April 2, 2019
How many times have you explained a medication’s instructions, but left the consultation unsure if the patient understood key information?
“There are many instances where we assume patients understood. They nodded their head, smiled and said, ‘yes,’ but it turned out they had no idea what we were talking about,” said Richard N. Herrier, Pharm.D., FAPhA, CAPT., U.S. Public Health Service (Ret.), professor at the College of Pharmacy at the University of Arizona in Tucson, Ariz.
Herrier co-developed a method for counseling patients that aims to improve patient understanding through questioning with Robert Boyce, B.S.Pharm., FASHP, CAPT., U.S. Public Health Service (Ret.), director of pharmacy services in the Student Health Center Pharmacy at Oregon State University in Corvallis, Ore.
Research confirming this method’s effectiveness was recently published in the Journal of the American Pharmacists Association.
In a typical consultation, Boyce said a pharmacist explains the prescription’s label or reads directions from the provider. “This method is one way, and rarely assesses what knowledge the patient might know.”
To fix this, Boyce and Herrier created three open-ended “prime”questions designed to verify that patients truly understand all the directions. These are, ‘What did the doctor tell you the medication was for?,’ ‘How did the doctor tell you to take the medication?’ and ‘What did the doctor tell you to expect?’
If a patient can’t answer all the questions, the pharmacist fills in the information gaps. This can sometimes make the consultation longer.
This questioning method takes about two minutes, while traditional counseling takes 75 seconds, according to the study. But, the study found that the added time comes with an improvement in patient understanding.
According to the study, 71 percent of patients counseled using this approach answered all three prime questions correctly after the consultation, compared with 33 percent of patients who were instructed using the traditional method.
Ensuring patients understand their medications is key to improving adherence, which offers other benefits for your business.
“Enhancing adherence means you’ll fill more prescriptions,” Herrier said. “If patients take their medication, you’ll see an increase in prescription volume and income.”
Taking the time to counsel patients also shows that you care. “If they know you care and are knowledgeable, then they’re more likely to trust your expertise and interest in them,” Herrier said. “They’ll be more likely to ask for advice, potentially leading to more business in over-the-counter (OTC) medicines and medical devices.”
Implementing this method can be challenging. To make the process smoother, Herrier recommends pharmacists decide what they want patients to know about the medication ahead of time, so they’ll know what to listen for in a patient’s answers.
In his experience, Herrier said independent pharmacies have an easier time adopting the method.
“The reason was they talk to patients anyway,” Herrier said. “That transition for them was much easier in most cases.”
Boyce urges pharmacies to remain patient as they try this new method. “Over time they’ll find that they’ll never go back to the old method,” he said.
PBA Health is dedicated to helping independent pharmacies reach their full potential on the buy side of their business. The company is an independently owned pharmacy services organization based in Kansas City, Mo., that serves independent pharmacies with group purchasing services, expert contract negotiations, distribution services, and more.
PBA Health, an HDA member, operates its own VAWD-certified warehouse with more than 6,000 SKUs, including brands, generics, narcotics CII-CV, cold-storage products, and over-the-counter (OTC) products.
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