Bangabandhu Sheikh Mujibur Rahman Science and Technology

University, Gopalganj-8100, Bangladesh

An Assignment
on
“Patient Communication”

Course Code: PHR-563

Course Title: Public Health and Community Pharmacy

Submitted By Submitted To

ID: 20140109032 Khadija Akter

M. Pharm. 2nd Semester Lecturer
Department of Pharmacy Department of Pharmacy
Life Science Faculty Life Science Faculty
Bangabandhu Sheikh Mujibur Rahman Science Bangabandhu Sheikh Mujibur Rahman
and Technology University, Gopalganj-8100 Science and Technology University,
Gopalganj-8100

Date of Submission: 11.12.2020

 INDEX
SL CONTENTS PAGE NO.
NO
1 Introduction 3
2 Process of Communication 4-5
3 Understanding illness 5-6
4 Communication with special patients 6-7
5 Appropriate way of questioning and gathering information 7-9
6 Building the rapport 9
7 Competence of information 10-11
8 Evaluation of Communication 11
9 Importance of patient communication 11-12
10 Poor patient communication 12
11 Barrier to effective communication 12-14
12 Ways to go through effective Communication 14-18
13 Strategies to improve patient communication 18-19
14 Role of pharmacist –doctor collaboration in patient communication 20
15 Conclusion 20
16 Reference 21

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 Patient Communication

1. Introduction:
Communication is a crucial part of pharmacy practice. It is through high quality communication
that patients ‘needs can be assessed and information, education, and advice given, in this way
ensuring a rational use of medicine. In addition, effective inter-professional communication with
other health care professionals is central for positive health outcomes of patient treatments.
Communication is a complex area, dealing not only with the transmission of content, but also
intrapersonal relationships, social processes, etc. Through research in pharmacy practice
communication we can help develop skills, tools, and processes to make patient encounters and
other encounters as good as possible.
In order to meet professional responsibilities, pharmacists have become more patient-centered in
their provision of pharmaceutical care. Pharmacists have the potential to contribute even more to
improve patient care through efforts to reduce medication errors and improve the use of
medications by patients. Communication is the most important component of work with patients.
It is the cornerstone of interaction with people. A good and an effective exchange between
people helps them see what the other person thinks and how he or she feels. It helps people
understand each other better and, as a result, it brings them closer to each other. Pharmacy
professional sympathy and friendliness had a significant impact on patient satisfaction and
affected 5.9– 66.2% of patient–pharmacist interactions.
Pharmacists are accepting increased responsibility in ensuring that patients avoid adverse effects
of medications and also reach desired outcomes from their therapies. The changing role of the
pharmacist requires practitioners to switch from a “medication-centered” or “task-centered”
practice to patient-centered care. It is not enough for pharmacists to simply provide medication
in the most efficient and safest manner (i.e., focus on systems of drug order fulfillment).
Pharmacists must participate in activities that enhance patient adherence and the wise use of
medication (i.e., focus on patient centered elements including patient understanding and actual
medication taking behaviors). Patient-centered care depends on pharmacist’s ability to develop
trusting relationships with patients, to engage in an open exchange of information, to involve
patients in the decision-making process regarding treatment, and to help patients reach
therapeutic goals that are understood and endorsed by patients as well as by health care
providers. Effective communication is central to meeting these patient care responsibilities in the
practice of pharmacy.

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2. Process of Communication:
In personal and professional lives, people need to interact with many people. Some of these
interactions are successful, while others are not. This specific form of communication is best
described as a process in which messages are generated and transmitted by one person and
subsequently received and translated by another. The model includes five important elements:
sender, message, receiver, feedback, and barriers.
Sender
In the interpersonal communication process, the sender transmits a message to another person
(pharmacist). The initial sender of a message is usually the patient.
The message
In communication process, the message is the element that is transmitted from one person to
another. Messages can be thoughts, ideas, emotions, information, or other factors and can be
transmitted both verbally (by talking) and nonverbally (by using facial expressions, hand
gestures, and so on). Research has found that in some situations 55% or more of a message is
transmitted through its nonverbal component. In most situations, senders formulate or encode
messages before transmitting them. However, in some cases, messages are transmitted
spontaneously without the sender thinking about them, such as a glaring stare or a burst of
laughter.
The receiver
The receiver receives the message from the sender. The receiver decode the message and assign
a particular meaning to it, which may or may not be patients intended meaning. In receiving and
translating the message, pharmacist probably considered both the verbal and nonverbal
components of the message.

