PATIENT COUNSELLING

DR MBURU
CLINICAL PHARMACIST
PATIENT COUNSELLING
PATIENT COUNSELLING
PATIENT COUNSELLING
 PATIENT COUNSELLING
The guidance provided to the patient by
the pharmacist / pharmaceutical
technologist about the correct use of
medicines is Patient Counseling.
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 relevantinformation
about the illness
 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
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
PATIENT COUNSELLING
 PATIENT COUNSELLING
P O I N T S T O B E A S SESSE D IN
P A T IE N T CO U N SE L L ING:

1.Forgetfulness
2.Lack of confidence & understanding
3.Apathy
4.Health belief
5.Dissatisfaction
6.Non supportive.
POINTS 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.
 POINTS 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.
 POINTS TOBE ASSESSED

3. Apathy: Patient might develop lack of

interest or concern.

4. Health belief: People with low

confidence level possess a lot of negative
thoughts about their disease condition.
 POINTS TO BE
ASSESSED
Dissatisfaction:
5.
 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.
POINTS 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 aftera month will
also do.
PATIENT COUNSELLING
ROLE OF PHARMACIST /
PHARM TECH

1. Drug expert & Information provider

2. Patient helper & Problem solver
3. Counselor & Health promoter.
4. Medication intervener
5. Sensitive to personal problems
of patients
 ROLE OF PHARMACIST /
PHARMACEUTICAL TECH
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.
 …ROLE
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 1st option could be difficult to practice,
but is ideal.
 …ROLE
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.
 …ROLE
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
 …ROLE
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.
 …ROLE
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.
 …ROLE
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.
 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

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 and the Patient in the
treatment plan, patient understands the
importance of taking medicine in a right
way, patient compliance improves an treatment
outcomes are successful.
 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.
How does counseling help?
Advantages:
Patients getthe benefit & treatment
outcome improves
Pharmacist/pharm tech get professional
satisfaction and pharmacy profession image
improves
The business will eventually increase as more
number of patients would return to same
pharmacy for their drug purchase requirements
as they realize that they are getting useful advice
& special attention.
PATIENT COUNSELLING
C O M M O N INSTRUCTIONS
List of common instructions which
can be given to the patient:

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.
C O M M O N 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.
C O M M O N 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.
C O M M O N 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.
C O M M O N 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.
COMMON INSTRUCTIONS
10. Strictly avoid alcohol while on any drug
therapy as some drugs with alcohol can
produce dangerous effects.
PATIENT COUNSELLING
 INTERVIEWING SKILLS
 Professional attitude: positive attitude to
diseases/discomforts.

 Questionnaires: Less you say and let the patients

speak more.
Closed ended: O T C
Open ended: Tell about the medication problem etc.

 Patient prompting: Many patients are

uncomfortable to give information without
active support of pharmacists
PATIENT COUNSELLING
BARRIERS T O PATIENT
COUNSELLING
Physical barriers:
Physical positioning of counseling
centers

Lack of privacy

Uncontrolled sound
 …BARRIERS

Mental barriers:
 Lack of time
Lack of
confidence
Lack of
knowledge
Language
problem
Poor perception of
pharmacists by patients
PATIENT COUNSELLING
STEPS TO BECOMING A
SUCCESSFUL COUNSELOR
Value your own values and priorities

Evaluate your barriers

Arrange for counseling aids: Visual aids

Prepare for each counseling sessions:

Tailor made needs after taking patients
appointment.
…STEPS
Do self evaluation: recording of
sessions and find weakness in particular
areas by oneself

Follow up: Remind patient or

representative when refilling is to be
done and if necessary help patients to
follow up.
PATIENT COUNSELLING
QUESTIONS
Q. Write a note on Patient counseling.

Q. How will you counsel a patient with any

disease?
E.g. TB, Hypertension, Diabetes.