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http://www.flickr.com/photos/36521966253@N01/5596934455
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http://www.flickr.com/photos/36521966253@N01/5596934455
http://www.flickr.com/photos/36521966253@N01/5596934455
 http://www.flickr.com/photos/36521966253@N01/5596934455
http://www.flickr.com/photos/samgellman/4014696576/sizes/l/in/photostream/
Calculated?
http://www.hugoleung.com
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http://www.flickr.com/photos/legofenris/4039682937/sizes/o/in/photostream/
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http://farm4.static.flickr.com/3292/2713950973_5cbe805815.jpg
http://www.flickr.com/photos/luigimirto/5223273551/sizes/l/in/photostream/
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Adapted from: Makoul G, Clayman ML. An integrative model of shared decision making
in medical encounters. Patient Educ Couns Publication 2006 March;60(3):301-312.
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http://www.flickr.com/photos/clodreno/5061338495/sizes/l/in/photostream/
http://www.flickr.com/photos/cool-photos/1532310585/sizes/m/in/photostream/
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http://www.flickr.com/photos/joeyldotcom/4989229246/sizes/l/in/photostream/
Dr. Guirguis Personal Theory of
      Pharmacy Practice
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    47
’




    48
Respectful,
  longitudinal
 assessment &
shared decisions
                   49
Medication Partnerships
          • Drug knowledge
             – Pharmacology
             – Pharmaceutics
             – Medicinal chemistry
          • Physiology & Pathology
          • Interviewing
          • Models of Patient Perspectives &
            Behavior Change
          • Web, literature, referral patient
            resources
          • Insurance/ cost issues


                                         50
Medication Partnerships
•   Priorities in life
•   Goals for improvement
•   What has worked in past
•   Personal resources/lifestyle
•   Economic situation
•   Feasibility of regimen Questions
•   Diagnosis
•   Self management strategies
•   Side effects/adverse effects
•   Improvement on endpoints
•   Perceived benefits

                                       51
http://www.flickr.com/photos/andrewseajames/1566708408/sizes/l/in/photostream/
http://www.flickr.com/photos/seraphimc/1227677178/sizes/o/
You’re ready for a
    new car!




                                                                                    This is a great one!
http://1.bp.blogspot.com/-7anXMFW96NY/TqjDBs08odI/AAAAAAAADpg/c5RSf3S55Jw/s1600/image+01+buying+car.jpg
It is very good for driving fast
between places.
                          http://www.flickr.com/photos/richardgiles/3322739050/sizes/l/in/photostream/
Now when you drive it there
might be some issues
It has bad brakes




http://www.flickr.com/photos/33831378@N03/3221892151/sizes/l/in/photostream/
the wipers get stuck




http://www.flickr.com/photos/monsieurloupe/5936615226/sizes/l/in/photostream/
and one in every 1000
will spontaneously flip
But that
         doesn’t
         happen
         often.



http://www.flickr.com/photos/idreaminir/2103662898/sizes/m/in/photostream/
Good! I’ll follow-up with you in
a week. Can I call you by
phone?
Any questions?




http://www.flickr.com/photos/therealfauxtographer/3736354228/sizes/l/
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’
Why should a little old woman
like me take aspirin?




                          My doctors keep on telling
                          me to take it and that it is
                          good for me.
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Shared Decision Making - for pharmacists