Section: 4YA-1 Date: November 30, 2021

Worksheet 7:

PHARMACY CLIENT SERVICES

Instructions:

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● Highest Possible Points: 25

● Type of submission: Text entry or File Upload
● File name for file upload: LAST NAME_FIRST NAME_MI_CMPI_WORKSHEET NO.
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● Due Date: mm-date-year-time

Last Name, First Name MI. Task

Group members: Mabale, Pershiela Question 2

COLLEGE OF PHARMACY COMMUNITY PHARMACY INTERNSHIP

 Macadang, Claudine Vine Question 6, Zoom Recording Facilitator

Macadang, Michaella Nicole Question 3

Pablo, Raine Question 4

Pagdato, Airra Lyn Question 1, Collator, Powerpoint Presentation

Pineda, Mark Dioseph Question 6

Rosaros, Jamaica Question 2

WORKSHEET NO. 7:

PHARMACY CLIENT SERVICES

1. What is the importance of identifying yourself and the patient first in a patient counselling session?

Pharmacists are among the most accessible and trusted health care professionals. When initiating a
patient counseling session, pharmacists should introduce themselves with a brief, friendly greeting. This is to make
patients feel comfortable enough to ask questions about their medication therapies and health conditions.
Pharmacists who demonstrate a genuine interest in patient care are more likely to encourage dialogue.Research
for the examples of each barrier to communication listed below. Explain each.

● Communication barriers are usually affected by a number of interference or barriers. These barriers affect
the accuracy of the communication exchange, when you try to communicate with someone. Some issues
are rather obvious, while others are not. Some are easily removed, while others are more complex and
require multiple strategies to minimize their impact. To minimize communication barriers typically required
a two-stage process:

1. You must be aware that they exist.

2. You need to take appropriate action to overcome them.

1. ENVIRONMENTAL BARRIERS:
● The environment in which communication take place in critical in pharmacy practice and distractions within the
environment often interfere with this process

PRESCRIPTION COUNTER
COLLEGE OF PHARMACY COMMUNITY PHARMACY INTERNSHIP
 These prescription counters exist for three primary reasons:

1) They provide an opportunity for patients to identify where the pharmacy is located

2) They provide an opportunity for pharmacy staff to look over the store area periodically

3) They provide a private area in which the staff can work.

PRESCRIPTION COUNTER SITUATION 1 :

One of the most obvious barriers in most community practice settings is the height of the prescription counter separating
patients from pharmacy personnel. Unfortunately, in some situations, patients cannot see pharmacy personnel behind these
strategically placed partitions or counters. This type of environment may also give patients the impression that the
pharmacist does not want to talk to them.

SOLUTION:

● Many pharmacies provide areas where the counter is lower to facilitate pharmacist–patient interaction.
● Ideally, you and the patient should both be at eye level to enhance verbal and nonverbal communication. This will
also help counteract patient perceptions that you are not approachable.

LACK OF PRIVACY SITUATION 2:

If other people are within hearing range of your conversation, it limits the level of perceived privacy for the interaction.
Privacy is especially important when patients want to talk about personal matters. Privacy issues also exist in institutional
and ambulatory care clinics. Finding private locations to have meaningful discussions with nurses, physicians, or other
health care practitioners can be problematic in most settings. Many times, pharmacists must raise issues with their
colleagues about the medication therapy or the general treatment of patients. Such encounters should not be heard by
others due to the sensitive nature of these discussions and the high levels of professional pride that most health care
providers have. Thus, these conversations should take place in relatively private environments.

SOLUTION:

● Many community pharmacists have tried to address these issues by increasing the amount of privacy within their
setting.
● For example, many pharmacists use glass partitions, planters, or dividers to create the feeling of a private
conversation area that is away from common traffic areas.
● Some have installed private or semi private counselling areas or rooms.
● Privacy does not necessarily mean having a private room, but both the patient and pharmacist must feel that
privacy exists.
● In busy patient care areas within institutions, you need to find ways to discuss patient-specific issues with your
colleagues out of hearing range of family members, patients, and other individuals who happen to be in the area.
● While discussing therapy at patients’ bedsides, you will need to be sensitive to patient needs as well.
● Most institutions, especially teaching institutions, have developed protocols and standards for how to engage in
bedside conversation, recognizing the need to discuss clinical information and yet afford common courtesy toward
the patient.

