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Introduction to patient counselling

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Hello everyone, my name is Chen Chia-Hui. I’m currently a clinical pharmacist at Taipei Veterans General Hospital. Today I would like to talk about the patient counseling and advanced medication education. In this section, I will introduce the general concepts of communication skills for patient counseling. How to deal with specific populations like patients with terminal illness, chronic diseases, elderly or angry patients. And then show you the patient counseling and advanced medication education system which is currently used in our hospital.
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The learning objectives of this section are including to explain the communication skills that are essential to an effective patient counseling, to identify the benefits and challenges of patient counseling, to use appropriate techniques to counsel patients in different situations and to create education materials to enhance patient’s understanding of medications.
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According to Good Pharmacy Practice guideline Role 2 Function D: Provide information about medicines and health-related issues. Pharmacists should provide sufficient health, disease and medicine specific information to patients for their participation in their decision-making process regarding a comprehensive care management plan. Patient counseling is at the core of what pharmacists do in the provision of pharmaceutical care. The term patient counseling itself, is difficult to define, because it’s often used interchangeably with the term patient education and can have various meanings within multiple disciplines.
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A patient counseling session can be employed in a variety of settings, whether at the hospitalized patient’s bedside prior to discharge, in a clinic upon receipt of a new medication for an acute or chronic condition, or in the community pharmacy when a patient presents for advice on self-care treatment. In the hospital setting, the counseling session traditionally occurs at hospital discharge. Patient counseling offers several known benefits. Patient counseling can help to improve quality of life and health-related outcomes, leading to better quality of care. Patients who receive counseling also feel more satisfied with the care that they are receiving. If the patient accepts the offer,
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the counseling must include the following: The first one is name of the drug, both the generic name and brand name. The main indication of the drug and how it is intended to affect the patient. This is a 10-step checklist to the patient counseling encounter. Regardless of the approach utilized, all patient counsel should begin with the pharmacist introducing him or herself to the patient and confirming that he or she is speaking to the patient or caretaker. And then explain the purpose and importance of the patient counseling session and ask if he or she has time to discuss the medication. Provide any additional relevant information. Address any patient concerns with regard to therapy and the regimen prescribed.
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If the counseling session is intended to educate the patient on a newly prescribed medication, asking three questions enables the pharmacist to assess whether a patient knows the medication. The provision of written drug information to supplement the patient counseling encounter can be quite beneficial in helping the patient recall or clarify information provided. Written information has shown to be an essential complement to verbal patient counseling in those patients with low health literacy at the greatest risk for an adverse drug event related to misunderstanding. Communication skills are the fundamental link between the pharmacist’s expertise about drugs and his or her contribution to providing excellent patient-centered care.
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Although communicating with a patient may seem like a simple task, Active listening is a dynamic process that includes both hearing what is being said as well as processing and interpreting words that are spoken to understand the complete message that is being delivered. Empathy is when you place yourself in your patient’s situation and respond based on either similar personal experiences or through vicarious understanding. When you express empathy, it allows your patient to feel as though you understand his or her unique experience and that you are applying your expertise to the patient as an individual. The first impression you make on your patient will weight on the rest of the counseling as well as affect your relationship with the patient.
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Patients may sometimes withhold information if they feel uncomfortable or anxious about sharing their complaints because of lack of feeling respected, feeling as though their words are not being heard, or quite simply not knowing who you are and what your role is in their care. Therefore, building a good rapport sets the tone for the counseling and allows the patient to feel comfortable with you, thereby making the lines of communication more open and honest. Open-ended questions do not limit the patient to responding with a yes or no, they encourage the patient to disclose more information. For example, you can start the counseling by asking an open-ended question, such as “How are you feeling today?”
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or a closed-ended question, such as “Are you feeling well today?” The first approach allows for the patient to answer in free form and possibly give you more detail about the condition of his or her health, whereas the second way leads the patient to answer with either a yes or no, thereby limiting the information that you obtain from the patients. Additionally, you can use open-ended questions to determine the presence or absence of certain symptoms or to further explore a symptom that the patient is experiencing. Then, use closed-ended questions to collect the specific information.

Ms Chen will cover patient counselling in this step. She will explain the definition, benefits, and some of the technical details of patient counselling.

Key points

According to GPP, the pharmacist’s role includes providing patient counselling, aiding them with their decision-making process regarding a comprehensive care management plan.

A patient counseling session can be employed in a variety of settings:

  • Hospital

  • Ambulatory care

  • Community pharmacy

  • Telepharmacy

  • Online

Patient counseling can help:

  • Improve the quality of life and health-related outcomes.

  • Better quality of care.

  • Increase patients’ satisfaction.

Counseling must encompass the necessary information. The 10-step procedure is also a good guideline for patient counselling.

Communication skills are fundamental in providing excellent patient-centered care. Essential communication skills include:

  • Active listening

  • Empathy

  • Building good rapport

  • Good mix of open and closed-ended questions

Share and learn:

Do pharmacists in your hospital carry out patient counselling? Are other medical professionals involved?

In which settings does your hospital implement patient counselling?

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Good Pharmacy Practice: Medication Management

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