With pharmacists stretched thinner than ever, counseling patients efficiently but effectively has become a top concern. Drug Topics® asked 3 experienced pharmacists to share how they accomplish this important goal.
Ashley Gulyas, PharmD, a clinical pharmacist and pharmacist in charge at Spartanburg Regional Healthcare System in South Carolina and owner/editor of Academy & Apothecary, advises noting each patient’s preferred method of communication; although many appreciate in-person counseling, not all do. “Some patients prefer texting, so a secure, HIPAA [Health Insurance Portability and Accountability Act]–compliant text is the easiest way,” Gulyas said. Telepharmacy and videoconferencing can work, too. “Be flexible and creative,” she said.
Gulyas also recommends introducing oneself, if necessary, and setting time expectations by asking if the patient has several minutes to talk. Ask open-ended questions to ensure a better understanding and dialogue, she suggests. For example, instead of telling the patient to take a medication at night, ask, “Can you tell me what time of day you take this medication?”
Leah Nunez, PharmD, MS, director of pharmacy at Rio Grande State Center in Harlingen, Texas, noted that a patient may need explanations in basic terms. “Even highly educated people may have very little medical literacy,” she said. Like Gulyas, Nunez uses open-ended questions to determine how to adapt the conversation to the patient.
Nunez acknowledges the struggle of working in a busy pharmacy. “Getting information across in a timely manner is important when pharmacies are busy and the staff is pushed to do more with less,” she said. Using or creating a counseling area that allows private conversations with patients, without the distraction of other patients, shoppers, and staff, can be helpful. “A patient may be less willing to speak at a cash register where there is a long line,” she said.
Because providing detailed education can be difficult in a community pharmacy, Nunez recommends that pharmacists familiarize themselves with local community services, such as classes offered at a hospital or nearby support groups. Patients who are strapped for time may appreciate a pharmacist’s recommendation for reputable educational websites, such as that of the American Heart Association, as opposed to relying on Google for finding important information. “If we don’t have the time to tell the patient all we wish we could, we can give them the tools to increase their knowledge and improve their health,” she said.
Anne Henriksen, PharmD, owner of and pharmacist in charge at Malley’s Compounding Pharmacy in Richland, Washington, added that although it is important for the pharmacist to ask open-ended questions, a yes-or-no question from a patient should be addressed with caution. “There are very few yes/no questions when it comes to medicine,” she said. She recalled a patient if 2 medications were the same; a technician answered no, but Henriksen knew she needed to dig deeper. A conversation revealed that the patient was not supposed to take either medication. “If the patient had left the pharmacy with the simple answer of no, she would have continued to take both medications, which could have been dangerous,” Henriksen said.
What about a patient who takes a personal call when you need to convey important counseling points? Make clear that their full attention is needed, but be kind about it, Henriksen recommends. She said, “I will not perform a medication consultation with a patient who is on the phone. I kindly state that I am happy to complete the medication consultation when the patient is available and walk away, and ask them to please let my staff know when the patient is ready.”
Patients retain very few of the details provided, Henriksen said, so she highlights important points on written materials and recommends that patients read the information at home: “I always emphasize that patients can call anytime if they have any further questions after they get home.”