CONVERSATION BETWEEN PHARMACISTS-COLLEAGUES SITUATION 3

COLLEGE OF PHARMACY COMMUNITY PHARMACY INTERNSHIP

 This is a very common scenario in a community setting. Customer tends to wait more and unintentionally eavesdrops on
some of the conversation the pharmacist is chit chatting to his colleagues. This can be an environmental barrier for it can
create a noise environment and show unethical and unprofessional practice in a community setting pharmacies.

SOLUTION:

Conversations between pharmacists and colleagues should take place in relatively private environments. Pharmacists need
to find ways to discuss patient-specific issues about the medication therapy or the general treatment of patients with
colleagues out of hearing range of family members due to the sensitive nature of these discussions.

2. PERSONAL BARRIER

LACK OF KNOWLEDGE SITUATION 1

The pharmacist often avoids interpersonal communication in most situations, including interactions with patients, physicians,
or other health care providers. Patients often ask the pharmacist about medical information and drugs. If the pharmacist
shows uncertainty about what to say, patients tend to lose trust in the pharmacist.

SOLUTION: Pharmacists should be knowledgeable enough with drug interactions, drug information and should be updated
with new trends in the area. The pharmacist should be able to provide information and answer consumers/patients who are
asking about medications.

LACK OF OBJECTIVITY SITUATION 2

In counseling, when patients share vital information about their health condition, pharmacists may be tempted to take
on the emotional problems. Thus, patients tend to misinterpret and try to not overshare information that will stimulate
the mood of the healthcare professional such as pharmacist.

SOLUTION: Pharmacists should separate his role and should remain empathetic towards his patients, but try not get so
involved that he carries their emotional burdens as well. Be sure to talk firmly and try to show empathy and care while
talking to the patient.

FEAR OF NOT GETTING ATTENTION BETWEEN INTERACTIONS SITUATION 3

When a pharmacist asks for information and does not get any feedback from the customer, the pharmacist tends to
stay silent and dispenses the medication right away.

SOLUTION: Repeat the question since there is a big chance the customer did not hear the question. If the customer still did
not respond, try to write the information on a piece of paper, especially if it is vital information, and use nonverbal
communication to tell the patient about the instructions in the paper.

3. PATIENT BARRIER
COLLEGE OF PHARMACY COMMUNITY PHARMACY INTERNSHIP
 PATIENT NEGATIVE EXPERIENCES IN COMMUNITY PHARMACY SITUATION 1

Patient negative experiences in the past community pharmacy can mitigate problems in communicating and counselling
patients. The patient tends to stick for the experience and generalize the situations especially if patients may have been
treated poorly in the past.

SOLUTION: Talk willingly to the patient and listen carefully about his experience. Be sure to not interrupt the patient when
talking and try to understand the situation. Talk calmly if the patient asks questions and replace the bad experience of the
patient with good service experiences.

· Uncertainty about what to ask SITUATION 2

The patient tends to have information overload after getting a prescription. As a result, they don’t know what to ask since
they do not understand what is written in the prescription. Thus, creates hesitant about talking about medical information.

SOLUTION: Explain what is in the prescription. Mention the name of the drug, how many times the patient needs to take the
medications. And lastly, ask the patient about something in his prescription if he truly understands. If not, explain repeatedly
in a slow and calm voice. Pharmacists may need to convince some patients that they need to learn more about their
medications and that the few moments spent with the pharmacists will be valuable to them later on.

· Patient’s perception about Pharmacist SITUATION 3

Most people consider pharmacists to be “botikero/botikera”, ordinary retailers or people who sell medicines. Not a drug
expert or health advisor that can be very helpful when someone needs medications.

