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Transcript of Patient Counseling
Why is Counseling so Important?
Legislative aspect: OBRA '90
WHO Should Pharmacists Counsel?
Soheyla Mahdavian, Pharm.D., BCGP, TTS
Associate Professor of Pharmacy Practice
Most Accessible Healthcare Provider
The pharmacist may be the only available healthcare provider besides going to the ER. Counseling a patient could mean the difference between ignoring a potentially harmful situation, or receiving the necessary information to address it quickly and safely.
The Omnibus Budget Reconciliation Act of 1990 (OBRA '90), which mandates the offer to counsel patients about their prescriptions, also specifies the components of patient counseling.
Improves overall patient care by increasing medication awareness and patient adherence.
What Do Pharmacists Counsel On?
Three Components of Counseling
A. Greet the patient
B. Tell who you are
C. Explain the purpose of
2. Counsel the Patient
A. Summarize Key Points
B. Verify Patient's Understanding
C. Answer any questions
Patient counseling empowers the patient with the necessary tools to self-manage their disease states. And to recognize when there is an issue with their therapy.
Being the most accessible healthcare provider, Pharmacists counsel on EVERYTHING! But...OBRA '90 Specifies specifics counseling should encompass specific details.
Adherence: The extent to which patients take medications as prescribed by their providers and agreed upon in the treatment plan
Examples of nonadherence?
1. Forgetting to fill or get a refill
2. Taking more or less than prescribed
3. Stopping the medication early
4. Taking medication at the wrong time
5. Improper storage
6. Taking the medication with inappropriate food/drinks/other medications
7. Not using inhalers, insulin pens, or other devices correctly
8. Taking expired medications
Factors affecting adherence?
2. Complicated regimens
3. Emotional factors
5. Lack of information
6. Side effects
7. Misinterpretation of physician/pharmacist instructions
2. Cognitive impairment/confusion
3. Certain disease states (depression, asymptomatic illness, substance abuse, etc)
4. Poor health literacy
5. Health belief, religious, or socioeconomic factors
Ways to improve adherence?
2. Educating on illness, proper medication use
3. Simplifying medications
4. Clear communication
5. Open ended questioning
6. Nonjudgmental tones
7. Demonstrating device use
8. TEACH BACK method
7. Continuous involvement with patient care