3. patient pharmacist interaction
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Durdana Waseem, Lecturer RIPS
Patient Pharmacist Interaction
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1. Hospital
1. In pharmacy
2. In wards2. Community
1.
Areas for Patients-Pharmacist
Interaction
Hospital
Community
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A skill that helps people to overcome temporary stress, to get along
with other people, to adjust to the unalterable, and to overcome
psychological blocks which stand in the way of self-realization
Therapeutic Communication
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Objectives of Interaction
to educate the patient
about the drug therapy
he/she is receiving
and/or taking
to negotiate the terms
of the goals of therapy
and the patient's role in
achieving them
to elicit necessary
information from the
patient to make your
decisions
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Ethical Principles
Beneficence Do the very best you can for every patient
Nonmaleficence Above all, do no harm
Veracity Tell the patient the truth
JusticeFair, equitable and appropriate treatment
regardless of ethnicity, class or gender
Fidelityconcept of faithfulness and the practice of keeping
promises
Autonomy Allow the patient to be the ultimate decision maker
Confidentiality Always protect your patient's privacy
Concepts that describe the moral standards applied in patientcare
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Welcome to patient
Initial questioning (patient history, medication use behavior,
perceptions)
Prescription handling/medicine assessment (written directions for
use)
Dispensing/medication compliance/ evaluation
Counseling (language, patients understanding ofinstructions,
disease, drugs and dosage schedule, encouragement to comply
with regimen)
Follow up
Parts of Interaction
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Every patient has a right to
be treated according to his/her unique character
decide and act on his/her own values to fulfill individual life plans
expect complete objective information and the emotional support
necessary to act effectively on that information
control of his/her time and effort
expect whatever benefit is possible in the health care setting and to
expect no avoidable harm
expect that agreements established with the health care professionals
will be kept
Decision making Principles in Patient-
Pharmacist Interaction
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Care About What They Want
Know When to Refer Them to Someone with Different Expertise
Possess the Technical Knowledge and the Clinical Experience and
Confidence It Takes to Apply that Knowledge to Their Individual Case
Be Realistic and Honest About What They Can Expect from TheirMedications
Put Their Needs First, before Your Own
Receive the Appropriate Medication for Their Medical Problems, and They
Expect the Medication to Work
Be Accountable for the Decisions You Make and the Advice You Give
The patient will expect you toWhat Patient can Expect
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Characteristics & Behaviors Associatedwith Interaction
Putting the patients needs first
Offering reassurance
Seeing the patient as a person
Mutual respect/trust
Cooperation
Caring
Building confidence
Supporting the patient
Paying attention to the patient's
physical and emotional comfort
Honesty/authenticity/open
communication
Empathy/sensitivity
Patience and understanding
Competence
Assuming responsibility for
interventions
Being held accountable for
the decisions and
recommendations made
Characteristics about yourself
21
Behaviors you manifest toward your patient
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Attend to your appearance and be conscious of the impact it has on
the patient
Be conscious of the impact the appearance of your surroundings
has on the patient
The vocabulary and language that you use to greet the patient will
set the tone of the meeting
Listen and give attention to the patient, he/she will be expecting it
General behaviors that will always impact
the impression you have on your patients
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What your patient wants to know
What the patient already knows
The best way to recognize this difference is to
determine the preferred language of the patient
determine the level of comprehension best suited to the patientthis
will determine the vocabulary/terms that are familiar to the patient
identify any cultural or religious issues that are relevant to
communicating with the patient
First understand the patient
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The medication is appropriate
There is a clinical indication for each medication being taken.
All of the patient's medical conditions that can benefit from drug therapy have beenidentified
The medication is effective
The most effective drug product is being used
The dosage of the medication is sufficient to achieve the goals of therapy
The medication is safe
There are no adverse drug reactions being experienced
There are no signs of toxicity
The patient is compliant
The patient is willing and able to take the medications as intended
Patient Pharmacist Encounter
Assess patients drug related needs
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The reason the patient is taking each medication
Explain how the medication works
Use pictures and diagrams whenever possible
Provide patients with information and labeling to take home with
them
Convey to the patient
Explain the following to the patient
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The specific instructions of how to take the medication explained in
a manner the patient can understand
Use the same terms from one encounter to the next
Use phrases that are familiar to the patient so they are not
misunderstood (twice a day, dissolved in water, with food)
Start from your patient's point of reference (when do they eat,
what time do they go to bed)
Convey to the patient
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A description of how the patient will know that the medication is
working well
Describe how the patient's symptoms will change and when to expect
these improvements
Create an understandable system for complicated terms (clinical
parameters or laboratory values)
Include specific values that will serve as endpoints
Communicate how confident you are that the patient's pharmacotherapy
will be effective
Convey to the patient
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Explain the undesirable effects that might be expected
Be specific about when adverse reactions are most likely to
occur.
Be clear about what the patient should do if a dose of the medication
is missed or if he/she takes an extra dose of the medication
Convey to the patient
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Inform the patient of when and how you intend to follow-up to
evaluate effectiveness and safety of the medication
Provide the patient with clear instructions of what to do if any
problems arise with the medication
Provide the patient with a way to contact you if the medication is not
working within the timeframe you discussed
Convey to the patient
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Workup of an Ethical Problem InPatient Pharmacist Interaction
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1. Recognize when a patient encounter raises an important ethical
problem, and gather the relevant facts
What are the clinical facts?
What are the legal facts?
What are the ethical facts?
2. Work with the patient to describe the problem that has to be resolved
What is the ethical dilemma?
What ethical principles are involved?
Workup of an Ethical Problem
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3. Determine what each of you (practitioner and patient) consider to be
an acceptable resolution to the problem
4. Generate reasonable alternatives to resolve the ethical problem, and
consider each option in relation to the fundamental ethical principles
and the patient's preferences
What are the possible strategies to address the problem?
Workup of an Ethical Problem
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Autonomy: What does the patient want?
Paternalism: How am I affecting the patient?
Beneficence: What good can be done for the patient?
Nonmaleficence: Is harm to the patient being avoided?
Justice: Is the patient receiving what is fair?
Veracity: Is the patient being told the truth?
Confidentiality: Is the patient's privacy being protected?
Workup of an Ethical Problem
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5. Select the resolution that you and the patient will implement
What should be done?
What is the final decision that you plan to implement?
6. Critically examine the decision that has been made, and justify it
What makes this the best choice?
What would make you change your mind?
7. Do the right thingimplement it
How am I going to accomplish this?
What is the best strategy to implement the solution?
How will I know if my actions were appropriate or not?
Follow-up with the patient
Workup of an Ethical Problem
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Mr. Z., age 63, has had two heart attacks in the past. He now has a
prescription for a medication to prevent recurrences of heart attacks
that must be taken regularly to be effective. He tells you that he does
not think he will bother to take the new medication because he does not
believe another heart attack will harm him. How would you approach
his care?
Assignment 1 Case
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Prepare a set of principles that a pharmacist
must follow to establish and run a community
pharmacy.
Assignment 2
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THANK YOU!
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