3. patient pharmacist interaction

7/27/2019 3. Patient Pharmacist Interaction

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Durdana Waseem, Lecturer RIPS

Patient Pharmacist Interaction


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1. Hospital

1. In pharmacy

2. In wards2. Community

1.

Areas for Patients-Pharmacist

Interaction

Hospital

Community


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A skill that helps people to overcome temporary stress, to get along

with other people, to adjust to the unalterable, and to overcome

psychological blocks which stand in the way of self-realization

Therapeutic Communication


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Objectives of Interaction

to educate the patient

about the drug therapy

he/she is receiving

and/or taking

to negotiate the terms

of the goals of therapy

and the patient's role in

achieving them

to elicit necessary

information from the

patient to make your

decisions


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Ethical Principles

Beneficence Do the very best you can for every patient

Nonmaleficence Above all, do no harm

Veracity Tell the patient the truth

JusticeFair, equitable and appropriate treatment

regardless of ethnicity, class or gender

Fidelityconcept of faithfulness and the practice of keeping

promises

Autonomy Allow the patient to be the ultimate decision maker

Confidentiality Always protect your patient's privacy

Concepts that describe the moral standards applied in patientcare


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Welcome to patient

Initial questioning (patient history, medication use behavior,

perceptions)

Prescription handling/medicine assessment (written directions for

use)

Dispensing/medication compliance/ evaluation

Counseling (language, patients understanding ofinstructions,

disease, drugs and dosage schedule, encouragement to comply

with regimen)

Follow up

Parts of Interaction


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Every patient has a right to

be treated according to his/her unique character

decide and act on his/her own values to fulfill individual life plans

expect complete objective information and the emotional support

necessary to act effectively on that information

control of his/her time and effort

expect whatever benefit is possible in the health care setting and to

expect no avoidable harm

expect that agreements established with the health care professionals

will be kept

Decision making Principles in Patient-

Pharmacist Interaction


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Care About What They Want

Know When to Refer Them to Someone with Different Expertise

Possess the Technical Knowledge and the Clinical Experience and

Confidence It Takes to Apply that Knowledge to Their Individual Case

Be Realistic and Honest About What They Can Expect from TheirMedications

Put Their Needs First, before Your Own

Receive the Appropriate Medication for Their Medical Problems, and They

Expect the Medication to Work

Be Accountable for the Decisions You Make and the Advice You Give

The patient will expect you toWhat Patient can Expect

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2

3

4

5

6

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Characteristics & Behaviors Associatedwith Interaction

Putting the patients needs first

Offering reassurance

Seeing the patient as a person

Mutual respect/trust

Cooperation

Caring

Building confidence

Supporting the patient

Paying attention to the patient's

physical and emotional comfort

Honesty/authenticity/open

communication

Empathy/sensitivity

Patience and understanding

Competence

Assuming responsibility for

interventions

Being held accountable for

the decisions and

recommendations made

Characteristics about yourself

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Behaviors you manifest toward your patient


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Attend to your appearance and be conscious of the impact it has on

the patient

Be conscious of the impact the appearance of your surroundings

has on the patient

The vocabulary and language that you use to greet the patient will

set the tone of the meeting

Listen and give attention to the patient, he/she will be expecting it

General behaviors that will always impact

the impression you have on your patients


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What your patient wants to know

What the patient already knows

The best way to recognize this difference is to

determine the preferred language of the patient

determine the level of comprehension best suited to the patientthis

will determine the vocabulary/terms that are familiar to the patient

identify any cultural or religious issues that are relevant to

communicating with the patient

First understand the patient


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The medication is appropriate

There is a clinical indication for each medication being taken.

All of the patient's medical conditions that can benefit from drug therapy have beenidentified

The medication is effective

The most effective drug product is being used

The dosage of the medication is sufficient to achieve the goals of therapy

The medication is safe

There are no adverse drug reactions being experienced

There are no signs of toxicity

The patient is compliant

The patient is willing and able to take the medications as intended

Patient Pharmacist Encounter

Assess patients drug related needs


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The reason the patient is taking each medication

Explain how the medication works

Use pictures and diagrams whenever possible

Provide patients with information and labeling to take home with

them

Convey to the patient

Explain the following to the patient


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The specific instructions of how to take the medication explained in

a manner the patient can understand

Use the same terms from one encounter to the next

Use phrases that are familiar to the patient so they are not

misunderstood (twice a day, dissolved in water, with food)

Start from your patient's point of reference (when do they eat,

what time do they go to bed)



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A description of how the patient will know that the medication is

working well

Describe how the patient's symptoms will change and when to expect

these improvements

Create an understandable system for complicated terms (clinical

parameters or laboratory values)

Include specific values that will serve as endpoints

Communicate how confident you are that the patient's pharmacotherapy

will be effective



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Explain the undesirable effects that might be expected

Be specific about when adverse reactions are most likely to

occur.

Be clear about what the patient should do if a dose of the medication

is missed or if he/she takes an extra dose of the medication



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Inform the patient of when and how you intend to follow-up to

evaluate effectiveness and safety of the medication

Provide the patient with clear instructions of what to do if any

problems arise with the medication

Provide the patient with a way to contact you if the medication is not

working within the timeframe you discussed



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Workup of an Ethical Problem InPatient Pharmacist Interaction


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1. Recognize when a patient encounter raises an important ethical

problem, and gather the relevant facts

What are the clinical facts?

What are the legal facts?

What are the ethical facts?

2. Work with the patient to describe the problem that has to be resolved

What is the ethical dilemma?

What ethical principles are involved?

Workup of an Ethical Problem


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3. Determine what each of you (practitioner and patient) consider to be

an acceptable resolution to the problem

4. Generate reasonable alternatives to resolve the ethical problem, and

consider each option in relation to the fundamental ethical principles

and the patient's preferences

What are the possible strategies to address the problem?



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Autonomy: What does the patient want?

Paternalism: How am I affecting the patient?

Beneficence: What good can be done for the patient?

Nonmaleficence: Is harm to the patient being avoided?

Justice: Is the patient receiving what is fair?

Veracity: Is the patient being told the truth?

Confidentiality: Is the patient's privacy being protected?



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5. Select the resolution that you and the patient will implement

What should be done?

What is the final decision that you plan to implement?

6. Critically examine the decision that has been made, and justify it

What makes this the best choice?

What would make you change your mind?

7. Do the right thingimplement it

How am I going to accomplish this?

What is the best strategy to implement the solution?

How will I know if my actions were appropriate or not?

Follow-up with the patient



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Mr. Z., age 63, has had two heart attacks in the past. He now has a

prescription for a medication to prevent recurrences of heart attacks

that must be taken regularly to be effective. He tells you that he does

not think he will bother to take the new medication because he does not

believe another heart attack will harm him. How would you approach

his care?

Assignment 1 Case


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Prepare a set of principles that a pharmacist

must follow to establish and run a community

pharmacy.

Assignment 2


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THANK YOU!

3. patient pharmacist interaction

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