Communication skill for pharmacy

1. 1
COMMUNICATION SKILLS FOR PHARMACISTS
❑Establishing Pharmacist-
Patient Relation
By:
Yadeta B.( MSc)
February 2023

2. Contents
2
 Establishing PPR
 Guide to patients counseling
 Interviewing patients
 Educating patients
 Communication w/special patients
 Ethical principles

3. Establishing the pharmacist-patient
relationship
3
 Effective communication between pharmacists
and patients family members is extremely
important to pharmaceutical care.
 Ineffective communication leads to,
confusion
misunderstanding
may contribute to inappropriate decisions
regarding drug therapy

4. Establishing the pharmacist-patient
relationship…
4
 Strategies to establish relationship with patients
▪ Introduce self to patients during an encounter
▪ Outline for the patient what will occur during the
encounter
▪ Demonstrate empathy or caring attitude so that the
patient feels at ease
▪ Discuss with the patients the amount time needed
for the encounter
▪ Discuss the expected outcome of the encounter
▪ Use feedback strategies throughout the encounter
to ensure patient understanding

5. Establishing the pharmacist-patient
relationship…
5
 Patient titles
▪ Common courtesy dictates that patients be
addressed by appropriate title (e.g., Mr., Mrs., Ms.,
Rev., Dr.)
▪ Use the correct title by asking each patient how he
or she wants to be addressed.
▪ The one exception to this approach is in addressing
disoriented, confused, or sedated patients;
✓ these patients usually respond better to their
first names than to their titles.

6. Establishing the pharmacist-patient
relationship…
6
 Respect for the patient
▪ Display a genuine respect for the patient.
▪ Respond to the patient as a person, not as prescription
or case.
▪ Maintain a professional relationship and avoid
exchanging personal information and confidences with
the patient.
▪ Respect for the patient is conveyed by acknowledging,
without judgment, patient specific attributes that may
be different from the pharmacist’s value system or
even offensive to the pharmacist.

7. Establishing the pharmacist-patient
relationship…
7
 Attributes such as smoking, excessive drinking, use of
illicit drugs, self destructive behaviors, nonadherence
to prescribed regimens, deficient hygiene, and gross
obesity may be offensive but must be dealt with non
judgmentally.
 Other patient specific traits such use of alternative
medications or an orthodox medical treatments also
must be acknowledged without judgment.
 Pharmacists also must be able to acknowledge
differences in socioeconomic backgrounds and ethnic
origins without passing judgment.

8. Establishing the pharmacist-patient
relationship…
8
 Arrange adequate time for patient interaction
and minimize interruptions from phone calls,
beepers, and other patients or health care
professionals.
 Introduce yourself, obtain permission to interact
with the patient, and explain the purpose of the
interaction.
 Explain who will see the information obtained
by the pharmacist and how the information will
be used.

9. Establishing the pharmacist-patient
relationship…
9
 Questioning technique
▪ Start with open-ended questions,
▪ Allow patients to talk freely about their
medications and concerns

10. Establishing the pharmacist-patient
relationship…
10
 Medical jargon
 Avoid medical jargon when communicating with
patients
 Commonly misunderstood terms

11. Establishing the pharmacist-patient
relationship…
11
 Patient Centered Care (PCC)
 The five dimensions of PCC
▪ The pharmacist must be able to:
✓ Understand the illness experience of the patient.
✓ Perceive each patient's experience as unique.
✓ Foster a more equal relationship with patients.
✓ Build a therapeutic alliance with patients to meet
mutually understood goals of therapy.
✓ Develop self-awareness of personal effects on
patients

12. Establishing the pharmacist-patient
relationship…
12
 The healthcare professional should encourage
patients to share experiences with therapy
 Because,
 they have unanswered questions
 they have misunderstandings
 they experience problems to therapy
 they can “monitor” their own responses to treatment
 they make their own decisions regarding therapy
 they may not reveal information to you unless you
initiate a dialogue.

13. Problems in establishing helping
relationships
13
 There are countless sources of problems in
interpersonal communication between patients
and pharmacists,
 However, certain pharmacist attitudes and
behaviors are particularly damaging in
establishing helping relationships with patients.
 These include:
Stereotyping
Depersonalizing
Controlling behaviors

14. Problems in establishing helping
relationships
14
 Stereotyping : what image comes to mind
when you think of;
An Elderly Patient
AIDS patient
Dying Patient
Noncompliant patient
Patient with Welfare Assistance
Hypochondriacal patient
Psychiatric patient

15. Problems in establishing helping
relationships…
15
 If you hold certain stereotypes of patients,
▪ You may fail to listen without judgment.
▪ I already know what he is going to say
▪ She is the type that never really wants help

16. Problems in establishing helping
relationships…
16
 Depersonalizing
▪ Delivering a canned speech “a rigid
communication format of a pharmacist
monologue rather than pharmacist-patient
dialogue”
▪ Perceiving the patient as a case or number,
▪ Impersonal: Focus on the disease rather than the
person, the focus on narrow clinical rather than
broader personal issues
▪ Communication with third parties instead of patient

