PATIENT
COUNSELLING
KEERTHANA.N
FIRST MPHARM
DEPT OF PHARMACY PRACTICE
GRACE COLLEGE OF PHARMACY
DATE:11.10.2019
DEFINITION:
Patient counselling refers to the process of providing,
information,advice & assistance to help patients use
their medications appropriately.
The information & advice is given by the pharmacist
directly to the patient or the patient representative.
The information usually given verbally , but may be
supplemented with written materials.
To provide accurate advice & information , the
pharmacist should be familiar with the pathophysiology
and therapeutics of the patient.
PURPOSE OF COUNSELING
Better patient understanding of their illness and the role
of medication in its treatment
Improved medication adherence
More effective drug treatment
Reduced incidence of medication errors, adverse effects
and unnecessary health care costs
Improved quality of life of the patients
Better coping strategies for medication related adverse
effects
Improved professional rapport between the patient and
the pharmacist
COMMUNICATION SKILL FOR EFFECTIVE COUNSELLING
Good communication skills are needed to gain the patients
confidence and to help motivate the patient to adhere to the
recommended regimen.
The counselling process uses both
Verbal communication skills.
Non verbal communication skills.
VERBAL COMMUNICATION SKILLS
It include language & paralingustic features such as
Tone
Volume
Pitch
Rate of speech
Listening
Understanding
Advising
Language
When speaking to patients, use simple language and avoid using
unnecessary medical words . If possible, speak the patients own language.
Tone
During counselling the tone of one’s important .
Changes in the level and range of pitch convey
information about the feelings & attitude of the person
speaking,the tone of the voice should be caring and
reassuring.
Volume
Ideally , counselling should be conducted in a quiet,
private setting where it is unnecessary to raise ones
voice although it may be necessary to speak more
loudly to patients with a hearing problem.
Speed
The clarity of our communication depends on our rate
of speed . patients may be reluctant to interact with a
pharmacist who speaks quickly because they may feel
that the pharmacist is too busy . In contrast the listener
may lose interest if the pharmacist speaks too slowly.
NON –VERBAL COMMUNICATION SKILLS
It includes body language such as the movement and
positions of the head , limbs ,& body . other aspects
such as whether the pharmacist is dressed in a
professional manner .
During any interaction, approximately 50 % of the way
a message is received from body language.
Aspects of non verbal communication still include
proximity , touch , eye contact, facial expressions , head
movements ,gestures with hands , arms & body posture.
Proximity
This refers to the distance that people maintain between
themselves during the counselling process .
This space has been classified in to 4 zones
intimate(45cm or less)
personal(45cm-1.2m)
social(1.2-3.6m)
public (more than 3.6 m).
Generally , counsellors or healthcare proffesionals use intimate
or personal proximities.
Eye contact
Listeners look at the speaker more often and for longer periods
of time . For cultural or personal reasons such as sadness , or
depression . some people may avoid looking in to the counsellors
eyes.
Facial expressions
This can be used during counselling to demonstrate
empathy towards the patient . Head movements such as
nodding ,hand gestures & body postures also can be
used for advantage.
TYPES
General counselling
Disease based counselling
Diet based counselling
Drug based counselling
Life style modifications
STEPS DURING PATIENT COUNSELLING
Counselling is a two way communication process &
interaction between the patient & the pharmacist is
essential for counselling to be effective.
There are mainly 4 steps:
Preparing for the session
Opening the session
Counselling content
Closing the session
PREPARING FOR THE SESSION
The success of counselling depends upon the
knowledge and skills of the counsellor . The pharmacist
should know as much as possible about the patient &
his treatment details.
In the hospital setting this may possible through
reference to the patient case notes . In the community
pharmacy setting, sources of information include the
patient and their prescription.
If the patient is in hurry , pain or is non communicative
, it is very difficult to counsel the patient effectively.
OPENING THE SESSION
The first phase of counselling is used for information
gathering.
The pharmacist should introduce himself or herself to
the patient & greet them by name . Next pharmacist
gathers information from the patient , about their
understanding of their illness , drug treatment or use of
alternative medications such ayurvedic medications or
home remedies.
Other information which may be relevant includes
previous drug allergies ,past medical history & personal
habits such as cigarette smoking and alcohol
consumption.
Using open ended questions is a useful technique for
gaining confidence of the patient . For eg :what did your
doctor tell about your illness ? what do you know about
your disease etc...
Patients may be disturbed and distressed due to their
illness, & this may reduce their ability to receive and
understand information from both the doctor and
pharmacist.
During counselling the pharmacist should avoid asking
questions in a direct or embrassing way , discussing the
patients personal problem , passing moral judgement ,
interrupting when the patient is speaking & arguing with
the patient.
If the patient become hostile or aggressive despite the
pharmacist ,best efforts to calm the patient , it is
preferable to finish the counselling session.
COUNSELLING CONTENT
The counselling content is considered to be the heart of
the counselling session.
During this step the pharmacist explains to the patient
about his or her medication & treatment regimen . Life
style changes such as diet or exercise may also be
discussed.
Topics commonly covered include:
Name is strength of the medication
How to take the medication
Expected duration of treatment
Possible adverse effect
Possible drug interactions
What to do a dose is missed
Special monitoring requirements e g : blood tests
It is important that pharmacist uses language which is
understandable to the patient . Medical jargon & even
simple medical terms will not be understood by most
patient and should be avoided.
CLOSING THE SESSION
Before closing the session it is essential to check the
patients understanding .This can be assessed by feed
back questioning , such as ‘can you remember what this
Medication is for , or how long should you take they
medication for’. The patient may have new questions or
doubts?
Before, final closure & if time permits , summarise the
the main points in a logical manner.
If appropriate , the pharmacist can give their telephone
number to encourage the patient make contact if they
need further advice or information.
BARRIERS TO PATIENT COUNSELLING
Barriers include:
Patient based barriers
Provider based barriers
System based barriers
STRATEGIES TO OVERCOME BARRIERS
The provider based barriers are easiest to overcome.
The pharmacist can start updating their knowledge
and counselling skills
REFERENCE
A TEXTBOOK OF CLINICAL PHARMACY
PRACTICE 2nd EDITION BY G.PARTHASARATHY
PHARMACEUTICAL PRACTICE 4TH EDITION BY
A.I.WINFIELD
THANK U....
