PHRM 3900: Pharmacy Communications

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PHRM 3900Pharmacy Communications

• Matthew Perri, Ph.D., R.Ph.
• Professor of Pharmacy
• Clinical and Administrative Pharmacy
• Room 250G Ph542-5365
• mperri_at_mail.rx.uga.edu

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Plan for today

• Course overview introduction
• ID Cards
• Name, where you are from, any prior degrees,
  something about yourself that will help me
  remember you
• Web page
• Course objectives, Grading, Lecture outlines,
  Handouts
• Other interesting stuff
• OBRA 90 and Pharmacy Care
• Common communication mistakes health
  practitioners make
• Basic communication skills

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The Pharmacy Care Process
Collect and use patient information
Follow up to assess patient outcomes
Identify patients drug related problems
Select and recommend therapies
Develop solutions to these problems
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OBRA 90

• Three parts
• Patient Information
• Prospective Drug Utilization Review
• Patient Counseling

Public Law 101-508, S4401, 1927(g) (November 5,
1990) and OBRA 90 Regulations.  Federal Register
November 2, 199257FR(212)49397-49401.
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Patient Information

• Full name
• Address and phone
• Date of birth (DOB) / age
• Gender
• Drug list (profile) including all OTC, Rx, herbal
  supplements, etc.
• Pharmacist comments
• Chronic medical conditions (diagnoses)
• Keep for 2 years

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Prospective DUR

• Over / underutilization
• Therapeutic duplications
• Drug-disease interactions
• Drug-drug interactions
• Incorrect dosage or duration of treatment
• Drug allergy interactions
• Clinical abuse - misuse

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Patient Counseling

• Name (generic)
• Intended use and expected action
• Route, dosage form, dosage and administration
  schedule
• Special directions for preparation, storage or
  administration
• Precautions to be observed while taking
• Common side effects, how to avoid or action
  required if they occur
• Techniques for self monitoring of drug therapy
• Potential interactions or therapeutic
  contraindications
• Refills
• What to do if you miss a dose
• Any other information THIS patient may need to
  ensure safe use

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10 Communication Mistakes Pharmacists Make

• From Lessons from medicine and nursing for
  pharmacist-patient communication, Am Jour of
  Health System Pharmacists, Vol. 53, June 1996,
  pages 1306-14.

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Basic Communication Skills in Pharmacy Practice
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The Communication Model
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The communication model

• Communication takes two
• sender and receiver
• To optimize communication we must consider the
  channel
• Two way flow of information
• Potential for a breakdown to occur at any time
• Barriers will exist minimize these when you can

Communications Skills in Pharmacy Practice,
Tindall, Beardsley and Kimberlin, third ed.,
1994, Lea and Febiger, p 15.
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Barriers to communication

• Pharmacy Environment

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Barriers to communication

• Pharmacy Environment

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Barriers to communication
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Basic Counseling and Communication Skills

• Courtesy and rapport
• Quite possibly the most critical skills you will
  need to develop, and includes
• How to address patients
• Introducing yourself
• Learning patient names
• Being aware of your appearance, attitude, issues
• Respecting patient privacy issues
• Avoiding stereotypes
• Using appropriate body language

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Basic Counseling and Communication Skills

• Body language
• Facial expression smile
• Eye contact
• Open posture
• Distance
• Tone of voice
• Get CLOSER
• Control distractions, lean in, open posture,
  smile, make good eye contact, relax

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Good body language?
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Stereotypes

• Everyone does this to some extent
• Biker at 855PM on Saturday.
• What is your favorite stereotype?
• What is the impact of this on rapport?
• Being aware of how you may stereotype others is
  critical
• Treat everyone as an individual

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Rapport

• Mutual consideration and respect
• The warm fuzzy part of communication
• Paves the way for good communication
• Trust is critical
• How do you build trust?
• How do you keep it?
• What happens when you break it?

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Perceptions
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• FINISHED FILES ARE THE RE-
• SULT OF YEARS OF SCIENTIF-
• IC STUDY COMBINED WITH THE
• EXPERIENCE OF MANY YEARS
• OF EXPERTS

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Basic Skills Listening

• Listening
• Perceptions (F test)
• Being non-judgmental
• Being an active listener
• Use appropriate listening body language
• Use silence where appropriate

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Basic Skills Information

• When Communicating Information
• Talk in lay terms, but dont oversimplify
• Avoid technical jargon
• Avoid information overload
• Keep it short and simple, to the point

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Basic Skills Gathering Information

• When gathering information
• Ask open-ended questions
• Much more information can be gained
• Saves time
• Provides opportunities for patients to reveal
  information we might not be thinking about
• How are you supposed to be taking this?
• Tell me more about this

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Basic Skills Assessment

• Did your patient learn?
• Did the other person understand what you said,
  and meant?
• Summarize your teaching
• Verify what your patients know
• I know you believe you understand what you think
  I said, but I am not sure you realized that what
  you heard is not what I meant.
• Reinforce patient understanding when you can
• Thats right, this medication will make you
  sleepy

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Basic Skills Empathy

• Seek to understand what your patients feel
• This will help you shape your communication so
  that they better understand you!
• Difference between empathy / sympathy
• Some sample responses (p47 Tindall Book)

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Basic Skills Questions

• Encourage patients to ask questions
• When your patients are comfortable asking you
  questions, you know you have rapport and are
  doing a good job communicating

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Basic Skills Being Assertive and Persuasive

• Assertive not aggressive (well come back to this
  later)
• Use persuasion where appropriate, for example
  with medication compliance issues

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Counseling Methods We Will Learn

• Basic Counseling
• Interactive patient counseling
• The Prime Questions
• Counseling in challenging situations
• The PAR technique
• Prepare, assess and respond
• Counseling for compliance
• The RIM technique
• Recognize, identify and manage

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