Here are open-ended versions of the closed questions:

1. COMMUNICATION SKILLS FOR
EFFECTIVE
COUNSELING
Sanjiv kr Pandey

2.  Patient counselling is defined as
information orally or in written
their representitives on direction
providing medication
form to the patient or
of use, advice on side
effects, precaution, storage, diet and life style
modification .

3. WHAT ARE THE MOST COMMON WAYS
WE COMMUNICATE?
Written Word

5. NEED FOR PATIENT COUNSELING
 Safe and effective drug therapy dependent on patients being well informed
about their medication.
 Heavy patient work load
 Many prescribers have less time to explain the proper use of medication
to their patients.
 Many patient do not get enough information about use of their medication.
 Lack of information may lead to the patient not taking the medication in the
way that was intended.
 Therapeutic failure, adverse effect, additional expenditure on investigations
and treatment or even hospitalization.
 Drug use problems and their consequences can be addressed by
patient education.

6. FUNCTIONSOFPATIENT COUNSELLING
• Advise and assistance to help patients use their
medications.
• Information about patients illness
changes.
or recommended lifestyle
• Information is usually given verbally or also written materials.
• Pharmacist should assist patient understanding about his or
her illness and its treatment.
• Provide individualized advise and information.

7. AIMS OF PATIENT COUNSELING
• Better patient understanding of their illness and the role of
medication in its treatment.
• Improved medication adherence
• More effective drug treatment
• Reduced incidence of adverse effect
• Unnecessary health care costs
• Improve QOL for the patient
• Better coping strategies to deal with medication related adverse
effects.
• Improved professional rapport between the patient and pharmacist.

8. 1. Verbal Communication
- Language
- Tone
- Volume
- Rate of speed
2. Non-Verbal Communication
- Body language
- Movement
- Proximity
- Eye contact
- Facial expression.
COMMUNICATION SKILLSFOR
EFFECTIVEPATIENTCOUNSELING

9. Maintain eye
contact
Make encouraging
statements
Nod Your Head
Keep an open
body position
Repeat a sentence
or part of one
REPEAT THE LAST
WORD OR TWO OF
THE PRIOR SPEAKER

12. LANGUAGE
• Use simple language and avoid using unnecessary medical words.
• Speak the patient’s own language
TONE
• Changes in the level and range of pitch convey information about
the feelings and attitude of the persons speaking.
• Tone of the voice should be caring and reassuring.

13. VOLUME
 Counseling should be conducted in quiet, private setting where it is
unnecessary to raise one’s voice.
 May be necessary to speak more loudly to patients with hearing
problem.
 Most deaf patients gain more benefit if the speaker moves closer and
directs their voice towards the patient’s care.
SPEED
• Rate of speech
• Pharmacist speaks too slowly
• Pharmacist should present clear, relevant messages in a
logical sequence.
• Patient to understand and remember the concepts more easily.

14. NON-VERBALCOMMUNICATION
PROXIMITY
• The distance that people maintain between themselves during
the counselling process.
• This space has been classified into four zones:
 Intimate (45 cm or less)
 Personal (45cm to 1.2 m)
 Social (1.2-3.6 m)
 Public (more than 3.6 m)

15. EYE CONTACT
 The duration of time that people look at one another during a conversation
varies depending on whether they are speaking or listening.
 Listeners look at the speaker more often and for longer periods of time.
 Cultural or personal reasons – timidity, sadness or depression.
FACIAL EXPRESSION
• Used during counseling to demonstrate empathy towards the patient.
• Head movements such as nodding, hand gestures and body postures also
can be used to advantage.

