Patient medication counselling.

1. -PATIENT MEDICATION COUNSELLING-
Definition-
Patient counselling is defined as providing medication information orally or in written form
to the patients or their representatives on directions of use, advice on side effects,
precautions, storage, diet and life style modifications.
The content of a counselling session should include the information listed below,
• The medication’s trade name.
• Besides, the medication’s use and expected benefits and action.
• Moreover, the medication expected onset of action and what to do if the action does
not occur.
• In addition to, the medication’s route, dosage form, dosage, and administration
schedule.
• Directions for preparing and using or administering the medication.
• Action to be taken in case of a missed dose.
• Precautions to be observed during the medication’s use or administration.
• Potential common and severe adverse effects.
• Techniques for self-monitoring of the pharmacotherapy.
• Potential drug–drug (including non-prescription), drug–food, and drug–disease
interactions or contraindications.
• The medication’s relationships to radiologic and laboratory procedures (e.g., timing of
doses and potential interferences with interpretation of results).
• Prescription refill authorisations and the process for obtaining refills.
• Instructions for 24-hour access to a pharmacist.
• In addition to, the Proper storage of the medication.
• Proper disposal of contaminated or discontinued medications and used administration
devices.
• Any other information unique to an individual patient or medication.

2. Steps of Patient Counselling process
It varies according to the health system’s policies and procedures, environment, and practice
setting, Generally, the following steps are appropriate for patients receiving new medications:
1. Establish caring relationships with patients.
Introduce yourself as a pharmacist. Explain the purpose and expected length of the Sessions.
Obtain the patient’s agreement to participate. Determine the patient’s primary spoken
language.
2. Assess the patient’s knowledge about his or her health problems and medications.
Asses their capability to use the medications appropriately, and attitude toward the health
problems and medications. Ask open ended questions about each medication’s purpose and
what the patient expects Ask the patient to describe or show how he or she will use the
medication.
3. Provide information orally and use visual aids or demonstrations.
Open the medication containers to show patients the colours, sizes, shapes, and markings on
oral solids. For oral liquids and injectables, show patients the dosage marks on measuring
devices. Demonstrate the assembly and use of administration devices such as nasal and oral
inhalers. As a supplement to face-to-face oral communication, provide written handouts to
help the patient recall the information. In addition to, if a patient is experiencing problems
with his or her medications, gather data and assess the problems. Then adjust the
pharmacotherapeutic regimens according to protocols or notify the prescribers.
4. Verify patients’ knowledge and understanding of medication use.
Ask patients to describe or show how they will use their medications and identify their
effects. Observe patients’ medication-use capability and accuracy and attitudes toward
following their regimens.

3. Role of pharmacist:
Pharmaceutical care requires that pharmacists take responsibility for preventing and resolving
drug related problems. Also, for optimising drug therapy, while involving the patient
throughout the whole process. For this reason, pharmaceutical care does not end when the
patient leaves the pharmacy. It involves assessment, monitoring, documenting care and
progress, and follow-up care. Finally, as pharmacists, one of the most important counselling
points to all patients is the importance of medication adherence.
Skills for patient counselling:
Following are 10 features of effective patient counselling:
1. Establish Trust
Pharmacists are among the most accessible and trusted health care professionals. When
initiating a patient counselling session, pharmacists should introduce themselves with a brief,
friendly greeting. This is to make patients feel comfortable enough to ask questions about
their medication therapies and health conditions. Pharmacists who demonstrate a genuine
interest in patient care are more likely to encourage dialogue.
2. Communicate Verbally
Pharmacists can encourage dialogue by asking questions. They should assess what the patient
already knows about his or her chosen therapy. That is to tailor the counselling to meet their
needs. Ask patients what their physician has told them about the selected therapy. Also ask
them about the condition for which they are being treated.
3. Communicate Nonverbally
In addition to verbal communication, it is essential for pharmacists to be aware of nonverbal
communication. This is such as maintaining eye contact with the patient, to demonstrate
interest in the information the patient is relaying. Pharmacists also should be cognizant of
other nonverbal clues, such as facial expressions and tone of voice, when interacting with
patients.

4. 4. Listen
Listening to the concerns, questions, and needs of the patient is essential. Listening skills can
be categorized into 4 classes: passive listening, acknowledgment responses, encouragement,
and active listening. Passive listening occurs when the pharmacist enables the patient to
communicate without interruption. An acknowledgment response such as nodding occurs
during passive listening. This alerts the patient that the pharmacist is indeed listening.
Pharmacists also can use encouragement strategies through the use of words such as “yes” or
“go on.”
Active listening involves 2-way interactions between the patient and the pharmacist. It should
always be implemented after passive listening.
5. Ask Questions
Pharmacists should state the reason for asking certain questions, so as not to offend the
patient. Asking open-ended questions enables pharmacists to gather more information that
may lead to other questions. This type of question provides valuable information to the
pharmacist to further assess the patient.
6. Remain Clinically Objective
It is important for pharmacists not to allow personal beliefs to affect their ability to counsel a
patient effectively. Pharmacists should make every possible effort to be non-judgmental and
impartial. This is to focus on patient care, and to maintain a professional demeanour.
7. Show Empathy and Encouragement
When a pharmacist displays empathy and encouragement, a patient may feel more
comfortable. And so patient discusses his or her medical condition and medication use. This
enables the pharmacist to obtain pertinent information on the patient’s needs and concerns.
Emphasizing to patients the importance of adherence to medication regimens promotes
positive therapeutic outcomes. Also motivate patients to take an active role in the
management of their health. Pharmacists also should remind patients to call the pharmacy
with any concerns about their medications.

