Patient counseling Definition of patient counseling; steps involved in patient counseling, Special cases that require the pharmacist

1. Patient Counseling
Mr. Ravinandan A P
Asst. Prof.
Department of Pharmacy Practice
Sree Siddaganga College of Pharmacy
Tumkur, Karnataka

2. Presentation outlines
1. Definition of patient counseling
2. Steps involved in patient counseling
3. Special cases that require the
pharmacist

3. Introduction
•Safe and effective use of drugs depends on
patients being well informed about their
medication
•Effective patient counseling makes the
patient understand their illness and thus
enhance patient compliance
•The pharmacist has immense responsibility in
providing patient counseling

4. What is patient counseling?
•Patient counseling is defined as
providing medication information,
advice and assistance to help the
patient use their medication
appropriately

5. •It can be provided orally or in written form
to the patients or their representatives
•May include information on directions of
use, advice on side effects, precautions,
storage, diet and life style modifications

6. AIM / OBJECTIVES
•Improve patient understanding of their illness &
role of medicine
•Improve medication adherence
•Reduce incidence of medication errors, ADR,
unnecessary healthcare costs
•Prevent drug interactions
•Improve QOL
•Improve professional rapport between patient &
pharmacist

7. Communication skills for effective counseling
VERBAL SKILLS
Language
Tone
Speed
Volume
NON-VERBAL SKILLS
Proximity
Facial
Expression
Body
language
Eye contact

8. Proximity:
•It refers to the distance that people maintain
themselves during the counseling process.
Classified into:
1. Intimate: 45cm or less
2. Personal: 45cm to 1.2m
3. Social: 1.2-3.6m
4. Public > 3.6 m

9. QUALITIES OF A GOOD COUNSELOR
•Be a good listener
•Be flexible
•Be empathetic
•Be non- judgmental
•Be tolerant
•Communicate confidently
Pharmacist has to give unbiased
and authentic information in a
most professional manner

10. Steps of Patient Counseling
•Preparing for the counseling
•Opening the counseling
•Counseling Content
•Closing the Lecture

11. Preparing for the Lecture
•Success of counseling depends on knowledge & skill
of the counselor
Know about the patient & his/ her treatment
details
•Hospital setting- refer patient case notes
•Community setting- prescription, a record of
previous dispensing
•Know mental and physical state of the
patient

12. Opening the
Lecture
•Introduce your self
•Explain purpose of counseling
•Obtain drug related information such as allergies, use
of alternative medicine etc.
•Assess the patients understanding of the disease and
treatment
•Eg: What did the doctor tell you about your illness?
What do you know about your disease? Can u tell me
the symptoms you have been experiencing?
•Use open ended questions

13. Counseling Content
•Heart of the counseling Lecture
•Pharmacist explains the patient
•About the disease
•About the medication
•About lifestyle modifications

14. Counseling Content
• Name & strength of the medication
• Reason why it has been prescribed
• How it works
• Directions for administering the medicine
– How often to take the medicine
– How much to take at one time
– How long it will be necessary to take the medicine
– When to take it : before, during, after meals? At bed time? At
any other special times?
– How to take it? With water? With fruit juice? How much?
– What to do if you forget to take it (miss a dose)

15. - Foods, drinks, or other medicines that you should not take
while taking the medicines
– Restrictions on activities while taking the medicine
– Possible side effects. What to do if they appear. How to
minimize the side effects. How soon they will go away.
– When to seek help if they are problems
– How long to wait before reporting no change in
symptoms.
– How to store the medicine
– The expiration date
– The cost of the medicine
– How to have your prescription refilled, if necessary
– Necessity to complete the course.
– Drug-Drug, Drug-Food interactions

16. Closing the Lecture
• Before closing the Lecture it is essential to check patients
understanding
• Ask feedback questions
Eg:
1. Can you remember what this medication is for?
2. For how long you should take this medication?
3. Ask whether patient has any doubts / questions?
Encourage patient to contact pharmacist if they need
further advice/ information

17. Closing the Lecture
1. Verify the patient’s understanding by means of
feedback
2. Summarize by emphasizing key points
3. Give an opportunity to the patient to put forward any
concerns.
4. Help the patient to plan follow-up

18. Counseling Aids
•Medication cards : written summary
of patients medication which is easy
to understand
•Patient information leaflets
•Visual aids Leaflets on how to use
ear drops, eye ointments, pessaries,
suppositories, nebulizer etc.

19. Medication card

20. Pill card

21. Pill box

22. Patient Information Leaflet

24. Be aware of barriers to patient counselling
•Provider based- Language, Lack of pharmacist
training/ time, knowledge, interest, no financial
benefits and encouragement
•Patient based-Hearing/ vision problems, Disease
state dementia, stroke, lack of time
•System based- Environmental: noise, lack of
privacy, space, busy community and hospital
pharmacies

25. Minimize Barriers Effective
Communication Skills
•Provider based barriers are easiest
to modify
•Update knowledge and counseling
skills
•Use of counseling aids
•Use appropriate language

26. Counselling for iron
•What would you counsel for an anemic patient prescribed
with iron supplements??
•Given for anemia
•Take this for one month, complete the full course
•Take it every day night, two hours after dinner
•Iron should not be taken along with any milk, food or
breakfast or meal because its absorption is severely
limited if taken along with food
•Iron absorption happens faster if taken along with acidic
things, like fruit juice.
•Iron absorption is impeded by alkaline things like antacids

27. •Side effects - headache or diarrhea or gastritis. If
they occur do not stop iron use
•Oral iron will cause your stools to blacken , you
need not worry about it.
•Iron tablets must be kept away from children; as
iron poisoning can be especially dangerous in
children
•After using iron for one month you must meet
the doctor again and if necessary he will extend
the prescription for iron

28. Conclusion
•Pharmacists, being active members of
the healthcare team can play an
important role in providing patient
counseling so as to improve patient
compliance and hence the therapeutic
outcomes and quality of life

29. Summary
•Safe and effective use of drugs depends on
patients being well informed about their
medication
•Effective patient counseling makes the
patient understand their illness and thus
enhance patient compliance
•Patient counseling is defined as providing
medication information, advice and
assistance to help the patient use their
medication appropriately

30. Thank you