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 Figure 1: Patient communication process
Feedback
Feedback is the process whereby receivers communicate back to senders (patient) their
understanding of the senders’ message. In most situations, receivers do not passively absorb
messages; they respond to them with their own verbal and nonverbal messages. By using verbal
and nonverbal communication, the receiver feeds back information to the sender about how the
message was translated. In the feedback loop, the initial receiver becomes the sender of
feedback, and the initial sender becomes the receiver of feedback, as noted in the model. In the
interpersonal communication process, individuals are thus constantly moving back and forth
between the roles of sender and receiver.
The model that have presented is useful because it is easy to understand, but it does oversimplify
the communication process.
Barriers
Interpersonal communication is usually affected by a number of interferences or barriers. These
barriers affect the accuracy of the communication exchange. Barriers should be identified and
then minimizing possible communication barriers.

3. Understanding illness:
Modern medicine is moving away from a purely biomedical model of care with an emphasis on
disease and its associated biological
components (signs, symptoms, and
laboratory tests) to a bio psychosocial
model. The bio psychosocial model of
care is a holistic framework to describe
and explain how illness is the result of
the interplay of biological,
psychological, and social factors plus
individual health-related behaviors.
Recognizing, understanding, and
responding to all factors that affect
health requires the healthcare provider
to integrate the biological aspects of the
disease with the psychological and
social aspects of the patient. The goal of
this model is to develop a patient-

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centered care plan that is realistic in order to achieve the best possible health outcomes.
Figure 2: bio psychosocial model diseases and illness

Pharmacists, in their Code of Ethics, promise to place the “well-being of the patient at the center
and consider their stated needs as well as those defined by science”. When patients are more
involved in their care, they are better able to manage complex chronic conditions by
understanding and incorporating their plan of care, are more likely to feel comfortable
communicating their concerns and seeking appropriate assistance, have reduced anxiety and
stress, and have shorter lengths of stay.

4. Communication with special patients:

The elderly
In certain individuals, the aging process affects the
learning process, but not the ability to learn. Some
older adults learn at a slower rate than younger
persons. The elderly might also have problems
such as poor vision, speech or hearing. Therefore,
it is very important to set reasonable short-terms
goals and break down learning tasks into smaller
components. It is also important to encourage
feedback as to whether they understand the
intended message. Figure 3: Communicating with elderly
patient
Communicating with children
-Attempting to communicate at the child’s development level.
- Ask open ended questions rather than questions requiring only a yes or no response.
- Use simple declarative sentence for all children.
- Ask the child whether he or she has questions for you.
- Nonverbal communication is very important with children therefore be aware of your facial
expressions, tone of voice, gesture and so on.
- Children want to know. Healthcare professionals should communicate directly with children
about medicines and treatment.
Terminally ill patients

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 Are usually intimidating to work with because people do not want to say the “wrong” things that
would upset them. Before interacting with them, be aware of your own feelings about death and
about interacting with terminally ill patients. Simply being honest with them can improve their
interaction with them. It will also open them up to voice out their concerns as well. Many
terminally ill patients know that they can make others feel uncomfortable. You should not avoid
talking to them unless you sense that they do not want to talk. Not interacting with them only
contributes further to isolation and may re affirm that talking about death is uncomfortable.
Mentally ill patients
Patients who are mentally ill can be difficult to communicate with. Open-ended questions would
be more effective as they can be used to determine the patient’s cognitive abilities. Ethical
considerations include whether they require consent from the patient for treatment. Mentally ill
patients might not always understanding their treatment or medication purposes.

5. Appropriate way of questioning and gathering information:

Responsibilities as pharmacists mean that they must strive to communicate well. Issues that lead
to misunderstandings can be addressed using basic communication skills: questioning,
explaining, listening and reflection. Questions, as most pharmacists know, are of two main types:
open questions and closed questions. In general, open-ended questioning is the preferred
technique to use during patient interviews to compel the patient to provide more in-depth and
insightful responses. Because open-ended questions do not limit the patient to responding with a
yes or no, they encourage the patient to disclose more information. But when dealing with
patients 94 per cent of the questions asked by pharmacists are closed. When dealing with minor
ailments, for example, pharmacists need to use a combination of open and closed questions.
These can be used to steer the interaction and this allows us to come up with the best
management decision.
Difference between Open-ended question and Closed-ended question:

