Advanced Patient Counselling Flashcards
Section 3 of the code of conduct for pharmacists of the pharmacy board of Australia is working with patients or clients. Why is this important?
Important to maintain relationships based on respect, trust and good communication
Domain 2 of competency standards framework for pharmacists in Australia is communication and collaboration. What are the two aspects of this domain?
2.2 collaborate with professional colleagues
- Show a commitment to interprofessional practice
- Engage in teamwork and consultation
2.3 communicate effectively
- Use appropriate communication skills
- Confirm the effectiveness of communication
PSA professional practice standard 8 is counselling, the pharmacist provides counseling to patients to support the safe and optimal use of all therapeutic goods, what is the criteria to achieve the counseling standard?
Patient centered care
- Policy and procedures
- Education and training
- Privacy and confidentiality
- Cultural safety and health equity
- Accessibility
- Assessment, consultation and reconciliation
- Counselling practice
- Communication and collaboration
- Documentation
- Monitoring, review, and follow-up
What type of reference texts for pharmacists must be available? Why do they have to be readily accessible?
- Examples include APH, AMH, e-mims, complementary medicines document.
- Has to be current editions of these texts, either in the form of a published document (hard copy) or via electronic means
- Has to be accessed by pharmacists uring clinical assessment, reviewing and dispensing and counseling processes
What are some of the discussion points for pharmacists on providing medicines information to patients? (PSA GUIDELINES)
- Confirmation of the indications for particular medicines, all illnesses or conditions the patient has and the patients total drug therapy
- The proposed approach to drug treatment
> what proposed treatment entails
> expected benefits
> common side effects and material risks of treatment
> whether the treatment is conventional or not
- Other treatment options
- Degree of uncertainty about the therapeutic outcome
- Likely consequences of not choosing the proposed treatment, or of not having any treatment at all
- Any significant long term physical, emotional, mental, social, sexual or other outcomes which may be associated with using the medicines
- The time involved in the treatment
- The costs involved
- How the medicines work
- How to use the medicines effectively
- Precautions and contraindications which apply to the particular patient.
> where applicable, written information should also be provided to the patient via a CMI
Are the guidelines for pharmacists on CMI mandatory?
Not a mandatory standard –> application may vary in some circumstances (it is intended to assist pharmacists understand legal and professional obligations regarding the provision of a CMI)
WWHAMMA is used as a basis, but need to add questions specific to the patient/medical condition/current medication/ any additional question relevant to the case.
What additional/specific questions should be asked when counselling a medication for a cardiovascular condition?
- When were you first diagnosed with high blood pressure?
- When did you last measure your blood pressure and what was the reading?
- Have you tried lifestyle modification OR what is your normal diet like?
- Do you exercise?
What additional/specific questions should be asked when counseling a medication for diabetes?
- What is your weight/BMI?
- What type of diabetes do you have?
- Have you gone through any prior treatment/therapy for diabetes?
- What is your lifestyle like (including diet)?
- Do you exercise?
- What is your BSL, do you have any other lab results?
What additional/specific questions should be asked when counseling if a patient presents with a prescription for a contraceptive, such as the combined oral contraceptive (COC)?
- What is your age and weight
- Have you tried any prior contraceptive methods
- What is your usual menstruation time
- Do you smoke or drink alcohol
What are the 3 steps to patient counseling after WWHAMMA?
- Open the counselling session introduce yourself
- IDARL format (as a guide)
- Close the counselling session –> ask if the patient has any other questions and check for understanding of the information provided (give self-care card + CMI)
FYI: CAL (cautionary advisory labels) also forms part of the counseling points.
When to give CMI to patient? How to counsel with a CMI?
Consumer Medicines Information (CMI) for a particular medicine should be routinely supplied where it exists, and pharmacists should draw patient’s attention to it
Counselling with a CMI
- Does not replace counselling by a pharmacist
- Does not reduce a pharmacist’s duty to counsel
- Not all aspects of a CMI needs discussion with the patient
Why is written information provided? How is it individualised?
Effective additional written information may be in the patient’s own language and personalised, i.e. has the patient’s name and address on it
Individualized i.e. refers to or highlights:
- conditions/illnesses which the patient has and is being treated for
- the indications for which the medicines are being used in the particular patient
- precautions, side-effects, contraindications relevant to the particular patient
- dosage and administration information which is particular to the patient
- the patient’s own pharmacist and doctor as sources of further advice
