Patient Education and Counselling

OBJECTIVES:
At the end of the lecture students will be able to:
• Define counseling.
• Differentiate between counseling, consulting and patient
education.
• Explain the need of counseling.
• List down the benefits of counseling from pharmacist and
patient point of view.
• Generate the broad-spectrum goals and the educational goals
of counseling.
What is Patient counseling ?
Giving
advice to
patients
psychotherapy
techniques use Patient
by therapist to counseling is
help their patient
clients. Education
The word Counsel is defined as
giving advice, but it also implies
mutual discussion and exchange
of opinions.
To Consult means to seek advice,

and suggests almost exclusively
receiving advice rather
exchanging information .
Education is defined as
“instruction and development to
impart skills and knowledge.”
As per British Association for counseling (BAC)
“Giving clients the opportunity to explore, discover
and clarify ways of living more resourcefully and
towards greater well being”
Another definition states that:

“The sympathetic interaction between
pharmacists and patients ,which may go beyond
conveyance of straight forward information about
the medicine and how and when to use it.”
INTEGRAL PART OF THE
PHARMACEUTICAL CARE:
The American Society of Health System Pharmacists

states that:
‘Pharmacist - conducted patient counseling is a
component of pharmaceutical care and should be
aimed at improving therapeutic outcomes by
maximizing proper use of medications’
According to the Centers for Disease Control, patient
counseling plays a key role in these areas:
• Well-informed patients…
• Are less likely to visit an emergency room

• Are less frequently in the hospital
• Are more likely to follow their treatment plans
properly
• Have lower mortality rates
What is the need of
counseling ?
BENEFITS OF PATIENT
COUNSELING TO PATIENTS:
• Reduced errors in using medication.
• Reduced non compliance.
• Reduced adverse drug reactions.
• Reassurance that a medication is safe and effective.
• Additional explanations about their illness.
• Assistance with self care.
• Referral for assistance with non drug related
situations ( family planning, emotional problems.)
• Reduction to health care costs to individuals,
government & society.
BENEFITS OF PATIENT
COUNSELING TO PHARMACIST:
• Maintenance of professional status as part of the
health care team that cannot be replaced by a non
professional.
• Enhanced job satisfaction.
• Enhanced professional status in the view of patients
and other health care providers.
• An added service to attract customers and aid in
market competition.
• Increased revenue through payment for counseling
services and reduced loss resulting from unfilled or
un refilled prescriptions.
COUNSELING GOALS:
• To establish a relationship with the patient and to
develop trust.
• To demonstrate concern and care for the patients.
• To help the patient manage and adapt to his or her
medication.
• To help the patient manage and adapt to his or her
illness.
• To prevent or minimize problems associated with side
effects ,adverse effects, or present or future non
compliance.
• To develop the patient’s capacity to deal with such
problems.
EDUCATIONAL GOALS
• To provide information appropriate to the particular
individual and the particular problem.
• To provide skills and methods that the patient can use
to optimize the usage and effects of the medicines.
• To present information and instruction using
educational methods that are appropriate to the
particular individual
and the particular situations.
THE PHARMACIST APPROACH TO
PATIENT COUNSELING:
OBJECTIVES:
• Prepare for the counseling encounter.
• Propose different stages of counseling.
PREPARING FOR THE COUNSELING
ENCOUNTER:
STAGES FOR PATIENT
COUNSELING:
OPENING
DISCUSSION
DISCUSSION TO
GATHER
FOLLOWUP INFORMATION
DISCUSSIONS AND IDENTIFY
PROBLEMS
DISCUSSION TO
CLOSING PREVENT OR
RESOLVE
DISCUSSION PROBLEMS
AND EDUCATE
OPENING DISCUSSION:
DISCUSSION TO GATHER INFORMATION
AND IDENTIFY PROBLEMS
RETURNING
NEW PATIENT PATIENT
NON
NEW REFIL PRESCRIPT-
PRESCRIPTION PRESCRIPTION ION DRUGS
DISCUSSION WITH A NEW
PATIENT:
If the patient is new to the pharmacy then the

pharmacist will need the patient basic information
Conducting a medication history interview with a new
patient is an important activity that allow the
pharmacist to promote a value added service offered
by the pharmacy.
DISCUSSION WITH A RETURNING
PATIENT:
For a returning patient , certain information should

already be available from a previously conducted
medication – history and from the patient record. In
this case ,the pharmacist simply has to inquire to
confirm that there are no changes such as new
condition or medications received elsewhere either
prescription or non prescription.
DISCUSSION FOR A NEW
PRESCRIPTION:
The following information should be discuss with
the patient , keeping in view the patient’s present
knowledge about medication and condition:
a. Previous use of the medicine .
b. Purpose of medication
c. Medication regimen.
d. Treatment goal
DISCUSSION FOR A REFIL
PRESCRIPTION:
Discussion should involve the following :
a. Details of medication use i.e. frequency of
medication used and possible reasons for non
compliance.
b. Effectiveness of medication.
c. Presence of adverse effects.
DISCUSSION FOR NON PRESCRIPTION
DRUGS:
A wide range of potential problems can arise
including interactions with other prescribed or non
prescribed medicines, interference with existing
chronic conditions, interference with the course of
pregnancy or fetal development, delay in receiving
correct diagnosis and treatment for more serious
disease and adverse effects or allergic reactions.
The most recent edition of the “Handbook of Non
prescription drugs ” clearly states that the course of
action chosen by the pharmacist might include any
one or a combination ,of the following :
• Referral to a physician for a medical opinion.
• Selection of the most appropriate product and specific
recommendation for its use.
• Re assurance that no treatment is necessary .
DISCUSSION TO PREVENT OR RESOLVE
PROBLEMS AND EDUCATE:
NEW OR REFILL PRESCRIPTION:

Having gathered complete information ,the desired
pharmaco therapeutic outcomes for each real or
potential problem should be established.
NON PRESCRIPTION DRUGS:
Medication No medication
recommended recommended
Advice patient
Name, purpose
to see physician,
,directions, Side
suggest non
effects
drug treatment
Provide
precautions,
information as
future treatment
necessary,
,Reassurance
Reassurance
CLOSING DISCUSSION:
• Encourage questions.
• Recap.
• Additional information sources
• Get feedback.
FOLLOW UP DISCUSSION:
• The pharmacist can start to follow the patient’s
progress and may determine the degree of success of
treatment .
OBJECTIVES:
• Identify the factors to be considered in tailoring counseling.
• Solve the barriers to counseling.
• Interpret the counseling with the children and adolescent .
• Define patient education.
• Develop patient education program.
• Suggest the suitable educational method according to learning
objectives of the program.
FACTORS TO BE CONSIDERED IN
TAILORING COUNSELING:
Characteristics Characteristics Characteristics

of the patient of the Drug of the condition
Characteristics
of the Situation
BARRIERS TO PATIENT
COUNSELING:
Patients • inaccessibility of the pharmacist
• Awareness of need for counseling,
Barrier Emotional barrier
Pharmacist • Lack of knowledge, Lack of confidence

to counsel. Poor physician – pharmacist
Barrier relationship, Poor communication skills
Common • lack of time, lack of privacy;

• Comprehension difficulties, Language
barriers differences.
REMOVING THE BARRIERS:
There are four A’s for effective and efficient patient
counseling:
1. Availability
2. Atmosphere
3. Approach
4. Attitude
COUNSELING CHILDREN AND
ADOLESCENT:
Suggestions for talking to children about their
medication includes:
• Talk to parents and children about how to protect
young children from accidental poisoning and what
to do if they occurs.
• When children are old enough to understand ,speak
directly with them about their medicines. Tell children
what you expect from them to do and how.
• Encourage children to ask you questions about their
illness and treatment.
WAYS TO ESTABLISH A HELPING
RELATIONSHIP:
• Greetings: Friendly and unhurried
• Conversation: Brief general conversation to start
• Personal Attention: Introduce yourself and use
patient’s name
• Invite requests and respond to questions
appropriately
• Demonstrate Genuine interest and concern by
spending time, display empathy
• Nonverbal language: Showing attentiveness, interest
and concern
Some final suggestions are:
• Be aware of the customs and religious belief of the
patient.
• Try to work in the health belief system of the patient
and the family.
• Respects patient viewpoints; listen to them
• Learn about the traditions of the patient, alternate
health care methods and medications
• Explain risk of not taking the medication
PATIENT EDUCATION:
Education is defined as:
“progressive changes of a person affecting
knowledge, attitudes and behavior as a result of
instruction and study”
DEVELOPING PATIENT EDUCATION
PROGRAM IN PHARMACY:
What factors need to be
considered when deciding how to
educate a patient?
• What is the patient’s level of literacy?
• Is the patient able to read and comprehend written
directions?
• What is the best method for providing information
(visual, audio, tactile, etc.)?
• What is the most comfortable language for the
patient?
• Does the patient respond to more than basic
information, or are they resistant?
• How well does the patient see and hear?
THINGS TO BE CONSIDER IN
DEVELOPING PROGRAM:
• Identify the problems that require educational
intervention.
• Identify the educational needs of the patient.
• Establish educational goals
• Select appropriate educational methods
• Implementing the program
• Evaluate the program
EDUCATIONAL METHODS AND
LEARNING OBJECTIVES:
To improve Lecture, Reading,
audiovisual
knowledge dialogue methods
To improve
Demonst
understand discussion
ration
ing
To develop Encourage
Practice
the patient
skills to
techniques
To change discussion
Video
attitude stimulation
THANX FOR YOUR
ATTENTION.
REFERENCES:
• Pharmacist talking with patients
(William and Wilkins)
• Pharmaceutical practice (Winfield)

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OBJECTIVES:

At the end of the lecture students will be able to:

To Consult means to seek advice,

Another definition states that:

The American Society of Health System Pharmacists

• Are less likely to visit an emergency room

If the patient is new to the pharmacy then the

For a returning patient , certain information should

NEW OR REFILL PRESCRIPTION:

Characteristics Characteristics Characteristics

Pharmacist • Lack of knowledge, Lack of confidence

Common • lack of time, lack of privacy;

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