SOLUTION: Since people still tend to look pharmacists that way, pharmacists need to show more of their value in the
society. Patient counsel as much as possible. Be caring, compassionate, knowledgeable, and responsive to people around
you especially if it’s about medications. Try to change the perspective of the people by showing wisdom and knowledge and
the importance of having a pharmacist checking prescriptions to reduce medication errors.

4. ADMINISTRATIVE BARRIER

COUNSELLING SERVICES SITUATION 1:

Many pharmacy managers perceive the task of talking with patients as an expensive service and not a high priority.
However, studies have shown that many consumers are willing to pay for such services. Community pharmacists are being
encouraged by professional organizations to seek reimbursement for the patient care services they provide pharmacies
often make policies that discourage pharmacist-patient interaction.

● The mechanics of dispensing prescriptions may distract from the communication process

SOLUTION :

● Pharmacist’s desire to answer every phone call, which may give the impression to the patient that the pharmacist
does not want to talk to him or her.

POLICIES SITUATION 2:

Staffing policies

COLLEGE OF PHARMACY COMMUNITY PHARMACY INTERNSHIP

 ● Reduced the number of staff members who can assist pharmacists.
● Workflow issues need to be monitored.

SOLUTION :

● Mechanisms that allow patients to have ready access to the pharmacist need to exist.
● Support staff need to be aware of situations where patients need to talk with the pharmacist.
● Training of staff is a crucial component to enhancing patient care.

PHARMACIST-OWNER DIFFERENCES IN DUTIES SITUATION 3:

● A pharmacist and owner's differences in intention often tend to show a barrier in managing a community pharmacy.
The owner’s perspective might be different from pharmacist duties and responsibilities. Example: allowing the
consumer to buy antibiotics without prescription, just for the sake of sales.

Solution:

● Explain the risk of taking antibiotics without prescriptions.Try to explain antibiotics resistance in layman’s terms.
Antibiotic resistance happens when germs like bacteria and fungi develop the ability to defeat the drugs designed
to kill them. That means the germs are not killed and continue to grow. Infections caused by antibiotic-resistant
germs are difficult, and sometimes impossible, to treat. Self-medication of antibiotics is associated with the risk of
inappropriate drug use, which predisposes patients to drug interactions, masking symptoms of an underlying
disease, and development of microbial resistance.
● Under federal law, all antibiotics require a prescription from a health care provider.

5.TIME BARRIERS:

COMMUNITY PHARMACY PRACTICE SITUATION 1:

● The timing of the interaction is critical, since both parties must be ready to communicate at a given time.

SOLUTION:

● A possible solution might be to give the patient basic information to get the therapy started and then contact her at
a later time via phone or email when both of you may be more relaxed and ready to communicate.
● Another strategy is to have written information that can reinforce a short message during busy situations.
● Brief counselling encounters by “highlighting” pertinent information within the written information to emphasize key
points before the patient leaves the pharmacy.

INSTITUTIONAL PRACTICE SITUATION 2:

● Timing within institutional practice is also critical, since health care providers are performing multiple tasks in very
active environments. It may be difficult to get people’s attention and to choose the right time to interact with each
other.
● Many times, there is a sense of urgency, since there is no assurance that you will see the physician, nurse, or
other health care provider later in the day due to their busy schedules, so you need to find the best way to tactfully
approach them.
COLLEGE OF PHARMACY COMMUNITY PHARMACY INTERNSHIP
 SOLUTION :

● You must be assertive about your need to communicate with others, but at the same time be aware of their needs
as well.
● Assess nonverbal messages from health care providers or patients for assurances that communication is well
timed.
● Be aware of situations where people are trying to talk with you, but you are not listening appropriately.

TIME PRESSURE SITUATION 3:

● Consumers or patients tend to put time pressure on community pharmacists in dispensing medicines. Time
pressure will filter information and derive relevant content especially in counselling. This will create a problem since
pharmacists cannot check interactions and medication errors in a convenient time needed.