Open-ended question Closed-ended question

Using open questions to involve the patient, Closed-ended questions that require the
asking about other drug intakes, about patient generally limit the patient’s response to
possible symptomatology, making a real either a yes or no.
exploration of the situation by collecting
meticulous details and showing interest.
Do not require the patient to respond in your Causes the patient to become more passive.
frame of reference.
Permit open expression. Reduces the degree of openness

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 Less likely to result in misunderstanding Enables patient to avoid specific subjects and
emotional expression.
Promote rapport and develop a trusting Interrogation and impersonality.
relationship.
Patient centered questions. Pharmacist centered questions.
Topic Open-ended question Closed-ended question
Medical condition What can you tell me about the Does it hurt now?
pain?
Therapeutic regimen How are the meds working? Are you taking your meds?
Lifestyle and self- What are you doing to keep Do you still smoke?
care yourself healthy?
Psychosocial topic What’s happening with his father? What’s happening with his
father?

Here are 5 questions every medical practice should ask when a new patient arrives.
1. What are the patient medical and surgical histories?
The patient health record will be more complete and valuable if pharmacists know whether he or
she has ever been hospitalized, treated for a chronic condition, had medical tests, or had surgery.
Even if an adult patient had surgery or some other treatment as a child, it's important to know
about it when creating a treatment plan and delivering healthcare.
2. What prescription and non-prescription medications do the patient take?
Some people think that over-the-counter medications don't count, or that herbal supplements
don't matter. Make it clear to new patients that the physician needs to know not only about any
prescription medications he or she takes, but also over-the-counter medications, vitamins, and
herbal supplements.
It's ideal if the patient brings prescription bottles to the appointment so the information collected
is as accurate as possible.
3. What allergies do the patient have?
In addition to knowing whether a new patient has seasonal or food allergies, pharmacists need to
know if the patient have any drug allergies, a latex allergy, or a serious reaction to bee stings.
4. What is the patient smoking, alcohol, and illicit drug use history?
If the patient make it clear up front that pharmacists take patient confidentiality seriously and
protect their information at all times, they're more likely to be forthright about whether they use
tobacco products, drink alcohol regularly, or use (or have used) illicit substances. Answers to

8
these questions can make a difference when it comes to diagnosing and treating health
conditions, and reassuring patients of their privacy helps elicit honesty from the start.
5. Have patient served in the armed forces?
It's important to know if a new patient has served in the military, particularly if he or she
participated in one or more combat tours. This can help pharmacists learn more about physical
trauma, potential exposure to toxins, and possible mental health issues like post-traumatic stress
disorder, so that diagnosis and treatment options can be tailored to the patient's needs.

6. Building the rapport:

Building the rapport means preserving the confidentiality of the dialogue by implementing the
conversation in an appropriate location, being helpful and available/accessible, having good
manners, showing involvement and sincere concern, offering reassurance, meeting the needs of
the patient. The first impression of pharmacist make positive result on patient and it will weigh
on the rest of the patient interview as well as affect relationship with the patient. Building a good
rapport sets the tone for the interview and allows the patient to feel comfortable with pharmacist,
thereby making the lines of communication more open and honest.
Patients may sometimes withhold information if they feel uncomfortable or anxious about
sharing their complaints because of a
lack of feeling respected, feeling as
though their words are not being
heard, or quite simply not knowing
who the healthcare practitioner are
and what his or her role is in their
care. Therefore, starting the
interview by greeting the patient by
name, making sure that the patient
name is pronounced correctly,
asking how he or she prefers to be
addressed, and adding a title to his
or her name, if preferred, the
pharmacist will indicate his or her
interest in the patient and show that he or she care. Figure 4: Building the rapport with
patient
He or she should also give identity with name and title and then briefly describe the purpose of
the interview. For example, he\she could say, “Hello Mrs. Smith, my name is Ankur Kumar\
Atika Rahman. I am the pharmacist who is part of your medical team, and I am here to ask you a
few questions about what brought you to the hospital and discuss the medications you have been

9
taking at home.” If there are others in the room, he\she should greet each person in the room, and
then ask the patient for permission to continue with the interview in the presence of others. For
example, pharmacist may say, “I have a few questions for you, Mrs. Smith. Is it okay for me to
speak to you with your family/friends in the room or would you prefer to be alone while we
talk?” Making appropriate introductions, interacting respectfully with the patient, and making the
patient feel comfortable will build excellent rapport, leading to a strong foundation for the
patient–pharmacist relationship.

