communications chapter 1(lecture 1) (1)

8/13/2019 Communications Chapter 1(Lecture 1) (1)

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Communication Skills

in Pharmacy Practice

By

Hesham Shazly, PhD

Sunday, Sept. 22nd

Semester one BUE

Communication Skills

in Pharmacy Practice

By

Hesham Shazly, PhD

Sunday, Sept. 22nd

Semester one BUE


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Communication Passwordommunication Passwordwelcome


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E Prescriptions Prescriptions Department :Pharmacy

Academic :Anita Olivier

Anitas own opinion is: for pharmacy students; there will be a national

electronic prescribing option in the future. The course continues to be

used in the labs every Friday 3 hours in the morning and 3 hours inthe afternoon. There are 5 labs in the semester and three

preparations per lab. This year it was 133 students in the first

semester .The potential is about 240 students for all year. Anita is

hoping to expand it from optional to essential course.At the Pharmex symposium held in June 2007, the Minister of Health,

told us that he is committing to establish an electronic national

health database which should include electronic

prescribing options.


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Chapter 1

Patient-Centered Communication in Pharmacy Practice

Chapter 1

Patient-Centered Communication in Pharmacy Practice

1. Overview

2. Introduction

3. Pharmacists responsibility

4. Importance of communication in meeting your patients

5. What is Patients-Centered Care?

6. Encouraging a More Active Role in Therapeutic Drug

Monitoring TDM7. A Patient-Centered View of the Medication Use Process

8. Summary


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1- Overview1- Overview

Pharmacists have the potential to contribute even more to

improved patient care.

By reducing medication errors

By improving the use of medications The key element in this process is PatientsCentered

Care


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2- Introduction2- IntroductionWhy patient-centered communication is so crucial:

A 36-years-old man was prescribed a Fentanyl patch to treat pain. He

was not informed that heat could make the patch unsafe. He slept

with a heating pad and died. The blood levels of Fentanyl was found

to be 100 times more than it should be.

A patient prescribed Normodyne for HTN, was dispensed Norpramin.

She experienced numerous side effect, blurred vision and tremors.

Minimal communication between her and the pharmacist would have

prevent such error. An 83-years-old patients was given SR- diltiazem cap for HTN.

Because the cap was too large to swallow the patients chewed the

cap. Pulse rate shouts up. Changing to immediate release tab which

easier to slow solved the issue .


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2- Introduction cont.2- Introduction cont.Why patient-centered communication is so crucial:

Pharmacists have increasing responsibility in avoiding such side

effect and achieving the desired treatment outcome.

Changing the role of pharmacist from medication-centered to

Patient-Centered Care .

This need to develop a trustful relationship with the patients.

To involve the patient in decision making process regarding the

treatment options.

By helping the patients to reach the therapeutic goal.

No other way to achieve this without effective communication that use

Patient-Centered Care strategy.


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3- Pharmacists Responsibility in Patient Care3- Pharmacists Responsibility in Patient Care

The incidence of the adverse events and the associated cost related

to mortality and morbidity are of growing concern.

The Institute of Medicine (IOM) repot on patients safety due to

medication errors are preventable ones.

The pharmacists can play a pivotal role in reducing the medication-errors and drug-related illness.

The Patient-Centered Role envisioned by the pharmacy mission

statements afford pharmacist value far beyond the drug-centered

role The quality of the relationships pharmacist develop with patients

depends on effective communication.


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4- Importance of Communication in Meeting your

Patients Care Responsibility

4- Importance of Communication in Meeting your

Patients Care ResponsibilityCommunicating with your patients serves two primary function:

1. Establish relation between you and your patients

2. Exchange of information to assess your patients health conditions and

evaluate the effects of treatment on the quality of life QOL

Trusting relationship is essential to be real for Pharmacy Practice as allcommunication/activities take place on the context of this relationship.

This is the base to meet professional responsibilities in patients care.

The aim of the professional-patients relationship is to achieve therapeutic

goals that improve patients QOL based on individual's need.

Your goal is not to get patients to comply but helping to reach intended

treatment outcomes.

Because of yourknowledge and responsibilities you must bear the greater

burden of assuring effective communication.


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5- What is Patients-Centered Care?5- What is Patients-Centered Care?

Pharmacist must be able to:

1. Perceive each patients as a person. Understand the patients illness

through: social, psychological and biomedical factors.