Solution:

● Explain to the patient or customer the need of triple checking before dispensing the drugs. Pharmacies are
verifying prescriptions more often to reduce medication errors and is a critical work to do that needs time. Through
this, medication errors can be avoided and further drug interactions can be prevented also. Pharmacists are doing
this to supervise patients in their health and overall wellness.

3. Differentiate Verbal Communication between Nonverbal Communication.

Verbal communication - Verbal communication refers to the production of spoken language to deliver information. Writing
and speaking is a form of verbal communication. Verbal communication includes the ability to listen, understand and
respond. In the field of pharmacy practice, information is delivered to patients through written words and spoken language.
Its advantage is that the feedback from patients is immediate and pharmacists can correct a statement if they feel that they
have been misunderstood.

Non-verbal communication – Non-verbal communication is any form of communication without relying on written words or
spoken language. Hand gestures, facial expressions and other body language are a form of non-verbal communication. It
includes the ability to interpret the non-verbal communication and respond. Pharmacists also deliver non-verbal
communication through body language, personality and tone of voice to the patient or other health care professionals.

Reference/s:

Berger BA. Communication Skills for Pharmacists: Building Relationships, Improving Patient Care. 3rd ed. Washington, DC:
American Pharmacists Association; 2009.

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 4. Give at least 10 examples of nonverbal cues of warmth and coldness. Explain.

1. Body Behavior

- Body movement includes the posture people take and the way they move their face, eyes, hands or other parts of
the body. In most instances the messages the body generates operate only when in combination with other
messages.

2. Voice

- The vocal cues in our speech also carry much more information than we realize.
- The accent of a speaker gives away his or her ethnic background or place of origin;

The tone of voice tells of the real intention of the speaker;

The volume and rhythm of speech can show a speaker’s emotional state.

3. Time and Space

- Spatial language is often presented in the distance people use in interaction.

- Seating and arrangement of furniture may also give information to the observer and influence the on-going
interaction in that setting.
- Americans’ understanding of time is typical of Western cultures in general and industrialized societies in particular.
- Americans view time as a commodity, as a “thing” that can be saved., spent, or wasted.

4. Facial Expression

- The facial expression is a good indicator of emotions---happiness, surprise, sadness, fear, anger, disgust, interest
and many more.
- Basic emotions are expressed in the essentially same nonverbal way, i.e. the same facial expressions.
- For example, fear is universally expressed by opening the eyes wide and so on, and happiness is shown by
smiling and laughing. But cultural norms often dictate how, when, and to whom facial expressions are displayed

5. Eye Contact

- Shakespeare said, “There is language in her eye, her cheek, her lip.”
- The Chinese saying goes, “The eye is the window of the soul.”
- in English, people are told “not to trust anyone who won’t look you in the eye.”
- in China, it was not uncommon that people looked at foreigners for a long time.
- Americans tend to make eye contact with the listeners.

6. Posture

- Posture refers to ‘how you position your body’ often indicating your feelings or attitudes at the time. Posture can be
open or closed (defensive).
- Posture offers insight into a culture’s deep structure.

COLLEGE OF PHARMACY COMMUNITY PHARMACY INTERNSHIP

 - Eg: in Japan, such low posture as bow is an indicator of respect.
- However, in the U.S., where people greet each other by hugging, high posture is indicative of equality and
friendliness.

7. Gestures

- Specific movements or gestures can indicate what a person wishes to convey to you.
- For example, a listener might nod their head during a conversation or a member of the police force might hold up a
hand with the palm outwards to signify ‘stop!’
- You might use a beckoning gesture to call a person to you or wave to say goodbye.
- It is important to be aware that gestures have different meaning in other cultures.

8. Touch

- Touch must occur at the right moment and in the right context, otherwise it can be violently rejected and may even
lead to charges of harassment.
- Physical contract differs between cultures.

