Communication Skills Lecture 1-2 Patient-Centered Communication in Pharmacy Practice

Topics What is Communication skill? Pharmacists’ Responsibility in Patient Care Importance of Communication in Meeting Your Patient Care Responsibilities What is Patient-Centered Care? Understanding Medication Use from the Patient Perspective

What are Communication skills? One of the pharmacist mission which aim to develop a formal relationship between pharmacist and the patients in which the information is - exchanged, - hold in confidence Used to optimize patients care Ensure appropriate drug therapy By to improve therapeutic outcomes Pharmacists can improve patients care by 1. Reduce medication errors 2. Improve the use of medications by patients. 3. Enhance patient adherence and the wise use of medication through participating in activities.

Pharmacists’ Responsibility in Patient Care Reducing the incidence of both - medication-related errors, and - drug-related illness (also receiving increased attention). depends on the pharmacist’s ability to develop trusting relationships with patients to: 1. engage in an open exchange of information, 2- involve patients in the decision-making process regarding treatment, and 3- help patients reach therapeutic goals that are understood and endorsed by patients as well as by health care providers. This care is Pharmaceutical care: the responsible provision (supplied) drug therapy for the purpose of achieving definite outcomes that improve a patient’s quality of life

Importance of Communication in Meeting Your Patient Care Responsibilities - The communication process between you and your patients serves two primary functions: 1- establishes the ongoing relationship between you and your patients 2- provides the exchange of information necessary to: - assess your patients’ health conditions, - reach decisions on treatment plans, - implement the plans, and - evaluate the effects of treatment on your patients’ quality of life. - An effective relationship forms the base that allows you to meet professional responsibilities in patient care. - The purpose of the relationship is to achieve mutually understood and agreed upon goals for therapy that improve your patients’ quality of life.

providing patients with drug information Importance of Communication in Meeting Your Patient Care Responsibilities Your goal is changed providing patients with drug information ensuring that patients understand their treatment to take medications safely and appropriately. . So, Your goal is not to get patients to do as they are told but to help them reach intended treatment outcomes.

Patient-Centered Care

Patient-Centered Care Patient-centered care is a quality of personal, professional, and organizational relationships We can describe five dimensions of patient-centered medical care: Practitioners or providers must 1. Understand the social and psychological as well as the biomedical factors that relate to the illness experience of a patient. 2. Perceive the “patient as person.” This requires understanding your patients’ unique experience of illness and the “personal meaning” it entails.

Patient-Centered Care 3. Share power and responsibility. 4. Promote a “therapeutic alliance.” This involves: - incorporating patient perceptions of the acceptability of interventions in treatment plans - defining mutually agreed upon goals for treatment, and - establishing a trusting, caring relationship between you and your patients. 5. Aware of their own responses to patients, and the sometimes unintended behaviors that may have effects on patients.

Patient-Centered Care PCC Social Bio psycho patient as person power & responsibility therapeutic alliance aware own responses

Understanding Medication Use from the Patient Perspective Models of the prescribing process that are “practitioner-centered” have primarily focused on decisions made and actions taken by physicians and other health care providers. patient is “acted upon, Not really active participant Many patients make autonomous decisions to alter treatment regimens—decisions that may be made without consultation or communication with you or other health care providers Ignorance of patient-initiated decisions on medication use, in turn, makes it difficult for health care professionals to accurately evaluate the effects of drug treatment.

Understanding Medication Use from the Patient Perspective A patient-centered view of the medication-use process focuses on the patient role in the process. Medication-use process: patient perceives a health care need or health -related problem: interprets the perceived ' problem Social factor Psychological factor Decision (Patient+ Health care provider) The practitioner’s skill in communicating information about the diagnosis may alter or refine the patient’s conceptualization of her illness experience, making patient understanding more congruent (identical) with that of the health care provider

Understanding Medication Use from the Patient Perspective Once the health care provider reaches a professional assessment or diagnosis of the patient’s problem based on patient report, patient examination, and other data, she or he makes a recommendation to the patient. If the recommendation is to initiate drug treatment the patient may or may not carry out the recommendation. When patients do accept the recommendations to initiate drug treatment, they can do so only to the best of their ability as they understand the drugs are intended to be taken

Understanding Medication Use from the Patient Perspective For many patients, medication taking includes misuse caused by : - misunderstanding of what is recommended or - unintended deviations from the prescribed treatment regimen (e.g., doses are forgotten). - intentional modifications of the regimen by the patient. influence the patient decision to re-contact providers The nature of their relationships with you and other providers, the degree to which patients feel “safe” in confiding difficulties or concerns, the skill of providers in eliciting patient perceptions, and the extent to which a sense of “partnership” has been established regarding treatment decisions-all These factors also influence the degree to which medication-taking practices are reported and perceptions shared.

Regardless of how completely patients report their experience with therapy when they contact providers, the provider will make a professional assessment of patient response to treatment based on: - what the patient does report and/or - laboratory values and - other physiological measures. This assessment will lead to recommendations to - continue drug treatment as previously recommended, - alter drug treatment (i.e., to change dose, change drug, add drug), or - discontinue drug treatment.

- Analysis of the medication-use process highlights several things: 1. the decision by you and other providers to recommend or prescribe drug treatment is a small part of the process. 2. patients and professionals may be carrying out parallel decision making with only sporadic communication about these processes. 3. one of the aims of the communication process should be to make the understanding of the patient regarding the - disease, - illness experience, and - treatment goals as congruent as possible. The key is to maximize patient outcomes by using patient-centered communication skills.