WWHAM Flashcards
What is the most important part in a consultation?
- Asking questions
- Considering the range of treatment options
- Giving general and lifestyle advice
- Having good product knowledge
- Knowing about a lot of complaints / conditions
- Knowing the evidence base
- Listening
- Working with patients / 3rd party
Responding to patients
- Listening
- Asking questions to gather information
- Working with patients / 3rd party
- Knowing about a lot of complaints / conditions
- Considering the range of treatment options
- Having good product knowledge
- Knowing the evidence base
- Giving general and lifestyle advice
W (1)
Who’s is the medicine for?
W (2)
What are the symptoms?
H
How long have the symptoms been present?
A
What action has been taken?
M
What medication is patient taking?
Limitations
-family history
-previous symptoms
-general appearance
-social factors
-lifestyle factors
Red flags
- Knowing when to refer
- Knowing who to refer to
- Distinguishing between minor and major illness
Examples
Long duration of symptoms
Recurring or worsening problem
Severe symptoms (depends on the condition)
Shortness of breath, tightness of chest, wheezing
Blood / bleeding
Suspected link with medication
Recently returned from travels
Asking deeper questions
TED + ICE
TED
TELL
EXPLAIN
DESCRIBE
ICE
IDEAS
CONCERNS
EXPECTATIONS
Helpful example questions
- Tell me why you have come to the pharmacy today
- Explain the problem to me …and who is it for?
- Describe your symptoms to me…and how long have you had these?
- Ideas: Do you have any ideas about what might have caused it?
- Concerns: Is there anything in particular that is worrying you?
- Expectations: Have you had any thoughts on what might be the best approach?
- Have you tried anything already?
What other medicines do you take?
ENCORE
Explore
No medication?
Care
Observe
Refer
Explain
AS METHOD
Age/appearance
Self or someone else
Medication
Extra medicines
Time persisting
History
Other symptoms
Danger symptoms
SIT DOWN SIR
Site or location?
Intensity or severity?
Type or nature?
Duration?
Onset?
With? (Other symptoms)
N annoyed or aggravated by?
Spread or radiation?
Incidence or frequency pattern?
Relieved by?
There’s more
QuEST
SCHOLAR
CHAPSFRAPS
WWHAM example
W: 25-year-old male requesting information for himself
W: sore throat symptoms
H: 4 days
A: has not taken anything for the sore throat
M: no regular medication
ENCORE example
E: sore throat symptoms – little information apart from throat looks a little sore
N: not taking any medication – not an adverse drug reaction
C: No warning symptoms are present – for example bacterial infection such as swollen glands or white tonsil exudate. Sore throat only of 4 days’ duration.
O: 25-year-old male, looks generally healthy but a little run down as if he is not taking care of himself
R: no need to refer in this case
E: suck a lozenge or pastille to soothe throat etc.
AS METHOD example
A: 25-year-old male, looks generally healthy but a little run down as if he is not taking care of himself
S: requesting information for himself
M: no regular medication
E: has not taken anything for the sore throat
T: 4 days
H: has a tendency to have sore throats associated with cold symptoms, blames this on workplace
O: no other symptoms
D: no symptoms to cause concern
SITDOWNSIR
S: throat
I: quite sore
T: worse on swallowing
D: four days
O: usually associated with cold
W: no other symptoms
N: no information
S: no spread of symptoms
I: two recent colds and usually associated with sore throat
R: has not tried any medication, throat continually sore but worse on swallowing
