Patient counselling

It is a very important topic in healthcare. Pharmacists must be aware of few important counselling points for every medicine. Community Pharmacist must be aware of counselling.

1. PATIENT PATIENT
COUNSELLINGCOUNSELLING
Mrs. Mayuri Padhye, Assistant professor,
Department of Pharmacology,
Saraswathi Vidya Bhavan’s College of Pharmacy

2. PATIENT COUNSELLING PATIENT COUNSELLING

3. PATIENT COUNSELLING PATIENT COUNSELLING

4. PATIENT COUNSELLING PATIENT COUNSELLING

5. PATIENT COUNSELLING PATIENT COUNSELLING
The guidance provided to the patient by the
pharmacist about the correct use of
medicines is Patient Counseling.

6. PATIENT COUNSELLING PATIENT COUNSELLING

7. PATIENT COUNSELLING PATIENT COUNSELLING
It is instructing the patient about various
aspects of medicines like;
1.How to take?
2.How long to take?
3.What to avoid?
4.Precautions, common side effects, storage
5.Any other relevant information about the
illness

8. PATIENT COUNSELLING PATIENT COUNSELLING
The counseling is also given on issues like
diet, nutrition, alcohol quitting etc.
To be successful in patient counseling, one
must have:
1.Friendly approach
2.Willingness to help customer
3.Sound knowledge about the drugs/disease

9. PATIENT COUNSELLING: FORMS PATIENT COUNSELLING: FORMS
The patient counseling can be in two
forms:
1.Verbal counseling:
Interacting with the patient & talking to
him / her about the matters mentioned
above
2.Written instructions:
Giving printed information about the drugs
& disease

10. PATIENT COUNSELLING: FORMS PATIENT COUNSELLING: FORMS
Face to face with written information:
Separate private room
Provide written information only:
1.Notes attached in prescriptions
2.Patients need to be literate
3.Local simple language
4.Severity & frequency of Adverse
reactions may increases without
explanation

11. PATIENT COUNSELLING: FORMS PATIENT COUNSELLING: FORMS
Brief face to face: Fastest communication &
high competence of pharmacists required
Use of picture & demonstration:
How to install eye drop
Nasal drop
How to use NDDS
Use of tablet counts in strips
Interview patients

12. PATIENT COUNSELLING PATIENT COUNSELLING

13. PATIENT COUNSELLING PATIENT COUNSELLING
POINTS TO BE ASSESSED IN
PATIENT COUNSELLING:
1.Forgetfulness
2.Lack of confidence & understanding
3.Apathy
4.Health belief
5.Dissatisfaction
6.Non supportive.

14. POINTS TO BE ASSESSEDPOINTS TO BE ASSESSED
1.Forgetfulness:
It is very common in case of geriatric
patients.
Busy and stressful life could be the reason
in case of adults.
Pediatric patients will always show their
hindrance for taking medication.

15. POINTS TO BE ASSESSEDPOINTS TO BE ASSESSED
2.Lack of confidence & understanding:
Patients lose their confidence because of
development of the disease.
They think they will not be able to recover
from the illness.
Few people are neither hospitalized nor
have taken any medication in their life.
They may develop a negative attitude
because of this.

16. POINTS TO BE ASSESSEDPOINTS TO BE ASSESSED
3.Apathy: Patient might develop lack of
interest, enthusiasm or concern due to
the developed disease.
4.Health belief: People with low
confidence level possess a lot of negative
thoughts about their disease condition.

17. POINTS TO BE ASSESSEDPOINTS TO BE ASSESSED
5.Dissatisfaction:
If positive outcome is not achieved with
the treatment people lose their confidence
with the physician and pharmacist.
They start to search a new physician but
will never think that some time is required
for improvement.

18. POINTS TO BE ASSESSEDPOINTS TO BE ASSESSED
6.Non supportive:
People are not ready to accept any line of
treatment.
They are not ready to take any extra
medication for their betterment.
If they are asked for a follow up visit after
2 weeks, they will think visiting after a
month will also do.

