostering a culture of innovation takes much work. It takes vision, leadership and willingness to take risks in the right proportion. Sachin Dev Duggal, co-founder of Builder.ai, has perfected the art of this balance, creating a company culture where creativity and growth are nurtured at each stage.
2. Case I
• A 1 year old baby is admitted to a clinic with a severe infection.
The mother came to a nearby rural drug vendor and while the
dispenser was speaking to her, he leant that about 1 wk ago,
her son had developed a minor bacterial infection and received
an antibiotic, which she gave him for 4 days until the infection
appeared to be cleared up.
3. Case 1, contd.
• When asked why she stopped the antibiotic, the mother
stated that she was just following the directions on the label
of the container which reads:
• “Take one-half of teaspoonful three times a day
for infection until all gone”.
2. What went wrong with this communication?
3. Was it possible to avoid the misunderstanding and how?
4. Say true or false to the following statements
based on Case 1
A The dispenser didn’t have a good communication skill T F
B Communication barrier is a hindrance to therapeutic T F
success
C “Until all gone” is the wrong term in this T F
communication that made the mother stop giving the
antibiotic prematurely
D When advising clients, simple to remember terms have T F
to be used (avoid medical jargons)
E Such terms as “take a tablet; apply an eye drop; insert a T F
suppository; apply a cream” have to be used in
communication
5. Objectives
Describe the basic principles and/or processes of
communication
Explain the various means of communication
Identify the different barriers to communication
Review the basic skills to effective communication
Describe the best approaches to communicating with
health care providers
Demonstrate effective communication with patients
and between providers
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• My mother loves me.
• ÑödÃÁ g— M
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7. Patient-oriented pharmaceutical services
• Clinical pharmacy services are patient-oriented
services developed to promote the rational use of
medicines, and more specifically,
• to maximize therapeutic benefits (optimize treatment
outcomes),
• minimize risk, reduce cost, and
• support patient choice and decisions
• there by ensuring safe, effective and economic use of
drug treatment in individual patients.
• Effective communication is the key to successful
patient-oriented pharmaceutical services
8. Pharmaceutical Care
• is the responsible provision of medicine therapy for the
purpose of a definite outcome that improves a
patient’s quality of life.
• is based on a relationship between the patient and the
healthcare providers who accept responsibility for the
patient.
• it implies the active participation of the patient in
medicine therapy decisions, the cooperation of
healthcare providers across disciplines, and gives
priority to the direct benefit of the patient.
9. THE COMMUNICATION PROCESS
Three parts of communication process
Sender
Message
Receiver
The goal of all communication is understanding
Effective communication occurs only when the
meaning of a message is held in common by the
participants.
11. VERBAL AND NONVERBAL COMMUNICATION
Verbal Communication
Involves the words which are spoken
Actual words convey about 10% of the message
Non verbal communication
Involves the use of body languages:
Gestures, facial expression, eye contact
physical contact, body posture
body space and proximity
12. Challenges of Communication for Patients
Inferiority
Low-literacy
Anxiety
Conflicting information
Forgetfulness
Prefer not to disclose their concerns
Impaired faculties of communication
Blind, deaf, etc.
13. BARRIERS TO COMMUNICATION IN DISPENSARIES
1. The Environment
Physical barriers
Lack of privacy
Noise
A busy rural drug vendor
14. Inside View of a Dispensing Unit - small dispensing window
15. Outside View of a Dispensing Unit - no privacy when counseling
20. BARRIERS TO COMMUNICATION IN DISPENSING SETTINGS (2)
1. The Patient Factors
• Physical disabilities
• Illiteracy
2. The Dispenser
Lack of adequate knowledge
Lack of confidence
Lack of interest
Laziness
Delegating responsibilities to untrained staff
• Time: suitable timing of information
21. Case II
• A young woman suffering from vaginal candidiasis was
given the usual 15 nystatin vaginal tablets and was told
by the dispenser to “use one tablet daily for two
weeks.”
• She returned to the pharmacy after two weeks in
severe discomfort with a complaint that “those nystatin
tablets taste terrible!”
• What was the problem with this communication?