2. Fair relationship with patients; allows to be involved in the dialogue

of the treatment decision making process.

3. Build a therapeutic alliance with your patients for treatment

acceptability.

4. Develop self-awareness on patients behavior


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5- What is Patients-Centered Care? Cont.5- What is Patients-Centered Care? Cont.

Prescriptions that are practitioner-centered are focused on the

decisions made by physician, patient is following rather than sharing.

Dispensing a medication is a key step in the medication process.

Chronic disease care consumes 75% resources. Many patients make

autonomous decisions to alter the treatment regimens without consultingheath care providers.

This is makes it difficult to evaluate the treatment outcome.

Ultimately; patients has control over the treatment implementation.

To be more productive; strength the therapeutic alliance with yourpatients; increase the patients participation in the treatment decision

Patient perception that you care for them rather than providing the

care makes a great difference.


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6- Encouraging a More Active Role in TDM6- Encouraging a More Active Role in TDM

Pharmacists, could enable patients and their family or caregivers to

take active role in monitoring response to treatment.

The information a patient provides you is essential to get treatment

goals.

While INR or HbA1c values provide a "scientific" basis for therapeuticmonitoring; for chronic conditions you must rely on patient report of

response to treatment.

Treatment of depression and pain, for example, have only patient self

report as the basis of evaluation of response to therapy.


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6- Encouraging a More Active Role in TDM6- Encouraging a More Active Role in TDM

Many other conditions such as asthma, angina, GERD, epilepsy, and

arthritis rely heavily on patient report of symptoms.

Certainly, patient self-monitoring of blood glucose becomes standard

practice in managing diabetes

Encourage the patients; to ask about the safety .If an IV is given toask the nurse how long it takes for liquid to 'run out. Till the nurse if it

doesn't seem to be dripping properly (it is too fast or too slow).

Patients must be taught how to be more involved in decision making

process. Their assertiveness must be encouraged and notembraced.

Your role is try to establish more patient centered care .


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7- A Patient-Centered View of the Medication

Use Process


Use Process A patient-centered view of the medication use process focuses on

the patient role in the process.

It may be the experience of "symptoms" or lifestyle interruption

challenges or threatens the patient's sense of well-being.

These include the individuals experience with the health care system;family influences; cultural differences of health, and illness info.

The patient at this point may take no action to treat the condition,

either because the problem is seen as minor or transitory or because

the patient lacks the means to initiate treatment. Sometimes the action of self-treatment initiation through a nonmedical

provider (such as a faith healer), and/or contacting a hearth care

provider.


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Use Process (cont.)


Use Process (cont.)Pharmacist Should Encourage Patients to Share their Experience:

1. They may have unanswered questions.

2. They may have misunderstanding or misperceptions.

3. They may experience problems related to therapy and not tell you.

4. They may monitor their own response without involving you.

5. They may make their own decisions regarding the therapy.

6. They may not reveal key info to you unless you initiate a dialogue.

Regardless how patients report their experience with therapy.Professional assessment is based on patient report, lab values and

other physiological measures.


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Use Process (cont.)


Use Process (cont.) This assessment will lead to continue drug treatment, to alter

treatment (i.e., to change dose, change drug, add drug), or to

discontinue drug treatment.

Communication aim is to make the patients understand the disease

and treatment goals.

The quality of the patient-professional relationship affect the decisions

of both patients and you.

Your communication skills are critical and can have the most effect on

the outcomes of treatment.

The key is to maximize patient outcomes by using patient-centered

communication skills.


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Review Case StudyReview Case Study Mr. Rowe is a patient, 65-year-old man who has osteoarthritis. For

many years his hips have hurt him off and on. On days when he

experienced pain he would take one dose of 400mg of ibuprofen, and

that managed the pain. Gradually over the years, the pain became

more frequent, and the ibuprofen did not help as much. Then hisknees also began to ache when he went on walks. He talks to you as

his pharmacist about how he can manage his pain without having to

go to a physician because he does not want to start taking

prescription drugs if he can mange with OTC medication.

Question: What further information would you want to obtain

from Mr. Rowe that would assist you in deciding how to be of

help?


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8- Summary8- Summary

The patient is the focus of the medication use.

Your communications skills can facilitate formation of

trusting relationships.

An effective communication can optimize the patientsshare in decision making process, consequently the

appropriate use of medication and ultimately meeting the

treatment goals.


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communications chapter 1(lecture 1) (1)

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