9. Paralanguage

- Voice is a reliable indicator of nationality, regional origin, social class, educational level, age and gender.
- Allied to paralanguage (rate, pitch, stress, intonation) it can carry up to 38 percent of the message.
- It also discloses the emotional state of the speaker and conveys attitudes such as sarcasm.

10. Silence

- Silence serves as a type of nonverbal communication when we do not use words or utterances to convey
meanings. Have you ever experienced the “silent treatment” from someone? What meanings did you take from that
person’s silence? Silence is powerful because the person using silence may be refusing to engage in
communication with you. Likewise, we can use silence to regulate the flow of our conversations.

5. Enumerate and explain the different types of patients in a community pharmacy.

Elderly

● When doing patient counselling with an elderly, always keep in mind they need more time to talk and understand
what you say. And may have encountered a lot of communication barriers (mainly because of vision and hearing
impairment, low literacy skills, cognitive impairments).
● Be mindful about what they say and it is best to write information and compliance reminder aids in their
prescription and also talk to them with empathy while explaining their medications.

Children/ Adolescent

● It is best to talk to adolescents directly about their medications since they are reliable and can handle themselves
in talking about important matters.

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 ● With children, ask them simple questions and relay information that is easily understood and remembered.
Encourage children to ask you questions about their illness and treatment. Talk to their parents or guardian, if
needed, about their medications.

Person with Disability

● Interact with the person directly and be comfortable in your position while interacting with the patient. Introduce
yourself, listen carefully with the person who has difficulty speaking, use questions that require brief responses.
● Talk to the guardian if necessary, allow the person with disability to express and tell you directly about what they
feel.

Pregnant

● Offer them a seat or a place to rest before they begin to interact and talk. Be sure to ask about their situation if
they’re comfortable.Be direct about what you say and listen carefully about their medication.

6. What is the purpose of pharmacovigilance?

● Pharmacovigilance is the science and activities relating to the detection, assessment, understanding and
prevention of adverse effects or any other medicine/vaccine related problem.
● The information allows for the intelligent, evidence-based use of medicines and has the potential for
preventing many adverse reactions. This will ultimately help each patient to receive optimum therapy, and
on a population basis, will help to ensure the acceptance and effectiveness of public health programmes.
● It identifies the risks and the risk factors in the shortest possible time so that harm can be avoided or
minimized.
● It incorporates and provides training in the identification of adverse reactions, data collection, processing
and analysis.
● All medicines carry some risk of harm and it is important to monitor their effects, both intended and
unwanted, so that good evidence is available upon which to base an assessment of risk versus
effectiveness or risk versus benefit.
● Furthermore, particularly with new medicines, the early identification of unexpected adverse reactions and
their risk factors is essential, so that the medicines can be used in an informed manner with the least
chance of harm. This is the role of pharmacovigilance. Information gathered during pharmacovigilance
may also assist in selecting the most appropriate medicine for future use.

Reference:

The Safety of Medicines in Public Health Programmes: Pharmacovigilance an essential tool. (2006). Retrieved from
https://www.who.int/medicines/areas/quality_safety/safety_efficacy/Pharmacovigilance_B.pdf

Campbell, J. E., Gossell-Williams, M., & Lee, M. G. (2014). A Review of Pharmacovigilance. The West Indian medical
journal, 63(7), 771–774. https://doi.org/10.7727/wimj.2013.251

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 Beninger P. (2018). Pharmacovigilance: An Overview. Clinical therapeutics, 40(12), 1991–2004.
https://doi.org/10.1016/j.clinthera.2018.07.012

Steed, L., Sohanpal, R., Todd, A., Madurasinghe, V. W., Rivas, C., Edwards, E. A., Summerbell, C. D., Taylor, S. J., &
Walton, R. T. (2019). Community pharmacy interventions for health promotion: effects on professional practice and health
outcomes. The Cochrane database of systematic reviews, 12(12), CD011207.
https://doi.org/10.1002/14651858.CD011207.pub2

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