Communication Skills Patient-Centered Communication in Pharmacy Practice By Dr. Vian Ahmed BSc. Pharmacy, MSc. Clinical Pharmacy, PhD. Student

Communication skills The ability to convey information to another effectively and efficiently. It may be; vocally (using voice), written (using books, magazines, websites or emails), visually (using logos, maps, charts or graphs) non-verbally (using body language, gestures, the tone and pitch of voice)

So Communication is; The transfer of information meaningful to those involved. The process in which messages are generated and sent by one person and received and translated by another person. The goal is understanding.

A message is successful only when both the sender and the receiver perceive it in the same way. However the meaning generated by the receiver can be different from the sender’s intended message.

Three parts of communication process; Sender Message Receiver

Pharmaceutical Care Practice The responsible provision of drug therapy for the purpose of achieving definite outcomes that improve a patient’s quality of life.

Pharmacists have the potential to improve patient care through efforts to reduce medication errors and improve the use of medications by patients. Using effective communication skill is essential in the provision of patient care.

Why is patient-centered communication so crucial?

Example 1; A 36-year-old man was prescribed a fentanyl patch for back pain. He was not informed that heat could make the patch unsafe to use. He fell asleep with a heating pad and died. The level of fentanyl in his bloodstream was found to be 100 times the level it should have been (Fallik, 2006)

Example 2; A patient prescribed Normodyne (labetalol) for HTN was dispensed Norpramin (desipramine). She experienced S.E.s; blurred vision & hand tremors. Since she knew that she was supposed to be taking the drug to treat HTN, even minimal communication between the pharmacist and patient about the therapy would have prevented this medication error.

So Pharmacists’ Jobs; Ensure the avoidance of adverse effects of medications. Ensure reaching the desired outcomes from therapies. Provide medication in the most efficient & safest manner. Participate in activities that enhance patient adherence & the wise use of medication. Develop trusting relationships with patients.

So Pharmacists’ Jobs; Engage in an open exchange of information. Involve patients in the decision-making process regarding treatment. Help patients reach therapeutic goals that are understood & endorsed by patients & health care providers. Reduce the incidence of both medication-related errors & drug-related illness.

Importance of Communication in Meeting Your Patient Care Responsibilities Your goal is changed from providing patients with drug information to a goal of ensuring that patients understand their treatment in order to take medications safely & appropriately. Your goal is not to get patients to do as they are told (i.e., comply) but to help them reach intended treatment outcomes.

Encouraging a More Active Patient Role in Therapeutic Monitoring The information a patient provides you as part of therapeutic monitoring is essential to ensure that treatment goals are being met. INR or HbA1c values may provide the comfort of a “scientific” basis for therapeutic monitoring.

Encouraging a More Active Patient Role in Therapeutic Monitoring Treatment of the following diseases rely heavily on patient report of symptoms ; 1. depression 2. Pain 3. asthma 4. angina 5. GERD 6. epilepsy 7. arthritis

Encouraging a More Active Patient Role in Therapeutic Monitoring Patient self-monitoring of blood glucose has become standard practice in managing diabetes. In addition, blood glucose awareness training programs (BGAT) teach patients to recognize signs of both hyperglycemia & hypoglycemia.

A Patient-Centered View of the Medication Use Process The patient with symptom or discomfort may; Take no action or Take actions to treat the condition

Take no action Because of 2 reasons; the problem is seen as minor or transitory or 2. the patient lacks the means to initiate treatment.

Take action The action could be either; initiation of self-treatment, contact with a nonmedical provider (a faith healer), contact with a health care provider.

Contact with a health care provider Large numbers of prescriptions are written that are never filled or that are filled but remain unclaimed in the pharmacy. Failure to initiate prescribed therapy may be caused by; economic constraints, a lack of understanding of the purpose of the recommendation, or failure to “buy into” the treatment plan.

Contact with a health care provider Some of these patient decisions may reflect a failure in the communication process between the patient & the health care provider.

Contact with a health care provider For many patients, medication taking includes; 1. Misuse due to misunderstanding of what is needed 2. Deviations from the prescribed treatment regimen (doses are forgotten). 3. Administer the drug but with intentional modifications of the regimen.

Reasons to Encourage Patients to Share Their Experience with Therapy They have unanswered questions They have misunderstandings They experience problems related to therapy They “monitor” their own response to treatment They make their own decisions regarding therapy They may not reveal this information to you unless you initiate a dialogue.