16. BODY
LANGUAGE
• Gestures
• Mannerisms

19.  Purpose of medication.
 How medication work.
 Dose and duration of therapy.
 Goals of therapy.
 Adverse effect and how to deal with them.
 Specific drug issues.
COMMUNICATION DURINGTHEDRUGTHERAPY

20. 1. Preparing for thesession.
2. Opening of the session.
3. Counselling content.
4. Closing the session.
STEPS

21.  Counselling develop upon the knowledge and skills
 Pharmacist should know as much possible about the patient
treatment details.
 The source of information include patient and prescription or
a record of previous dispensing.
 If the pharmacist is unfamaliar about drug which is received
from the patient, go for drug information reference.
 Before counselling, you have to consider about mental&
physical status.
STEP 1- PREPARING FOR THE SESSION

22.  The pharmacist should introduce himself/herself
patient and treat them by name.
 It is best to use title such as mr,mrs,miss .
to the
Eg- hello mr, my name is x and I am your clinical pharmacist.
 I would like to tell about the medication.
 Do you have a few minutes to spend with me.
 Gather information from the patient about
disease, medication
STEP 2- OPENING THE SESSION

23.  Other information may releavent include previous drug
alleries, past medication history, personal habbit such as
diet, smoking, alcohol consumption.
 Use open ended question such as ‘what did your doctor
tell you about your illness? ‘what do you know about
your disease? ’can you tell me aboout the symptoms’?
 During counselling, the pharmasist should avoid asking
question directly in embarrassing way .

24. STEP 3 – COUNSELING CONTENT
 NAME AND STRENGTH OF MEDICATION.
 THE REASON WHY IT HAS BEEN PRESCRIBED OR
HOW IT
 HOW TO TAKE THE MEDICATION.
 EXPECTED DURATION OF TREATMENT.
 EXPECTED BENEFIT OF TREATMENT.
 POSSIBLE ADVERSE EFFECT.
 POSSIBLE MEDICATION OR DIETARY INTERACTION.
 STORAGE RECOMMENDATION.
work.
 Minimum duration required to show therapeutic benifit.
 What to do if a dose is missed.
 Special monitoring requirement

25.  Before closing the session, it is essential to check patient
understanding.
 This can be achived by feedback question, such as can you
remember what is this medication is for?
 Or how long should you take this medication?
 Ask the patient about any dout.
 Before final closure and if time permits, summarise the main
point in logical order.
STEP 4 - CLOSING THE SESSION

27.  Bea good listener
 Be flexible
 Be empathetic
 Be non-judgemental
 Be tolerant
 Communicate confidently
GOODQUALITIESOFPATIENTCOUNSELOR

28. COUNSELING AIDS
Be a Good Listener
• Pharmacist must listen attentively to the patient and observe both
verbal and non-verbal behavior.
• Pharmacist have an opportunity to assess the patient’s knowledge
about their disease and medications.
Be Flexible
• Be flexible and provide advice and information which is tailored to
the individual patient’s needs and capabilities.
Be Empathetic
• Try to understand the patient’s personal suffering and situation as
if the problem is his or her own.

29. BE NON-JUDGMENTAL
• Not judge the behavior of the patient based on their illness or the
group he or she belongs to.
Be Tolerant
• During counseling, patient may become agitated, unreasonable
or hostile. The pharmacist should acknowledge the patient’s
feeling and be tolerant of these.
Communicate Confidently
• Speak confidently as this will improve the patient’s acceptance of
the pharmacist’s advice.

30. PATIENTCOUNSELING &MEDICATION ADHERENCE
• Individual’s medication-taking behavior coincides with medical advice.
• Patient do not adhere to the direction given by their doctor, following
may be the interlinked
• Patient counseling aims to enhance patient’s understanding of their
illness and its treatment
• Make informed decisions about medication use.
Consequences
 Failure of treatment
 Increased chances of adverse reaction
 Increased chances of hospitalization
 Decreased quality of life

31. PRACTICE YOUR QUESTIONING SKILLS…
Rephrase the following closed questions to make them open-ended
 Are you feeling tired now?
 Isn’t today a nice day?
 Was the last activity useful?
 Is there anything bothering you?
 So everything is fine, then?

32.  What tires you out?
 What kind of weather are we having today?
 How was the last activity useful?
 Tell me what is on your mind.
 Why are you looking so happy?