17. Problems in establishing helping
relationships…
17
 Controlling
▪ Authoritarian style:
▪ Patients are told what they should do and what
they should not do,
▪ decisions are made, often with very little input
from the patient on preferences, desires, or
concerns about treatment.
▪ You don’t make room for the patients message or
feedback

18. Guide to Patient Counseling
18
 The communication process between health
professionals and patients serves two primary
functions.
 It establishes an ongoing relationship
 It provides the exchange of information that
helps,
 to assess a patient’s health condition,
 to implement treatment of medical problems,
 to evaluate the effects of treatment

19. Guide to patient counseling…
19
 Three prime questions to ask a,
 New patients who are receiving a new prescription,
What did your doctor tell you the medication is for
How did the doctor tell you to take it
What did the doctor tell you to expect
 A patient is receiving medications(refill),
What do you take the mediation for
How do you take it
What kind of problems are you having

20. Guide to patient counseling..
20
 Communication during drug therapy
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

21. Guide to patient counseling…
21
 Advantages:
▪ An effective communication process can optimize
the chance that patients will make informed
decisions, use medications properly, and meet
therapeutic goals.

22. Medication Counselling Skills
22
 Points how to improve medication-counseling skills
 Take the time to counsel,
 Create a relaxed and nonthreatening environment
 Use plain language
 Show the patient each medication while counseling
 Focus on one to three key points and repeat them
frequently.
Use teach-back method

23. Medication Counselling Skills…
23
Encourage patients to ask questions
Use pictures or illustrated medication
schedules
Supplement the interaction with patient
Review complete regimen and consolidate all
medicines into their daily schedule.

24. Interviewing Patients
24
 Tips for good patient interviews
❖ Greet the patient and introduce your self
❖ Direct the patient to the consultation area
❖ Explain why you need to collect the information
❖ Indicate how long the interview will last
❖ Pay attention to body language
❖ Ask open ended questions
❖ Use active listening skills and demonstrate
empathy
❖ Ask the patient to restate any unclear ideas

25. Educating Patients
25
 Educational sessions provide patients with more
comprehensive information regarding their,
▪ medical conditions,
▪ treatment strategies, and/or
▪ lifestyle changes.
 Asking open-ended questions to determine what
patients already know will be key to preventing
pharmacists from providing information that is not
needed.
 Minimize difficulty to understand medical terminology
and utilize patient friendly language.

26. Educating Patients…
26
 Targeted Methods for Achieving the Objectives
of a Patient Education Session

27. Non-prescription Medication Consults
27
 Counselling patients who are self-treating a
particular condition or symptom
 This provides a great teaching moment for
pharmacist with patients who are self treating
 Taking a mini-history becomes an essential
component of the nonprescription medication
consult.
 The patient care “work-up” in nonprescription
medication consults is similar to work-ups associated
with medication reviews or case management
services.

28. Non-prescription Medication Consults
28
▪ The information that should be collected includes,
❖ Patient age, sex, race
❖ Current and past medical history
❖ Family history
❖ Social history
❖ Dietary history
❖ Medication history
❖ Laboratory test

29. Communication w/ special patients
29
 Elderly
 Terminally ill patients
 Mentally ill Patients
 Children

30. Communication w/special patients…
30
 The Elderly
▪ In certain individuals, the aging process affects the
learning process, but not the ability to learn.
▪ Some older adults learn at a slower rate than
younger persons.
▪ The elderly might also have problems such as poor
vision, speech or hearing.
▪ Therefore, it is very important to set reasonable
short-term goals, and break down learning tasks
into smaller components.
▪ It is also important to encourage feedback as to
whether they understand the intended message.

31. Communication w/ special patients…
31
 Terminally ill patients
▪ They are usually intimidating to work with because
people do not want to say the “wrong” things that
would upset them.
▪ Before interacting with them, be aware of your own
feelings about death and about interacting with
terminally ill patients.
▪ Simply being honest with them can improve interaction
with them and It will also open them up to voice out
their concerns as well.

32. Communication with special patients...
32
▪ Many terminally ill patients know that they can
make others feel uncomfortable.
▪ You should not avoid talking to them unless you
sense that they do not want to talk.
▪ Not interacting with them only contributes further
to their isolation and may reaffirm that talking
about death is uncomfortable.

33. Communication with special patients…
33
 Mentally ill Patients
▪ It can be difficult to communicate with mentally ill
patients,
▪ Open-ended questions would be more effective as
they can be used to determine the patient’s
cognitive abilities.
▪ Ethical considerations include whether they require
consent from the patient for treatment.
▪ Mentally Ill Patients might not always understand
their treatments or medication purposes.

34. Communication with special patients…
34
 Children
▪ Attempt to communicate at the child’s developmental
level
▪ Ask open-ended questions rather than questions
requiring only a yes or no response
▪ Use simple declarative sentences for all children
▪ Ask the child whether he or she has questions for you
▪ Augment verbal communication with written
communication
▪ Nonverbal communication is very important with
children therefore be aware of your facial
expressions, tone of voice, gestures, and so on.

