Preparation of
Standard Patient Scripting
INTENDED LEARNING
OUTCOMES:
At the end of the exercise, the students should
be able to:
1. Develop a standard script for receiving
clients
2. Detect untoward incident in dispensing
functions
3. Make company policies and procedures
2
Standard Patient
Scripting
3
Patient Medication
Counseling:
▰ It is a two-way communication process whereby
drug and health-related information is provided
by a pharmacist to the patient during:
▻ the dispensing of (initial or refill) medications
in a drugstore or outpatient pharmacy setting
▻ discharge of a patient from the hospital
▻ the review of medications of a patient
4
Case 1: The customer was picking up a sympathomimetic
inhaler with a new prescription:
Pharmacist: Here is your medicine. Are you familiar with this
product?
Customer: No, I am not.
Pharmacist: Did the doctor tell you how to use this
medicine? Customer: No, he didn’t.
Pharmacist: Should I then open the package and show you?
Customer: I don’t know.
Pharmacist: At least read the leaflet inserted in the package.
5
Case 2: The customer asked for two OTC-medicines by a
brand name: Advil capsule and Gaviscon tablet.
Customer: Hi, I would like to buy a pack of Advil capsule .
Pharmacist: The “4+1” pack or 10 pieces?
Customer: The bigger one. And then 8 pcs of Gaviscon.
Pharmacist: The liquid sachet or the chewable tablets
Customer: Chewable tablets.
Pharmacist: Would you like to have anything else?
Customer: Nothing else.
Pharmacist: That will be Php 205 pesos Sir.
6
ASHP Guidelines on Pharmacist-
Conducted
Patient Education and Counseling (2011) 7
Purpose:
▰ ASHP believes pharmacists should educate and
counsel all patients to the extent possible, going
beyond the minimum requirements of laws and
regulations; simply offering to counsel is inconsistent
with pharmacists’ responsibilities.
▰ In pharmaceutical care, pharmacists should
encourage patients to seek education and counseling
and should eliminate barriers to providing it.
8
Content:
1. The medication’s trade name, generic name, common
synonym, or other descriptive name(s) and, when
appropriate, its therapeutic class and efficacy.
2. The medication’s use and expected benefits and action.
▻ This may include whether the medication is intended to
cure a disease, eliminate or reduce symptoms, arrest or
slow the disease process, or prevent the disease or a
symptom.
9
Content:
3. The medication’s expected onset of action and what to do if
the action does not occur.
4. The medication’s route, dosage form, dosage, and
administration schedule (including duration of therapy).
5. Directions for preparing and using or administering the
medication. This may include adaptation to fit patients’
lifestyles or work environments.
6. Action to be taken in case of a missed dose.
10
Content:
7. Precautions to be observed during the medication’s use or
administration and the medication’s potential risks in relation
to benefits. For injectable medications and administration
devices, concern about latex allergy may be discussed.
8. Potential common and severe adverse effects that may occur,
actions to prevent or minimize their occurrence, and actions
to take if they occur, including notifying the prescriber,
pharmacist, or other health care provider.
9. Techniques for self-monitoring of the pharmacotherapy.
11
Content:
10.Potential drug–drug (including nonprescription), drug–food,
and drug–disease interactions or contraindications.
11.The medication’s relationships to radiologic and laboratory
procedures (e.g., timing of doses and potential interferences
with interpretation of results).
12.Prescription refill authorizations and the process for
obtaining refills.
12
Content:
13.Instructions for 24-hour access to a pharmacist/physician.
14.Proper storage of the medication.
15.Proper disposal of contaminated or discontinued
medications and used administration devices.
16.Any other information unique to an individual patient or
medication.
13
Additional points…
1. The disease state: whether it is acute or chronic and
its prevention, transmission, progression, and
recurrence.
2. Expected effects of the disease on the patient’s
normal daily living.
3. Recognition and monitoring of disease complications.
14
Standard Patient Scripting
D – Dosage
R – Results
U – Underlying Issues
G – General Information
15
Standard Patient Scripting:
Dosage
▰ Discuss the dose of the medication
▰ How should the medication be taken?
▰ Any specific dosage timing issues, and
▰ What to do if the patient misses a dose
16
Standard Patient Scripting:
Results
▰ What should the patient expect while taking
this medication?
▰ How is the drug working in the body, and
how can the patient tell if the medication is
working?
▰ It is also important for the patient to
understand the consequences of
nonadherence. 17
Standard Patient Scripting:
Underlying Issues
▰ Does this medication have any Black Box
Warnings?
▰ Is the patient allergic to this medication?
▰ Is the patient taking any other medications
that may interact with this medication?
▰ Does this medication have any specific alcohol,
grapefruit, or sun sensitivity warnings?
18
Standard Patient Scripting:
Underlying Issues
▰ Does this medication have an effect on any
other disease states that the patient may have?
▰ Are there any special precautions with the
elderly, young, pregnant, or breast-feeding
patients?
▰ Are there any other medication specific cautions
or precautions that should be discussed?
19
Standard Patient Scripting:
General Information
▰ Assess the patient's understanding of the
above information.
▰ Discuss how to properly store the
medication, what to do about refills, how to
dispose of unused meds, and assure that the
patient knows who to call for questions
20
Case 1: The customer was picking up a sympathomimetic
inhaler with a new prescription:
Pharmacist: Here is your medicine. Are you familiar with this
product?
Customer: No, I am not.
Pharmacist: Did the doctor tell you how to use this
medicine? Customer: No, he didn’t.
Pharmacist: Should I then open the package and show you?
Customer: I don’t know.
Pharmacist: At least read the leaflet inserted in the package.
21
Case 2: The customer asked for two OTC-medicines by a
brand name: Advil capsule and Gaviscon tablet.
Customer: Hi, I would like to buy a pack of Advil capsule .
Pharmacist: The “4+1” pack or 10 pieces?
Customer: The bigger one. And then 8 pcs of Gaviscon.
Pharmacist: The liquid sachet or the chewable tablets
Customer: Chewable tablets.
Pharmacist: Would you like to have anything else?
Customer: Nothing else.
Pharmacist: That will be Php 205 pesos Sir.
22