7. Competence of information:
Communication competence focuses on the individual's ability and skill, which necessarily
includes both knowledge of the social communication rules and the wherewithal to perform in an
appropriate manner. Competent communication is both culturally and circumstantially
determined, such that what constitutes competent social behavior within one context may be
unacceptable in another. In the same way, assessment of the competence of a particular
interaction must consider the opinion or world view of the 'other'. Communication competence
represent that the individual has a repertoire of communication skills, has a predisposition
towards communicating with others and finally, has the opportunity to communicate
competently. Given the above constituents of competent communication, it is evident that a core
defining feature of competence is skill to perform the task effectively. Interpersonal skill is
defined as "a set of goal-directed, inter-related, situationally appropriate social behaviors which
can be learned and which are under the control of the individual". In order to appreciate the
relevance of this definition it is useful to consider the six components of skilled performance
contained within it and examine their relevance to community pharmacy.
1. Goal-directed. Skilled behavior is purposeful and intentional and is carried out in order to
achieve goals. These goals may not always be consciously pursued and indeed one feature of all
skilled performance is that goals are subconscious. The skilled car driver is not consciously
aware of goals when driving and does not have to consciously think 'I want to turn left therefore
I must move the steering wheel'. Likewise the skilled pharmacist does not have to consciously
think 'I want to find out if the patient has understood therefore I must ask a relevant question'.
2. Inter-related. Social skill involves elements of verbal and nonverbal communication which are
closely synchronized in order to bring about a desired consequence. For example, the
pharmacist's guggles (uh hu, hm hm), headnods and eye contact should be co-ordinated in such a
way as to encourage the patient to continue talking, thereby providing important additional
information about their situation
3. Appropriate. To be skilled, social behaviour must be appropriate to the situation. A simple
example of this is that the pharmacist may wear pyjamas to bed but should not wear them in the
pharmacy!

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4. Behaviours. This is really the essence of skill. We judge whether people are socially skilled or
not based upon how they actually behave.
5. Learned. For the most part, behaviours displayed in the social context are learned by a process
of modelling or imitating the performance of significant others. Thus a pre-registration
pharmacist is likely to observe and copy the styles, strategies and behaviour of experienced
practitioners working in the same environment. Given that skills are learned, it is therefore
important to identify effective pharmacist performance and teach the relevant skills to pharmacy
trainees.
6. Control. Skillful communication demands that individuals have control over their behaviour
and learn not just what the appropriate behaviours are but also how and when to use them. Thus
an important dimension of skill relates to the timing of certain aspects of performance. For
example, the pharmacist who will not be pressurized into supplying an antibiotic without a
prescription may allow considerable gaps in the flow of conversation to continue in order to
convey assertiveness.

8. Evaluation of Communication:
There was therefore a clear need within the pharmacy profession for an investigation of effective
interpersonal skills. The benefits of such research were anticipated as being of major
significance, both to the competence levels of pharmacists and the satisfaction and compliance of
patients. The stated aims at the outset of the project were as follows.
1. To identify what constitutes effective, as opposed to ineffective, communication practice in
pharmacy.
2. To identify and categories the range of specific social skill elements that constitute effective
performance in pharmacy practice.
3. To determine the communication issues associated with particular patients.
4. To determine the communication issues associated with specific health problems.
5. To provide, through the empirical identification of effective social skills, an appropriate and
validated content for communication skills training (CST) courses in pharmacy.

9. Importance of patient communication:

The communication process between pharmacist and patients serves two primary functions:
1. It establishes the ongoing relationship between pharmacist and patients; and

11
2. It provides the exchange of information necessary to assess the patients’ health conditions,
reach decisions on treatment plans, implement the plans, and evaluate the effects of treatment on
patients’ quality of life.
Some other object of Pharmacist-Patient communication are given bellow:
 Pharmacist-Patient communication plays an important role in reducing medication-
related problems and improving patients’ overall health status.
 Updated drug information provided by pharmacy professionals during patient
communication can save money and prevent unnecessary hospitalization.
 The provision of instruction on usage of medicines and provision of information on
disease condition increased patient satisfaction of patient communication.
 The extended role of community pharmacists in developing countries is largely inclined
to dispense medications. More than 50% of all medicines are prescribed and dispensed
inappropriately and 50% of patients fail to take them correctly. This inappropriate use of
drugs can lead to wasted resources and predispose patients to increased risk of adverse
drug reactions and fosters the development of drug resistance.
 Pharmacists should foster patient-centered communication to develop a trusting
relationship in order to improve patient health and reduce the number of medication-
related errors

10. Poor patient communication:

Poor communication skills between pharmacist and patient leads to:
-Inaccurate patient medication history.
-Inappropriate therapeutic decisions.
-leads to patient confusion, patient disinterest and patient non-compliance.

