Tiêu đề 10. PATIENT COUNSELING.pdf ✅

PHARMD GURU Page 1 DEFINITION: Patient counseling is defined as “providing information to the patient or patient’s care giver regarding the disease, medication, diet and life style modifications in layman language to achieve the desirable therapeutic outcomes”. The information may be given verbally and complimented with written information leaflets. OUTCOMES OF EFFECTIVE PATIENT COUNSELING:  Patient will understand the importance of the prescribed medication in management of the disease.  Improved medication adherence.  Achieving the desired therapeutic goals.  Reduced incidence of adverse effects and unnecessary health care costs.  Improved quality of life.  Improved professional rapport between the patient and pharmacist leading to an improved patient patronage to the pharmacy. Effective patient counseling is not simply providing the information. The timing and organization of information are very important to improve the patient's understanding and motivation to follow the instructions given during the counseling session. Often in community pharmacies, pharmacists are busy in filling the prescriptions and patients are in hurry to receive the medication. Every patient receiving medication should know about how to use them. But in busy practice it may not be feasible. Following guidelines may be used to identify the patients, who need counseling. STAGES IN PATIENT COUNSELING: 1) Introduction 2) Content 3) Process 4) Conclusion PATIENT COUNSELING
PHARMD GURU Page 2 1) INTRODUCTION:  Review the patient record prior to counseling.  Conduct an appropriate patient counseling introduction by self and patient.  Explain the purpose of counseling session.  Obtain pertinent initial drug related information. Ex: drug allergies, and other medications.  Warn the patient about taking other medications including OTC drugs, herbals, or botanical drugs and alcohol which could inhibit or interact into the prescribed medication.  Asses the patient understandings of reason for therapy.  Assess any actual or problems of importance to the patient. 2) COUNSELING CONTENTS ITEM:  Discuss the name and indication of the medication.  Explain the dosage regimen including duration of therapy when appropriate.  Assist the patient in developing a plan to incorporate the medication regimen into his/her daily routine.  Explain how long it will take for the drug to show its effect.  Discuss storage and refilling information.  Emphasize the benefits of completing the medication as prescribed.  Discuss the potential side effect.  Discuss how to prevent or manage the side effects of the drug.  Discuss the precautions.  Discuss the significant drug-drug, drug-food, and drug-disease interaction.  Explain precisely what to do if the patient misses the dose.  Explore the potential problems of the patient. 3) COUNSELING PROCESS ITEMS:  Use the language the patient can understand.  Use the appropriate counseling aids to support counseling.  Present the fact and order in a logical order.  Use open-ended question.  Use both verbal and non-verbal behavior.
PHARMD GURU Page 3 4) COUNSELING CONCLUSION STEPS:  Verify the patient understanding via feedback.  Summaries by acknowledging or emphasizing key points of information.  Provide an opportunity for final concerns or questions.  Help the patient to plan, follow up and next consecutive steps. BARRIERS FOR PATIENT COUNSELING: Following are the barriers identified for not happening of the patient counseling in India. The barriers are classified in to the following groups. 1) Patient based barriers 2) System based barriers 3) Provider based barriers 1) PATIENT BASED BARRIER: Counseling happens only when patients show interest in receiving the information. If they are in hurry to reach home it is very difficult to talk to them. Gender difference, language difference, and literacy are the identified patient based barriers. 2) SYSTEM BASED BARRIERS: Lack of reimbursement due to non-legalization of patient counseling, lack of adequate space and trained staff and the busy hours are considered as system-based barriers. 3) PROVIDER BASED BARRIERS: Provider is the Pharmacist. In India, majority community pharmacies run by pharmacists having Diploma in Pharmacy qualification. Their knowledge and their commitment towards counseling are inadequate. Lack of interest, lack of time, lack of knowledge, lack of confidence, lack of training are identified as pharmacist based barriers. STRATEGIES TO OVERCOME THE COUNSELING BARRIERS: To overcome the patient based barriers, following strategies can be implemented.  Using multimedia materials  Pictograms
PHARMD GURU Page 4  Oral or written information  Compliance aids  Follow up schedules  Audio-visual tapes  Tailoring prescription instructions Legalization of the patient counseling, introduction of counseling fee and continuous professional development programs are the important strategies to improve the counseling activity in pharmacies. Hi students, If you want more information about patient counseling topic, do refer “clinical pharmacy practice” by G. Parthasarathi.