Steps in the patient education and counseling process will vary according to the health system’s policies and procedures, environment, and practice setting. Generally, the following steps are appropriate for patients receiving new medications or returning for refills:
- Establish caring relationships with patients as appropriate to the practice setting and stage in the patient’s health care management. Determine the patient’s primary spoken language.
- Introduce yourself as a pharmacist
- Explain the purpose and expected length of the sessions
- Obtain the patient's agreement to participate
- Assess the patient's knowledge about his or her:
- Health problems and medications,
- Physical and mental capability to use the medications appropriately, and
- Attitude toward the health problems and medications.
- Ask open-ended questions about each medication’s purpose and what the patient expects, and ask the patient to describe or show how he or she will use the medication. Patients returning for refill medications should be asked to describe or show how they have been using their medications. They should also be asked to describe any problems, concerns, or uncertainties they are experiencing with their medications.
- Provide information orally and use visual aids or demonstrations to fill patients’ gaps in knowledge and understanding. Open the medication containers to show patients the colors, sizes, shapes, and markings on oral For oral liquids and injectables, show patients the dosage marks on measuring devices. Demonstrate the assembly and use of administration devices such as nasal and oral inhalers. As a supplement to face-to-face oral communication, provide written handouts to help the patient recall the information. If a patient is experiencing problems with his or her medications, gather appropriate data and assess the problems. Then adjust the pharmacotherapeutic regimens according to protocols or notify the prescribers.
- Verify patients’ knowledge and understanding of medication Ask patients to describe or show how they will use their medications and identify their effects. Observe patients’ medication-use capability and accuracy and attitudes toward following their pharmacotherapeutic regimens and monitoring plans.
The content of an education and counseling session may include the information listed below, as appropriate for each patient’s pharmacotherapeutic regimen and monitoring plan. The decision to discuss specific pharmacotherapeutic information with an individual patient must be based on the pharmacist’s professional judgment.
- The medication’s trade name, generic name, common synonym, or other descriptive name(s) and, when appropriate, its therapeutic class and efficacy.
- The medication’s use and expected benefits and action. This may include whether the medication is intended to cure a disease, eliminate or reduce symptoms, arrest or slow the disease process, or prevent the disease or a symptom.
- The medication’s expected onset of action and what to do if the action does not occur.
- The medication’s route, dosage form, dosage, and administration schedule (including duration of therapy).
- Directions for preparing and using or administering the medication. This may include adaptation to fit patients’ lifestyles, diet, work environments or other supportive non-pharmacological treatments.
- Action to be taken in case of a missed dose.
- Precautions to be observed during the medication’s use or administration and the medication’s potential risks in relation to benefits. For injectable medications and administration devices, concern about latex allergy may be discussed.
- Potential common and severe adverse effects that may occur, actions to prevent or minimize their occurrence, and actions to take if they occur, including notifying the prescriber, pharmacist, or other health care provider.
- Techniques for self-monitoring of the pharmacotherapy.
- Potential drug–drug (including nonprescription), drug–food, and drug–disease interactions or contraindications.
- The medication’s relationships to radiologic and laboratory procedures (e.g., timing of doses and potential interferences with interpretation of results).
- Prescription refill authorizations and the process for obtaining refills.
- Instructions for 24-hour access to a pharmacist.
- Proper storage of the medication.
- Proper disposal of contaminated or discontinued medications and used administration devices.
- Any other information unique to an individual patient or medication.
These points are applicable to both prescription and nonprescription medications. Pharmacists should counsel patients in the proper selection of nonprescription medications. Additional content may be appropriate when pharmacists have authorized responsibilities in collaborative disease management for specified categories of patients. Depending on the patient’s disease management or clinical care plan, the following may be covered:
- The disease state: whether it is acute or chronic and its prevention, transmission, progression, and recurrence.
- Expected effects of the disease on the patient’s normal daily living.
- Recognition and monitoring of disease
ASHP Guidelines on Pharmacist-Conducted Patient Education and Counseling. 2011.
(by Jessica Aryanti from Professional Development IPSF-APRO)