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 Figure 5. Consequences of the pharmacist as an unskilled or skilled communicator.

11. Barrier to effective communication:

Within the communication process, numerous barriers exist that may disrupt. Given the large
number of potential barriers that exist in pharmacy practice settings, it is a wonder that any
communication takes place at all. Some barriers are rather obvious, while others are more subtle.
Some general barrier issues within communication and provides examples in a few key areas
(practice environment, personal issues, administrative priorities, and lack of time and resources).
1. Pharmacist-related personal barriers:
 Lack of knowledge of drug
 Lack of updated drug information
 Dispenser work experiences
 Lack of good communication skills
 Shortage of time
 Educational qualification, knowledge and age had significant influence on
counseling response
 Lack of interest of practitioners
 Lack of confidence
 Poor attitude
 Impoliteness of the dispenser
2. Patient-related personal barriers:
 Lack of interest: lack of willingness to listen to the counselor were major claimed
barriers for smooth patient–pharmacist interaction.
 Patients not wanting to talk much: Patient factors like patients not wanting to talk
much and a bad attitude toward pharmacy was reported as a barrier for 12.8–
63.27% communications.
 Patient factors like illness, rush to leave and lack of willingness and shyness.
 Language and educational status of patient: Patients who are educated were 1.97–
2.71 times more likely to have satisfactory counseling than illiterate patients.
 Lack of patience to listen the counseling provided: According to World Health
Organization drug use indictor, the percentage of satisfactory counseling on
dispensed medicines should be 100%. However, more than 50% of all medicines
are prescribed, dispensed or sold inappropriately. This inappropriate use leads to
wasted resources and patient harm.
3. Health Facility-Related Barriers to Communication:
 High patient load

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  No legalization
 Absence of legal frame work to monitor and evaluate patient counseling practice
at the time of dispensing
 Suitability of dispensing area
 Privacy in dispensing area
 Absence of private counseling room
 Waiting time for service
 Not comfortable waiting area
 Unavailability of prescribed drug
 Location of outpatient pharmacy
 Lack of quality system
 Absence or inadequacy of counseling guidelines
Minimizing communication barriers typically requires a two-stage process: first, you must be
aware that they exist. Second, you need to take appropriate action to overcome them. To become
a more effective communicator, it is essential that you realize when you are not communicating
effectively with another person and then try to analyze why effective communication is not
taking place.

12. Ways to go through effective communication:

Interpersonal communication skills are important for pharmacists to master. Whether counseling
patients, communicating with physicians, or interfacing with associates, pharmacists use their
interpersonal communication skills daily. Effective communication by pharmacists is essential to
improve the use of medications by patients and ensure optimal therapeutic outcomes.
Pharmacists can improve patient adherence to drug therapy through appropriate strategies,
including patient counseling and education. In addition to verbal communication, appropriately
written recommendations to physicians to resolve drug therapy problems can be an effective
strategy for drug therapy changes. Pharmacist can grow communication skill by participating the
following task.
1. Establishing the Pharmacist-Patient Relationship

Pharmacists in all practice settings have opportunities to interface with patients, whether it is
through counseling, interviewing, or educating. These sessions provide excellent training
opportunities for students to develop therapeutic relationships with patients. This relationship is
built on the foundation of trust and an open exchange of information; it is a collaborative
relationship. Pharmacy students should understand the importance of this relationship and that it
builds over time with each patient encounter. This relationship establishes a covenant between
pharmacist and patient. Pharmacists promise to utilize their clinical knowledge and skills to
provide the best care for their patients. Patients, in turn, provide pharmacists with the

14
information needed to effectively manage their drug therapy. This covenant or promise is one of
the most important concepts for students to learn while on rotation: accepting responsibility for
their patient care activities.

