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The Benefits of Patient Counseling

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The counseling process between health professionals and patients serves two primary benefits:

  1. It establishes an ongoing relationship between the professional and the patient. Pharmacists can find opportunities to participate in health-system patient-education programs, to support the educational efforts and collaborate with other health care team members.
  2. It provides the exchange of information necessary to assess a patient’s health condition, implement treatment of medical problems, and evaluate the effects of treatment on a patient’s quality of life.

Patient Counseling to Enhance Medication Adherence

pce-tips-2_2     Poor medication adherence is a serious problem, many factors can influence patients for not taking their medications as directed. Nonadherence results in numerous medication-related hospitalizations and billions in health care–related costs annually. The most essential benefit of applying patient counseling in practice is to increase patients’ familiarity with and incorporation of educational methods aimed at reducing medication nonadherence.

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     Many pharmacists give patients advice about the importance of medication adherence by simply telling them to take their medication as directed. Patients may passively agree to take their medication regimens but not follow through. This approach to counseling patients is not effective because it fails to explore the patient’s barriers and motivations toward being adherent to the regimen and does not address the patient’s readiness to commit to following through with the prescribed plan. Motivational interviewing is an alternative form of communication that combines a patient-centered yet directive approach to discussing medication adherence and health behavior change. Motivational interviewing focuses on the patient’s own motivation for change and adherence to treatment and identifies reasons why a patient may be ambivalent or resistant to making a change.

pce-tips-2_5     Patients with a poor understanding of their disease and medication regimen and their personal consequences of nonadherence are more likely not to take their medications properly. Patients should be educated about the benefits of treatment and what may happen if medications are not taken as prescribed. Counseling should be tailored to address a patient’s specific diseases (e.g., a stroke may occur if blood pressure medications are missed). To enhance adherence, key points of the medication regimen should be reinforced, such as how the medication works, the proper dosage schedule and administration (e.g., show patients how to use an inhaler), what to do if doses are missed or delayed, proper storage, and common and serious adverse events. Use the “teach back” method to assess whether patients understand what you told them.

pce-tips-2_6     Trying to incorporate the dosage schedule into the patients’ schedule and lifestyle and using patient reminders are other interventions aimed at enhancing adherence. Talk to patients to determine the best time for them to take medications and find out if regimens with multiple daily doses may be problematic. Converting regimens to once-daily dosing options and reducing pill burdens by using combination tablets may be beneficial interventions for improving adherence. Patient reminder aids such as medication calendars, pill boxes, and/or telephone or mail reminders may also enhance adherence.

pce-tips-2_7     Given the high cost of drugs, the issue of reimbursement and access to care should be addressed with all patients. Medication nonadherence may be a result of a patient’s inability to pay for prescribed therapies. Talk to patients about insurance coverage, access to assistance programs, and the availability of cheaper options if cost barriers influence adherence.

References:
Counseling to enhance medication adherence, AphA, By Maria G. Tanzi, PharmD, 2012
Guide To Patient Counseling, By: Eugene Tsang, March 2008