Pharmacist Patient Counseling

INTRODUCTION

Safe and effective drug therapy depends on patients being well-informed about their medication. In India, health care is provided at primary, secondary, and tertiary levels. Lack of information may lead to therapeutic failure, adverse effects, additional expenditure on investigation and treatment, or even hospitalization. Many drug problems and their consequences can be addressed by patient education.

DEFINITION

Counseling is a special form of interpersonal communication in which feelings, thoughts, and attitudes are expressed, explored, and clarified.

OBJECTIVES OF PATIENT COUNSELING

• To provide correct information about drugs to the patient.
• It can support and help the patient to regain a sense of competence and skill in times of crisis.
• It can help to educate the patient about vaccination and immunization procedures mass sterilization issues, contraception, programs, etc.
• Patient counseling refers to the process of providing information, advice, and assistance to help the patient to use their medication appropriately.
• During counseling, the pharmacist should assess their patient's understanding of his or her illness and its treatment and provide advice information that will assist the patient in taking their medication in the safest and most effective manner.
• It provides realistic action suitable for different clients and circumstances.
• It helps to enhance determination, and self-confidence and improve family and community relationships and quality of life.

AIMS OF PATIENT COUNSELING

Effective patient counseling aims to produce the following results

• Better patient understanding of their illness and the role of medication in its treatment
• Improved medication in adherence
• More effective drug treatment
• Reduced incidence of adverse effects and unnecessary health care costs.
• Improved quality of life for the patient
• Better strategies to deal with medication-related adverse effects.
• Improved professional support between patient and pharmacist.

STEPS INVOLVED IN PATIENT COUNSELING

Counseling is a two-way communication process and interaction between the patient and the pharmacist and is essential for counseling to be effective.

1. Preparing for the Session

• The success of counseling depends upon the knowledge and skill of the counselor. The pharmacist should know as much as possible about the patient and his/her treatment details.
• In hospitals, it can be possible by referring to the patient case notes. In a community pharmacy setting, the source of information includes the patient and their prescription and in some cases a record of previous dispensing for the patient. If the patient is receiving a medication that is unfamiliar to the pharmacist then a drug information reference should be consulted before counseling commences.
• In some cases if the patient is in a hurry or in pain, is non-communicative, it is very difficult to counsel the patient effectively. In this situation, the aims of counseling may need to be modified or with the patient's agreement the session may be postponed to a later date.

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2. Opening the Session

• The first phase of counseling is used for information gathering. The pharmacist should introduce himself or herself to the patient and greet them by name. It is best to use titles such as Mr., Ms., and then switch to the first name. The pharmacist should identify the purpose of the session very clearly.
• For example: Hello Mr. Unni my name is Patel and I am a pharmacist. I would to tell you about your medication. Do you have a few minutes to spend with me?

3. Counseling Content

The counseling content is considered to be the heart of the counseling session. During this step, the pharmacist explains to the patient about his or her medication and treatment regimen.

• Topic commonly covered includes,
• Name and strength of the medication
• Expected duration of treatment
• Expected benefits of treatment
• Possible adverse effects
• Possible medication or dietary interaction
• Advice on correct storage

The information which is given should be tailored to the individual patient. It is important not to jump to conclusions about why a particular medication has been prescribed. Sometimes the patient's family members may visit the pharmacy to collect the medication. 

They should be given suitable advice after gathering information such as their relationship with the patient and their awareness of the patient's disease and medication history.

CLOSING THE SESSION

Before closing the session pharmacist or counselor should check the patient's understanding. This can be assessed by feedback questioning. We should finish the session by asking the patient “Do you have any questions”? Before final closure, if time permits summarize the main points in a logical order. The counselor should give their telephone number to encourage the patient to make contact if they need further advice or information.

BARRIERS

The common Barriers involved in patient counseling are,

1. Patient-based barriers
2. System based barriers
3. Provider-based barriers

1. Patient Related Barriers

It includes;

• Culture
• Language
• Hearing
• Vision
• Mental status
• Gender
• Limited patient availability

2. System Based Barriers

It includes;

• Lack of space
• Lack of staff

3. Provider Based Barriers

It includes;

• Lack of knowledge
• Lack of time
• Lack of training
• Lack of confidence
• Lack of interest

STRATEGIES TO OVERCOME BARRIERS

To conduct effective patient counseling, the common requirements are

1. Availability of pharmacist
2. Creating an atmosphere for the patient
3. Developing an effective approach to patient counseling
4. Approach to providing optimum information

To overcome the barrier like a lack of confidence one should be prepared prior to counseling. For effective counseling, communication skill is very important. The communication process was carried out either by verbal or nonverbal communication methods.

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