Communication Strategies in Pharmacy

Question 1

1. A Spanish-speaking woman is scheduled for a followup appointment today to assess her recent lifestyle
   changes. Two hours before her appointment, the
   patient’s interpreter calls, saying he will not be in until
   tomorrow because he has a family emergency. The
   clinic’s receptionist, who speaks fluent Spanish, offers
   to help fill in for the interpreter. Which would be the
   most appropriate request for the pharmacist to make of
   the receptionist?
   A. Step in for the interpreter during the encounter.
   B. Call the patient to reschedule the appointment.
   C. Ask the patient to bring a family member or
   friend.
   D. Explain to the patient on arrival why the interpreter will not be there.

Answer 1

1. Answer: B
   Because this routine maintenance medication therapy
   management is not an emergency, it would be best to use
   a professional interpreter according to the guidelines for
   using medical interpreters by the Association of American
   Medical Colleges. Therefore, only Answer B is the best
   option of those given

Question 2

2. A pharmacist is performing a patient medication
   history and would like to assess the risk of patient
   nonadherence to a multidrug diabetes regimen. Which
   method would be best to use for this purpose?
   A. The Adherence Estimator questionnaire
   B. The Morisky questionnaire
   C. The Background, Affect, Troubling, Handling,
   Empathy (BATHE) technique
   D. Motivational Interviewing

Answer 2

2. Answer: B
   The Morisky and the Adherence Estimator questionnaires
   are both methods to assess the likelihood of adherence.
   However, only the Morisky questionnaire is intended
   to evaluate adherence to one or more drugs in a regimen for a particular disease. The Adherence Estimator is
   used only with individual drugs. The BATHE technique
   or Motivational Interviewing may help identify reasons
   for nonadherence, but neither assesses the likelihood of
   adherence.

Question 3

3. An older adult male patient correctly completed the
   calculation in the Newest Vital Sign (NVS) questionnaire. In the package insert dispensed with his
   prescriptions, he was able to find relevant facts about
   adverse effects associated with medications he was
   taking. He is selecting a Medicare D program and is
   struggling to compare brochures from several companies to identify the best program for him on the basis
   of his medications. Which National Assessment of
   Adult Literacy (NAAL) classification is this patient
   most likely in?
   A. Below basic
   B. Basic
   C. Intermediate
   D. Proficient

Answer 3

3. Answer: C
   This patient is able to identify facts from dense text (the
   package insert) and perform simple calculations, so he is at
   least at the intermediate literacy level. Because he is having
   trouble integrating and applying information from several
   sources, he is unlikely to be considered proficient.

Question 4

4. A pharmacist is considering whether a commercially
   developed multimedia presentation would be appropriate to include as part of his institution’s comprehensive
   asthma education program for adults. Which would be
   the most appropriate method to evaluate the usability
   of this presentation?
   A. Ask a multidisciplinary group of colleagues to
   review the presentation’s content.
   B. Evaluate the presentation by using the Suitability
   Assessment of Materials (SAM) tool.
   C. Assess the presentation by using the Patient
   Education Materials Assessment (PEMAT) tool.
   D. Play the presentation in a random classroom and
   perform a survey on patient opinions of the video
   after class

Answer 4

4. Answer: C
   The PEMAT tool would be most appropriate because it was
   specifically designed for assessing the usability of audiovisual materials. The SAM tool has similar criteria, but it
   was designed originally for written materials. Obtaining
   feedback from either knowledgeable colleagues or typical
   patients would be useful, but this may not provide a comprehensive assessment of usability

Question 5

5. A pharmacist is asked to give a presentation to a group
   of physical therapists regarding new methods of pain
   management. Which topic would likely be of most
   interest to this audience?
   A. Mechanism of action and adverse events
   B. Cost and formulary status
   C. Pharmacology and pharmacokinetics
   D. Dosage and administration

Answer 5

5. Answer: A
   Whereas health care professionals typically learn at least
   some of the aspects of medication therapy, audiences are
   usually most interested in information related to their job
   responsibilities. Physical therapists would want to know
   the neuromuscular effects of a medication and their potential impact on patient movement. For example, the adverse
   effects of dizziness, hypotension, or sedation might impair
   a patient’s ability to participate in physical therapy sessions.
   Because these professionals are typically not responsible
   for prescribing or administering pain-related medications,
   they would usually be less interested in cost, dosing, formulary status, or pharmacokinetics. Thus the most correct
   option would be Answer A.

Question 6

6. In performing medication reconciliation for a patient,
   the pharmacist detected a discrepancy in the dosage of
   insulin glargine between the prescriber’s medication
   orders and the patient’s list. After clarifying the dosage
   with the prescriber, which would be the most appropriate way to document the correct dose and frequency of
   insulin in the patient’s medical record?
   A. “Inject 15 units daily at bedtime.”
   B. “Inject 15 U QD at HS.”
   C. “Inject 15 units QD at HS.”
   D. “Inject 15 U daily at bedtime.”

Answer 6

6. Answer: A
   U is listed on the ISMP error-prone abbreviations list and
   should not be used if possible. Units is the preferred way
   to note the insulin dose. The term QD (daily) is also listed
   on the ISMP list and is often mistaken as QID (four times
   a day) and should not be used; daily is preferred. The Joint
   Commission does not state a preference with respect to HS
   versus bedtime; however, ISMP lists this on the error-prone
   list because it is often confused with half-strength and, in
   general, these abbreviations should be avoided

Question 7

7. A pharmacist reads an editorial in the newspaper recommending the rejection of the school board’s latest
   policy for required vaccinations of new students. The
   pharmacist strongly agrees with the school board’s
   plan and carefully writes a 600-word rebuttal to this
   editorial. Which would be the most effective way to
   use this rebuttal to advocate for the new policy?
   A. Send the rebuttal as a letter to the school board to
   voice support.
   B. Submit the rebuttal as a letter to the newspaper’s
   editor.
   C. Read the rebuttal at the next open school board
   meeting.
   D. Offer the rebuttal to the newspaper as an “op-ed”
   piece.

Answer 7

7. Answer: D
   Responses to editorials of between 300 and 750 words
   are suitable for placement opposite the editorial (or op-ed
   piece). Letters to the editor can be used to respond to editorials, but they receive less visibility and generally should be
   fewer than 250 words. The school board would appreciate
   the support. Ideally, however, the pharmacist’s comments
   should reach the same readership as the newspaper’s original editorial. Sending them to the school board would not
   achieve this