35. Techniques to Improve Patient
Understanding
35
 Emphasize key points.
▪ This is very important helps them remember what
follows.
 Give reasons for key advice,
▪ e.g., with an antibiotic prescription, tell why it is
necessary to continue medication use even though
symptoms have disappeared.
 Give definite, concrete, explicit instructions.
 Any information that patients can mentally picture
is more easily remembered.

36. Techniques to Improve Patient
Understanding…
36
 Use visual aids, photographs, or demonstrations.
 Provide key information at the beginning and
end of the interaction.
 Supplement and reinforce spoken words with
written instructions.
 Assessment of a patient’s ability to read and
understand key written instructions is required.
 End the encounter by taking feedback

37. Ethical principles
37
 Beneficence: is the principle that health professionals
should act in the best interest of the patient.
 Autonomy: is the principle that establishes patient
rights to self-determination- to choose what will be
done to them.
 Honesty: principle states that patients have the right to
the truth about their medical condition, the course of
disease, the treatments recommended and the
alternative treatments available.
 Informed Consent: treatment can be implemented if
all relevant information is provided, if the patients
understand the information, and if consent is given freely.

38. Ethical principles….
38
 Confidentiality : Serves to assure patients that
information about their medical conditions and
treatments will not be given to individuals without their
permission.
 Fidelity (quality of being faithful or loyal)
▪ Is the right of patients to have health care professional
provided services that promote patients’ interests
rather than their own.
▪ Ethically, the responsibilities of physicians should be
directed towards the patients rather than directed at
the financial well-being of the clinic.

39. Strategies to improve communication
39
 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

40. Strategies to improve communication…
40
 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”

41. Strategies to improve communication…
41
 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

42. Strategies to improve communication…
42
 Use a “Teach Back” to Check Understanding
 Teach Back Scripts:
▪ I want to make sure, I explained everything
clearly, How to take this medicine ?
▪ 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.

43. Strategies to improve communication…
43
 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?

44. Practical skills for pharmacists
44
 A skill is defined as the ability to do something
that comes from training, experience or practice
 Communication in the broader sense incorporates
➢ content skills (what is being said),
➢ process skills (how it is being done), and
➢ perceptual skills (how the provider feels and reasons
during the encounter)
 A content skill has to do with the transfer of
knowledge

45. Practical skills for pharmacists…
45
 Pharmacists’ Practical skills include,
❖Listening and Empathic Responding
❖Helping patients manage therapeutic regimens
❖Medication Safety Issues
❖Assertiveness
❖Interviewing and Assessment

46. Listening and empathic responding
46
 Listening to patients
❖trying to understand their thoughts and
feelings
 It is crucial to effective communication.
 However, empathic communication requires
more than understanding.

47. Active Listening
47

48. Factors that Impact Listening
48
 Multitasking:
 to do two things at once (it evident to patients that
they don’t have your full attention)
 Planning ahead to what you will say next:
 Planning next point (interrupting)
 Jumping to conclusions
 before patients have completed their messages
(only hearing parts of messages)

49. Factors that Impact Listening
49
 Selective listening
 Focusing only on content-Listening with ears only
 Judging the person or the message may
conveyed,
 faking interest,
 your perceptions
 communicating in stereotyped ways

50. Listening well
50
 Listening well involves understanding both the
content of the information being provided and
the feelings being conveyed.
 Skills that are useful in effective listening include
summarizing,
paraphrasing,
empathic responding
 Empathic responding is reflection of feeling
through verbal, and nonverbal communication
that shows caring and attention to the patient.

51. Listening well…
51
 Empathy has many positive effects on a
pharmacist’s relationships with patients.
 It helps patients,
 to trust you as someone who cares about their
welfare.
 to understand their own feelings more clearly.
 to alleviate sense of isolation, which often
accompanies an illness experience.
 to facilitates the patient’s own problem-solving
ability

52. Nonverbal Aspects of Empathy
52
▪ Establishing eye contact while talking to patients
▪ Leaning toward them slightly with no physical
barriers
▪ Having relaxed posture and Head nods to talk.
▪ Tone of voice
▪ Establishing a sense of privacy by coming out from
behind the counter
▪ Conveying that you have time to listen
▪ Sensitivity to patients’ nonverbal cues (feelings, tone
of voice, facial expression and body posture)

53. Quiz!!
53
 Ms. Edwards is starting on a new medication for
schizophrenia. The drug has a number of side effects,
some of which can be serious. She asks you several
questions about the purpose of the medication and
possible side effects. When you ask her what her
physician told her about the medication, she reports that
he said, “I’ve got a lot of patients on this drug and
they’re doing fine.” It is obvious to you that she is unclear
about the purpose of the medication or any possible
problems. You are concerned that Ms. Edwards may
refuse to take the drug if told about possible side effects.
 1.What would you say to Ms. Edwards?
 2.Which ethical principles will be violated if you will not let
her to hear about possible side effects?