19. PATIENT COUNSELLING PATIENT COUNSELLING

20. ROLE OF PHARMACISTROLE OF PHARMACIST
1.Drug expert & Information provider
2.Patient helper & Problem solver
3.Counselor & Health promoter.
4.Medication intervener
5.Sensitive to personal problems of
patients

21. ROLE OF PHARMACISTROLE OF PHARMACIST
1.Drug expert & Information provider:
Pharmacist knows about the complete
profile of a drug.
He /She can explain the pharmacokinetics
and pharmacodynamics of drug.
Being a drug expert and information
provider, pharmacist can very explain the
correct use of medications to the patients.

22. ROLE OF PHARMACISTROLE OF PHARMACIST
2.Patient helper & Problem solver:
Thyroxine tablets prescribed to a
hypothyroid patient must be taken empty
stomach.
So either it has to be taken early in the
morning or around 4 pm in the evening
which is considered as empty stomach.
The 1
st
option could be difficult to practice,
but is ideal.

23. ROLE OF PHARMACISTROLE OF PHARMACIST
3.Counselor & Health promoter:
Patients suffering from any gastrointestinal
infection are prescribed probiotics and
antimicrobial agents (AMA) together.
Probiotics: will replenish the intestinal
flora and will improve the digestion
AMA: will take care of the infection
If both are taken together at the same
time, it will be of no use.

24. ROLE OF PHARMACISTROLE OF PHARMACIST
3.Counselor & Health promoter:
Duty of a pharmacist is to explain the
patient about this drug-drug interaction
and ask to keep a gap of minimum 2 hours
in administration of these two drugs
This will help to improve the clinical
condition of a patient at a faster rate

25. ROLE OF PHARMACISTROLE OF PHARMACIST
4.Medication intervener:
If a calcium channel blocker and calcium
supplements are prescribed together, then
pharmacist must explain the importance of
both the medications.
Patient must advised to keep a sufficient
time gap in between their administration.

26. ROLE OF PHARMACISTROLE OF PHARMACIST
5.Sensitive to personal problems of
patients:
People from lower socioeconomic class
may feel the burden of certain prescribed
medication because of money problem.
Like if AMAs, proton pump inhibitors
(PPIs) and B-complex group tablets are
prescribed together, then they prefer to
buy only PPIs and B-complex group tablet
being relatively cheaper in price.

27. ROLE OF PHARMACISTROLE OF PHARMACIST
5.Sensitive to personal problems of
patients:
In this case the importance of taking
AMAs needs to explained to the patient,
as the condition will not be improved by
taking only PPIs and B-complex group.

28. How does counseling help?How does counseling help?
Patient is the end user of the medicines.
He / She should know the correct use of it,
otherwise the medicines either will not
work properly or may produce adverse
effects.
e.g. Ciprofloxacin tablets & the iron tablets,

Tetracycline and Calcium supplements

29. How does counseling help?How does counseling help?
The pharmacist plays an important role in
this Patient education by way of counseling
the patient.
Counseling increases the involvement of the
Pharmacist & the Patient in the treatment,
patient understands the importance of
taking medicine in a right way, patient
compliance improve & the treatment
becomes successful

30. How does counseling help?How does counseling help?
Though in our country, so far we have not
been doing much counseling, our retail
pharmacists also have been helping the
patients in suggesting the OTC medicines
for minor illness & giving advice in many
other aspects.
Now what is required is we start instructing
the patients about correct use of medicines
in much more systematic way with updated
knowledge base.

31. How does counseling help?How does counseling help?
By doing so, the following advantages can be
attained.
1.Patients get the benefit & treatment
outcome improves
2.Pharmacist gets professional satisfaction,
the image of pharmacists & pharmacy
profession will improve

32. How does counseling help?How does counseling help?
3.The business of the shop will eventually
increase as more number of patients
would return to same shop for their drug
purchase requirements as they realize that
they are getting useful advice & special
attention.