Figure 6: Establishing the Pharmacist-Patient Relationship

2. Patient Counseling
Counseling patients regarding their medications is an important responsibility for pharmacists
and an excellent learning opportunity for students. Pharmacists are often the only health care
providers focusing patient education on medication: how to take it, what to expect, and side
effects and drug interactions. It is important that the students understand that communication
between individuals is a complex process involving more than just verbal communication. They
need to be aware of other communication strategies that can help make the pharmacist-patient
encounter more meaningful. These include active listening (focusing on the patient), eye contact
(being attentive, but not staring), being aware of your own body language (facing the patient and
15
giving them your undivided attention), recognizing and interpreting nonverbal cues from the
patient (comparing their nonverbal behaviors to their verbal communication), and being aware of
barriers that prevent a good exchange between the pharmacist and patient (lack of privacy,
interruptions, noise, etc). Pharmacist preceptors can periodically review patient encounters that
they have had or that students have had to discuss the communication process, problems that
they incurred during the patient encounter, what they did to resolve any problems, and what they
can do to improve the process in the future.
Patient counseling sessions are also excellent opportunities to briefly review patients'
medications and assess them for any drug therapy problems. Pharmacists routinely provide
prospective drug utilization review services during the filling or refilling of prescriptions.
Students can assist with and learn from this process. If a drug therapy problem is found, students
can participate with the pharmacist in the counseling session with the patient, the communication
to the physician, and the documentation within the pharmacy. This is also a good activity to
demonstrate to students that pharmaceutical care is a continuum: it occurs during the dispensing
process as much as in scheduled sit-down patient interviews.
The counselling content is considered to be the heart of the counselling session. During this step
the pharmacist explain to the patient about his or her medication and treatment regimen.
Lifestyle changes such as diet or exercise may also be discussed. Topics commonly covered
include.
- Name and strength of the medication
- Reason why it has been prescribed or how it works.
- How to take the medication
- Expected duration of treatment.
- Expected benefits of treatment.
- Possible adverse effects.
- Possible medication or dietary interaction.
- Advice on correct storage.
- Minimum time duration required to show therapeutic benefit.
- What to do if a dose is missed.
- Special monitoring requirements, eg blood tests.
- Arrangements for obtaining further supplies
Objectives of patient counseling:

16
1. Patient should recognize the importance of medication for his well-being.
2. A working relationship and a foundation for continuous interaction and consultation should be
established.
3. Patient’s understanding of strategies to deal with medication side effect and drug interaction
should be improved.
4. Should ensure better patient compliance.
5. Patient becomes an informed, efficient and active participant in disease treatment and self-care
management.
6. The pharmacist should be perceived as a professional who offers pharmaceutical care.
7. Drug interaction and adverse drug reactions should be prevented.
3. Interviewing Patients
There are times when pharmacists need to go beyond counseling patients during dispensing
functions and collect more in-depth clinical information. This may occur during the provision of
disease state or case management services, a comprehensive medication review, clinical services,
or other types of clinical encounter with patients. During this time, pharmacists need to be
systematic and organized with the patient interview to ensure that they are efficient with their
time, as well as accurate and comprehensive with data collection. Patient interviewing is an
essential skill that the students need to develop and pharmacist preceptors should routinely
provide these experiences. Many practices or colleges of pharmacy have developed their own
data collection forms to help ensure a complete history is taken. Pharmacist preceptors can
review these forms with the students, discuss how they are used, and demonstrate the use during
a patient interview.
4. Educating Patients
There are also several clinical situations where pharmacists should conduct an in-depth
educational session to meet patient needs. Students should understand the objectives of the
educational session and the most appropriate methods to use. Educational sessions provide
patients with more comprehensive information regarding their medical conditions, treatment
strategies, and/or lifestyle changes. Much like the patient interview, patient educational sessions
may take more time to complete. The same communication principles apply, but it is also
important for students to remember that the adult learner can only process so much information
at one time. Therefore, it is important to teach pharmacy students to provide concise information
that applies to the patients' needs or relates to what they already know. Asking open-ended
questions to determine what patients already know will be key to preventing pharmacists from
providing information that is not needed: in other words, the educational session should be
personalized. Also, preceptors should discuss with pharmacy students how to use language that

17
patients can comprehend. Sometimes this is a difficult transition for pharmacy students,
minimizing difficult to understand medical terminology and utilizing patient friendly language.
This requires careful thought about the terms used and possibly learning new terms that may be
easier for the patient to understand, and then actively integrating these terms into the
counseling/educational sessions.