5. 8. Provide Privacy and Confidentiality
Ensuring complete privacy helps enable patients to feel comfortable discussing personal
medical issues. Today many pharmacies are equipped with special counselling areas to
address privacy issues. When counselling, pharmacists can reassure patients of privacy. This
is by monitoring voice levels and counselling patients away from the dispensing area when
possible.
9. Tailor Counselling to Meet Patient Needs
The ability to tailor patient counselling to meet individual needs is critical. Pharmacists
should be aware of patients with disabilities and be prepared to treat them with respect and
understanding. Techniques should be tailored to accommodate the needs of each patient. This
is done by via verbal counselling or the use of visual aids and demonstrations when
warranted. When the medication therapy involves certain administration techniques,
pharmacists should demonstrate it. This is to ensure that patients are adequately trained.
10. Motivate Patients
Effective counselling not only provides patients with the pertinent information they need. It
also motivates them to adhere to their medication regimens. Pharmacists can motivate
patients by discussing the benefits of medication adherence, offering support, and explaining
the pros and cons of treatment. For example, when counselling a patient with diabetes, in
addition to teaching the patient about medications, in addition to, the pharmacist can stress
the importance of maintaining tight glycemic control. This is to decrease or prevent the
complications associated with diabetes. Pharmacists also can make suggestions, such as the
use of medication reminder containers, to facilitate patient adherence. Information always
should be relayed positively. Pharmacists should look continually for ways to inspire patients
to learn more about their treatment plan. A simple approach to help you as a community
pharmacist in patient counselling, there is a simple approach developed that helps keep you
focused while providing a patient counselling session.
Patient counselling resources:
Here are eight credible, user-friendly health sites you can feel good about recommending to
your patients:
1. National Institutes of Health

6. 1. American Diabetes Association
2. Mayo Clinic
3. Drugs.com
4. MedlinePlus
5. Cleveland Clinic
6. Family Doctor.org
7. HeartHub
CONCLUSION:
In general, patient counselling has 3 main objectives: assessing the patient understanding of
the therapy.
In addition to including proper use and adverse effects of the medication; improving patient
adherence; and motivating the patient to take an active role in health management.
Studies have shown that patient counselling can improve patient care in various ways:
Reducing medication errors, increasing patients understanding and management of their
medical condition. Moreover, Minimizing incidence of adverse drug reactions and drug-drug
interactions. Improving patient outcomes and satisfaction with care, Pharmacists should
understand the influence of the care they provide and work on their skills to improve it.
What are Guidelines of Patient Counselling?
Medicines play an important role in medical care. In addition to, the Effectiveness of
treatment depends on both the efficacy of medication and patient adherence to the therapeutic
regimen. Adherence to medications is essential to achieve the best possible pharmacotherapy
outcomes. Besides, the Non-adherence to medications result in higher health care costs,
longer hospitalisation, and increased morbidity and mortality. Moreover, the Patient
counselling refers to the process of providing vital information, advice and assistance. It’s
done to help the patients with their medications and to ensure they take them properly.
This also includes important information about the patient’s illness and lifestyle.
A patient is advised on whether medications should be taken with or without food, at bed
time or in morning, with water, juice or milk. Finally, all of this information results in the
proper use and best therapeutic action of the medications.

7. Guidelines of Patient Counselling in Elderly People
Elderly patients are at highest risk of experiencing ADRs, many of which are preventable.
Actual, perceived, or even fear of ADRs increases the likelihood for medication non
adherence This leads to suboptimal treatment efficacy and adding to the burden of disease.
Actual ADRs can result from medication pharmacology. Whereas perceived or fear of ADRs
are influenced by psychological factors. In addition to, these factors are such as
predetermined medication views, lack of belief in treatment necessity, anticipation of ADRs,
conditioning based on past experiences, and misattributing symptoms as ADRs. Besides, the
Clinician and pharmacist awareness of these factors will help to reduce risk for ADRs and
optimize management
In addition to, this will ultimately allow patients to benefit from intended treatment. Finally,
the American Society of Health-Systems Pharmacists (ASHP) provides guidelines and
emphasizes the role of pharmacists in comprehensive ADR management.
Here are some tips for Guidelines of Patient Counselling-
• Risk Minimisation
• Understand patient views about medication therapy. In addition to, educate about the
benefits of treatment.
• Inform patients about potential ADRs and management strategies should any occur.
• Ensure an updated and accurate medication list.
• Utilise decision support software to help prevent ADRs.
• Start with low doses and frequencies and slowly titrate as tolerated.
• Initiate less-potent agents, agents with direct mechanisms of action, or alternatives
with lower adverse event incidence.
• Avoid or reduce the use of interacting medications.
• Prescribe dosage forms with minimal systemic exposure (e.g., creams, patches).

8. Recognition, Detection
Be familiar with known ADRs of the medication as well as the patient’s pre-existing
symptoms. Evaluate new symptoms as possible ADRs, looking into health conditions, labs,
or other factors which may explain the symptoms. Besides, consider the temporal relationship
between medication initiation and symptom onset. Challenge concepts like stopping the
medication to see if the symptom subsides in absence of the medication, and restarting to see
if symptoms return. Utilise lab tests for more evidence to identify an ADR. Express empathy
and maintain a trusting relationship with the patient. In addition to, reduce dosing or
discontinue the offending medication. Switch to another agent or dosage form less likely to
cause ADRs. Moreover, treat side effects when necessary (beware of prescribing cascades).
Document the ADR in the patient’s medical record.
Reference:
• https://www.linkedin.com/pulse/patient-counselling-ahmed-
yossef#:~:text=Patient%20counselling
%20is%20defined%20as,diet%20and%20life%20style%20modifications.
• https://fadic.net/important-outcomes-and-benefits-of-the-patient-counselling /