33. Verbal counseling could become sometimes
difficult in our current setup due to high
customer flow at the counter
But as & when possible one can try to
implement the concept of counseling in
their own drug store

34. PATIENT COUNSELLING PATIENT COUNSELLING

35. COMMON INSTRUCTIONSCOMMON INSTRUCTIONS
List of common instructions which can
be given to the patient by pharmacists
for most of the medicines:
 
1.Take the medicine as directed by the
doctor. Do not stop medicines on your own
even if you start feeling better Consult
doctor or pharmacist.

36. COMMON INSTRUCTIONSCOMMON INSTRUCTIONS
2.Complete the entire course of antibiotics
as told by doctor, even if you start feeling
better in one or two days of the
treatment. (Resistance develops).
3.To gain the most benefit, do not miss
doses. If you do miss the dose, take a
missed dose as soon as possible. If it is
almost time for the next dose, skip the
missed one. Return to your regular
schedule. Do not take a double dose or
extra doses.

37. COMMON INSTRUCTIONSCOMMON INSTRUCTIONS
4.Keep the medicine in its original container
till it is all utilized. Do not cut the
tablet/capsule strip till it is utilized
completely.
5.Keep all medicine out of the reach of
children and pets.

38. COMMON INSTRUCTIONSCOMMON INSTRUCTIONS
6.Store medicines in cool, dark place away
from heat, sunlight & moisture. Do not
keep at window, in bathroom, or near
stove.
7.If you are diabetic, check your blood sugar
level regularly. If you are hypertensive,
check the blood pressure regularly.

39. COMMON INSTRUCTIONSCOMMON INSTRUCTIONS
8.Certain drugs should not be used during
pregnancy or breastfeeding, consult your
doctor or pharmacist.
9.Do not share your medicine with others
and do not take anyone else’s medicine.
Avoid Self medication.

40. COMMON INSTRUCTIONSCOMMON INSTRUCTIONS
10.Strictly avoid alcohol while on any drug
therapy as some drugs with alcohol can
produce dangerous effects.

41. PATIENT COUNSELLING PATIENT COUNSELLING

42. INTERVIEWING SKILLSINTERVIEWING SKILLS
Professional attitude: positive attitude to
diseases/discomforts.
Questionnaire Tech: Less you say and let
the patients speak more.
Closed ended: OTC
Open ended: Tell about the medication
problem etc.

43. INTERVIEWING SKILLSINTERVIEWING SKILLS
Patient prompting: Many patients are
uncomfortable to give information without
active support of pharmacists

44. PATIENT COUNSELLING PATIENT COUNSELLING

45. BARRIERS TO PATIENT BARRIERS TO PATIENT
COUNSELLINGCOUNSELLING
Physical barriers:
Physical positioning of counseling centers
Lack of privacy
Uncontrolled sound

46. BARRIERS TO PATIENT BARRIERS TO PATIENT
COUNSELLINGCOUNSELLING
Mental barriers:
Lack of time
Lack of confidence
Lack of knowledge
Language problem
Poor perception of pharmacists by
patients
Fear of infringement in physicians
territory.
Emotional display of anger & irritation

47. PATIENT COUNSELLING PATIENT COUNSELLING

48. STEPS TO BECOME A STEPS TO BECOME A
SUCCESSFUL COUNSELLING SUCCESSFUL COUNSELLING
PHARMACISTS:PHARMACISTS:
Value your own values & priorities.
Evaluate your barriers
Arrange for counseling aids: Visual aids
Prepare for each counseling sessions:
Tailor made needs after taking patients
appointment.

49. STEPS TO BECOME A STEPS TO BECOME A
SUCCESSFUL COUNSELLING SUCCESSFUL COUNSELLING
PHARMACISTS:PHARMACISTS:
Do self evaluation: Keep audio/ video
recording of sessions and find weakness in
particular area by oneself.
Follow up: Remind patient or
representative when refilling is to be done
and if necessary help patients to follow up.

50. PATIENT COUNSELLING PATIENT COUNSELLING

51. Q. Write a note on Patient counseling. 3M
Q. How will you counsel a patient with any
disease? E.g. TB, Hypertension, Diabetes.
3M