22. LISTENING AND QUESTIONING SKILLS
Listening
Listening is extremely important to effective communication
Good Listening Poor Listening
Helps to get better information Creates misunderstandings
Saves time Wastes time
Solves problems Creates problems
Reduces errors Allows for mistakes
23. LISTENING AND QUESTIONING SKILLS (2)
Keys to Effective Listening:
Take personal responsibility for understanding what you hear
Concentrate and make a good effort to focus on the person speaking
Listen without interrupting, disagreeing, or offering explanations
Use body language (nonverbal gestures) to show that you are involved in
the conversation.
Example: nod your head, keep eye contact, keep hands at side
Ask questions to be certain you are interpreting the message correctly.
Example: summarize and paraphrase what you heard
Take notes as necessary. This will help you remember or document what
was said
24. Sharing experiences
• Share your experience to the participants where
mistakes were made because of poor listening.
25. LISTENING AND QUESTIONING SKILLS (3)
Questioning
‘Questioning’ is one of the most widely used social skills
In a health setting, questions are normally asked to
encourage the listener to provide information
The type of question asked and the way in which it is
asked will dictate the level of response given
Health care providers can use two types of questions
• Close ended questions: Did you take your doses correctly?
• Open ended questions: How did you take your doses last
month?
26. STRATEGIES TO IMPROVE COMMUNICATION
Explain things clearly in plain language
Focus on key messages and repeat
Use a “teach back” or “show me” technique to check
understanding
Effectively solicit questions
Use patient-friendly educational materials to enhance
interaction
Together, these strategies and others will help ensure the environment is
patient-friendly and shame-free for ALL patients.
27. 1. Explain Things Clearly in Plain Language
Slow down the pace of your speech
Use plain, non-medical language
• “Blood pressure pill” instead of “antihypertensive”
• Pay attention to patient’s own terms and use them
back
Avoid vague terms
“Take 1 hour before you eat breakfast” instead of
“Take on an empty stomach”
28. Using Plain Language: What could we say instead of…
Adverse reaction Side effect
Hypoglycemia Low sugar
PRN When you need it
Topical On skin
Angina Chest pain
Your H.I.V. test was negative You don’t have
H.I.V
29. 2. Focus on Key Messages and Repeat
Limit information
Focus on 1-3 key points
Develop short explanations for common medical
conditions and side effects
Discuss specific behaviors rather than general
concepts
What the patient needs to do
Review each point at the end
30. 3. Use a “Teach Back” to Check Understanding
Teach Back Scripts:
I want to make sure I explained everything clearly. If
you were trying to explain to your husband how to
take this medicine, what would you say?
Let’s review the main side effects of this new
medicine. What are the 2 things that I asked you to
watch out for?
Show me how you would use this inhaler.
31. 4. Effectively Solicit Questions
Don’t say:
Do you have any questions?
Did you take your doses correctly?
Instead say:
What questions do you have?
How did you take your doses last month?”
32. COMMUNICATION B/N DISPENSERS AND PRESCRIBERS
The provision of pharmaceutical care requires a
collaborative relationship with the physician (Prescriber)
With rare exceptions, the primary reason dispensers call
physicians is that something is wrong or a problem needs
to be resolved.
Because these calls so often begin with a problem, they
can start off in a negative or adversarial way and trigger
defensiveness in the physician.
But skillful and sensitive dispensers can turn these
negatives into pluses.
33. Reasons for Communication
Untreated condition(s)
Improper drug selection
Dosage too high
Subtherapeutic dosage
Adverse drug reactions and side effects that cannot be
tolerated or won’t go away
Drug interactions
Unnecessary drug therapy
Compliance problems
Request for additional information about the patient
34. Preparation Before Communication
Have the necessary facts ready, including your
recommendation and rationale
Have a literature citation ready, if possible
Get sufficient information from the patient
Be prepared to the SOAP approach
Always have an alternative recommendation ready in
case your initial recommendation is not accepted
35. Communication Considerations
The entire focus should be on attacking problems or issues, not
people or personalities
There is a big difference between the following:
• Dr. Solomon, Ato Samson can’t use those tablets you prescribed. I would like
to recommend ….) and
• Dr. Solomon, Ato Samson has trouble of swallowing. I would like to
recommend ….)
