PATIENT

COUNSELLING
 PRESENTATION

PRESENTED BY

Muhammad Arsal 6619

Muhammad Asjad 6610
Abdul Rehman 6642
Muhammad Hashim 6643
Ali Abbas 6656
TOPICS
 Understand the need for patient counselling
 Identify outcomes of effective patient counselling
 What are various communication skills needed
 Steps in this process
 Which patient group needs most counselling
 WHAT IS PATIENT COUNSELLING
 Providing the following to patients

1. Information
2. Advice
3. Assistance

 WHY is patient counselling needed ?: So that patient use their

medication properly
Safe & Effective drug-therapy depends on patient being well-informed about their
medication
WHAT IS PATIENT COUNSELLING
 Understand patient illness & medications prescribed
 Personalized advice on taking medications
 Provide advise to lifestyle change
 This is done to ensure that medications taken with be SAFE &
EFFECTIVE
EFFECTIVE PATIENT COUNSELLING

Effective Patient
counselling
REQUIRES

Understand disease, Effective

pathophysiology communication skills
Pharmaco-therapeutics
EFFECT OF LACK OF COUNSELLING
 Patients on not clear on how to use medicines (when to take, how long to
take, what to do when missed etc.)
 This results in
1. Therapeutic failure
2. Adverse events
3. Avoidable additional treatment & cost
EFFECTIVE COUNSELLING WILL RESULT IN ..
 Better patient understanding of their illness
 Role of medication in treating illness
 Improved compliance/adherence
 Reduced incidence of adverse events (AE)
 Improved quality of life
 Better strategy for patients to handle drug related AE
COMMUNICATION SKILLS IMPORTANT FOR EFFECTIVE COUNSELLING

Verbal

Language Tone Volume Speed

COMMUNICATION SKILLS IMPORTANT FOR EFFECTIVE COUNSELLING

Verbal
 Simple, easy to understand
 Avoid medical jargon
Language Tone Volume Speed
 Prefer patient own language
COMMUNICATION SKILLS IMPORTANT FOR EFFECTIVE COUNSELLING

Verbal
 Tone tells a lot about the
person speaking
Language Tone Volume Speed
 Caring, assuring
COMMUNICATION SKILLS IMPORTANT FOR EFFECTIVE COUNSELLING

Verbal
 Stable volume
 Avoid high volume
Language Tone Volume Speed
 Ideally in a quiet setting
COMMUNICATION SKILLS IMPORTANT FOR EFFECTIVE COUNSELLING

Verbal
 Rate of speech should be
moderate
Language Tone Volume Speed
 Clear message in a logical
sequence
 This helps patient
understand what is being
said
COMMUNICATION SKILLS IMPORTANT FOR EFFECTIVE COUNSELLING

 Body language (movement

Non- of hands, limbs etc.)
Verbal  Dressing

Eye Facial
Distance
contact expression Did you know:
almost 50% of
message is received
in NON-Verbal
manner
COMMUNICATION SKILLS IMPORTANT FOR EFFECTIVE COUNSELLING

Patient Patient

Non-
Verbal

Eye Facial
Distance Private <= 45 cm
contact expression
Personal 45 – 1.2 m
Social 1.2 – 3.6 m
Public > 3.6 m
COMMUNICATION SKILLS IMPORTANT FOR EFFECTIVE COUNSELLING

Non-Verbal  Patient sensitive to eye

contact
Eye Facial  Cultural issues matter
Distance
contact expression
COMMUNICATION SKILLS IMPORTANT FOR EFFECTIVE COUNSELLING

Non-  Can be used to show empathy

Verbal
 Head, hand movements can be used
Eye Facial to signal empathy as well
Distance
contact expression

Empathy: The ability to identify with or understand another's situation or feelings

STEPS DURING COUNSELLING

Preparing for session

Opening the session

Actual Counselling session

Closing the session

PREPARING FOR COUNSELLING SESSION
 Success of session depends on Skill & Knowledge of pharmacist
 Through review of patient medical history, medication records

 Different sources can be used such as Hospital records,

community pharmacy drug dispensing records
 Pharmacist needs to have a good understanding of
pathophysiology & drug that are prescribed
 References such as “Drug Information Reference” should be
consulted before hand
 OPENING THE SESSION
 At start of session, focus on information gathering from patient
 Introduction from pharmacist, make the patient comfortable
 Greetings followed by intro & state objective of meeting
 Seek information from patient regarding his medication, understanding of his disease
 Other supplementary information such as ; previous allergies, past medications,
smoking, alcohol history etc.
 OPENING THE SESSION
 How to get information from patient:
 Open ended questions helpful.
 Question on patient understanding of disease:
 What symptoms are you experiencing ?
 What did your doctor tell you about the disease ?
 Question on patient understanding of his/her medication:
 What did your doctor tell you about this medication ?
 Reflective Questions also help
 Did these tablets help you last time, did you feel better ?
 OPENING THE SESSION
 Be aware of patients mental state, does he/she want to talk ??
 Try to empathize with patient, speak in a reassuring tone
 Avoid being aggressive, personal, intrusive questioning
 If the patient is getting aggressive, stop the session
 COUNSELLING CONTENT
 The main part (Heart) of session
 Pharmacist speaks about medication & lifestyle changes
 Typical topics covered
1. Name/Strength of drug
2. How long, how to be taken
3. Expected benefits, time frame
4. Possible side effects
5. Possible interactions
6. What to do if missed dose
7. Special monitoring requirements
 COUNSELLING CONTENT
 The main part (Heart) of session
 Pharmacist speaks about medication & lifestyle changes
 Counselling in simple language
 Medical jargon should be avoided
 In some cases, the advice given to family members
 CLOSING THE SESSION
 Before ending, important to know patients understanding of his medication
 This usually done by asking simple questions
 Example: Which is the blood pressure drug, how many will you take in a day ,
which one after meal ?
 FIRST TIMERS
 Getting confidence for young pharmacist is important before session
 Advisable to listen to sessions by senior pharmacists
 Start with limited counselling sessions
 Develop expertise in one area & then move to other (Antibiotics etc.)
 PRIORITIZE COUNSELLING
 Most of the time, pharmacist are too busy
 They need to prioritize which category of patients to counsel
 typically the focus groups are
1. Special medication group
2. Complex medication (TB, HIV regimens)
3. Specialized delivery drugs (Rotahalers)
4. Elderly patients on many drugs (polypharmacy)
 COUNSELLING AIDS
 Develop teaching, educational aids
 In addition to live counselling
 Good for follow up reading by patients
 Medication card : useful aid, has summary of drugs
 Easy format, patient can understand
 Pharma companies draft “Consumer Product Info”
 Pharmacist can also draft simple product info
THANK YOU