5. Physician Consults
Pharmacy preceptors can provide students with opportunities to consult with physicians
regarding medication issues affecting patients. This may be done over the phone or it may be
done face-to-face depending upon the clinical situation. In either scenario, information should be
provided in a standard format to ensure physician acceptance. Using appropriate communication
strategies during physician consultations is important. Pharmacists should teach students to use
the right words during a consult, to be assertive, but not aggressive, and to be ready to provide
clinical recommendations. In other words, pharmacists' recommendations should be concise,
provide physicians with information that they may not know (e.g. patient adherence to their
regimen or other medications that have been prescribed by other providers), and suggest
potential solution(s) to drug therapy problems that had been identified. For written or faxed
communications to physicians, students can be trained to use standardized forms. Students
should be taught to be concise with their recommendations and provide enough information to
physicians to help them assess the clinical situation.

13. Strategies to improve patient communication:

These strategies will help to ensure the environment is patient-friendly and Shame-free for all
patients.
1. Explain things clearly in plain language
• Slow down the pace of your speech
• Use plain, non-medical language

18
 Figure 7. What a pharmacist could say instead of using medical terminology
• Avoid vague terms: “Take 1 hour before you eat breakfast” instead of “Take on an empty
stomach”
2. Focus on key messages and repeat
• Limit information: focus on 1-3 key points
• Develop short explanation for common medical condition and side effects
• Discuss specific behavior rather than general concept: what the patient needs to do?
• Review each point at the end
3. Use a “Teach back” to check understanding

Figure 8: Use a “Teach back” to check understanding

Teach Back Scripts:
• I want to make sure I explained everything clearly. If you were trying to explain to your
husband how to take this medicines, what would you say?
• Lets review the main side effects of this new medicines. What are the 2 things that I asked you
to watch out for?
• Show me how you would use this inhaler.
4. Effectively solicit questions
• Don’t say:
Do you have any questions?

19
Did you take your doses correctly?
• Instead say:
What questions do you have?
How did you take your doses last month?

14. Role of pharmacist –doctor collaboration in patient communication:

Currently two medicinal institutes emphasized that safe utilization of medication can made
possible by inclusion of pharmacist by important interventions in critical areas, safe delivery of
drug in collaboration with physician and pharmacist.
The roles of the doctor and pharmacist are complementary and it has been established that the
expertise of pharmacists when channeled through a co-operative relation-ship with doctors has a
positive impact on patient outcomes. The benefits of such collaboration within the hospital
environment include the taking of complete and accurate drug histories, the provision of drug
information by medicines information pharmacists, the use of evidence-based prescribing,
improved detection of prescribing errors and improved drug safety through careful drug level
monitoring. Furthermore, close collaboration has been shown to improve the cost-effectiveness
of prescribing. Closer interprofessional collaboration may lead to greater knowledge, skills and
satisfaction for staff and a better service for patients. When teams are running efficiently patients
will benefit from simple outcomes such as getting the correct medicines at the correct dosing
intervals in setting their discharge medicines in timely fashion. Poor doctor-pharmacist
collaboration and communication may have a negative impact on the healthcare provided and the
outcome for a patient, for example, failure to detector communicate a prescribing issue.

15. Conclusions:
Pharmacists have a professional and ethical responsibility to consider the needs and situation of
the patient holistically, in the psychological and social realms as well as the biological realm.
Pharmacists can employ practical strategies to foster patient-centered communication that
engages patients to participate in their care and facilitates in the development of a trusting
pharmacist–patient relationship, leading to a shared understanding of the entire problem, the
goals of treatment, and the barriers to wellness. Only then can a realistic plan of care be
developed and followed, and in turn increase the likelihood of improved health outcomes.
Interactions between pharmacists and physicians revealed a clear desire for collaboration. They
recognized that they were taking care of the same patients and that identifying strategies was a
starting point for both improving their patients' care and improving their work efficiencies a
“win-win situation” for everyone.

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16. Reference:
1. Beardsley RS, Kimberlin CL, Tindall WN.Communication Skills in Pharmacy Practice: A
Practical Guide for Students and Practitioners. 5th ed, 2008. Lippincott Williams & Wilkins.
2. Sporrong SK, Kaae s. Communication in Pharmacy Practice. Special Edition. 2019. MDPI.

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