Make sure professional boundaries are respected
Make sure that you listen completely to the physician’s
rationale for the decisions made
Use 4F communication: “I know how you feel. I felt the same
way, too. But found in the literature….,” and stay focused on the
problem
36. Handling the Communication
Begin by identifying yourself
Identify the patient whom you are to discuss
Present the issue or concern that you have identified
Do not be judgmental
Use professional rapport to gain respect
Be prepared to discuss the issue on a professional level
Propose a solution
Await feedback
37. Handling the Communication (2)
You may not always have all of the answers to the
questions that follow
Be comfortable saying that you do not know the answer
at the moment, that you will look into it and get back to
the provider as soon as you can
The provider will respect that you provide only
information about which you are confident
Over time, you will build a working relationship with the
physicians and nurses that you work with
38. Outcome of the Communication
Preparation, focus, and interpersonal skills can make
a great deal of difference in the outcome of the
dispenser-physician interaction
Scenarios of pharmacist-physician interaction:
same problem but different communication style
affecting the final outcome
39. Dialogue 1
Dispenser: Hi Doctor, the amoxicillin you prescribed for Ms. Kidist’s kid is not
working. We need to get her something else.
Physician: Who is this?
Dispenser: Zewdu at Lions rural drug vendor – the dispenser
Physician: What do you mean it’s not working? Did she give it to the child correctly?
He’s only been taking it for 5 or 6 days. She has a 10 days supply. Is the child still
running fever?
Dispenser : I guess she’s giving it to him right. She says he is not feeling good and
she wants to give him something else. I didn’t ask about a fever.
Physician: Tell her to call me. I will take care of it.
Dispenser : You got it, Doctor!
Discussion
40. Dialogue 2
Dispenser: Hi Doctor Kamil. This is Zewdu Kassa at Lions rural
drug vender. I just got off the phone with Kidist Bikila, Tedy’s
mother. She called because she was concerned about Tedy. His
fever is 38 0C and he has been taking the amoxicillin for 6 days
now, three times a day as you prescribed. She said he is still in
a miserable condition. I assumed Tedy has otitis because she
talked about his ear infection and I saw from his medication
records that he was treated for otitis once before, about 3
months ago. I think it might be time to go to trimethoprim-
sulfamethoxazole twice a day.
41. Dialogue 2 Contd…
Physician: So he is still running a fever. From what you
said it sounds like he is not responding to the amoxicillin.
Ok, give him the trimethoprim-sulfamethoxazole twice a
day. Do you have his weight?
Dispenser: Sure Doctor.
Physician: Good. Let’s keep him on it for 10 days.
Dispenser: Ok, I’ll let Mss. Kidist know.
Physician: Thanks for calling.
Dispenser: You’re welcome. Thanks for getting back to me so
quickly.
Discussion
42. Lessons Learnt from this Dialogue
Well-prepared and skilled dispensers who focus on patient
problems rather than on prescribing problems can turn these
interactions into opportunities for professional collaboration
and cooperation, rather than conflict there by saving the
patient from unnecessary drug related problems which is the
ultimate goal of the communication.
43. Role Play
Demis came to your rural drug vendor and tells you that he has
been suffering from itching. He pulls up his shirt and shows you
a rash on his skin.
When you look at his medicine envelope, you realized that he
was taking cotrimoxazole.
Trying to gather more information from the patient to
determine if he is having a mild or severe rash, you established
that the patient has severe rash.
Contact the prescribing nurse or physician to change the
medication.
44. Role play
• Negus, a 24 year old daily laborer, comes to your
RDV with a prescription for Amoxicillin for
community acquired mild pneumonia:
Amoxicillin 500 mg capsule
P.O. TID for 7 days
• Provide him with the necessary information to
enable him take the drug correctly
45. Role Play
• A patient comes to your RDV with a prescription for Fansidar
stat and Chloroquine for 3 days.
• Contact the physician and propose a change of his/her
medication.
46. KEY POINTS
Successful communication of information, ideas, and concepts
is an integral skill that must be learned, developed, and used
by all dispensers.
Relationship between patients and dispensers provide the
basis for effective and valued communications.
Understanding feelings properly and empathic responding
strengthens the therapeutic alliance between the patient and
the dispenser.
Good communication with providers and patients is essential
for successful care and treatment.
The provision of pharmaceutical care requires a collaborative
relationship and team work with providers