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Introduction to patient education

Hello everyone, I am Chia Lin Chou from Taipei Veterans General Hospital. Today we are going to introduce patient education. Patient education is a part of clinical pharmacy service. In our daily practice, we usually can see patients are not adherent to their pharmaceutical treatment. This may lead to a worse outcome because of lack of sufficient knowledge about their health problems and medications. So, we understand that without adequate and accurate knowledge, patients cannot be effective partners in managing their own care. In pharmacist training, our profession include to provide patient education and counseling regarding to the pharmaceutical care in order to improve patient adherence, and reduce drug-related problems. Most importantly, patients can directly receive pharmacist’s service though patient education.
In Good Pharmacy Practice guideline, it recommends that pharmacists should provide sufficient drug information. And this information should aim at supporting adherence to treatment. In American Society of Health-System Pharmacist, as known as ASHP, the guideline on pharmacist-conducted patient education and counseling, it provides detailed recommendations about patient education. So, in today’s program, I would like to use these two guideline as reference to briefly introduce how to give an effective patient education before we introduce clinical pharmacy service. This is today’s outline, I will introduce patient education, including the goals, objectives, and tools. Then, I will introduce how to improve our skills to provide an effective patient education. And then introduce how to do a patient education service.
After this section, you may understand the pharmacists’ role on patient education. And understand how to find or make useful tools on patient education. In pharmacists’ work, most of time we are checking prescriptions, dispensing, and doing documentations. Although these works are also called patient care, most people do not know what we have done for them. Only when we provide patient education and counseling, patients may feel that they receive direct care by pharmacists. Therefore, patient education is an very important part if we want to earn patients’ trust. In addition, sometimes only through direct patient education and counseling, we can get some important patient information what the chart did not show. For example, giving patient education to whom receiving warfarin.
Because many vegetables can interact with warfarin, and some minor bleeding side effects may occur when they brush teethes. Thus information about the patient lifestyle such as what they eat and their daily routine is very important, but this kind of information rarely show on the patient’s medical charts. Only through direct patient education and counseling we can get these information and provide suitable treatment plans for them. Through patient education, patients can understand their treatment plan, what can be expected and what should be monitored. Thus, patients could cooperate with healthcare team
and finally we can reach our goal: To make a successful treatment outcome.
So, when we give a patient education,
the first question is: What is the important thing that patients should know? First, patient need to know about their disease. Different from doctors, we only briefly introduce the disease and the medications used in this disease. So, basically, we first tell patients about their disease,
including: Why this disease happen? Can this disease be cured by medication? Or the medication only release the symptoms of my disease? About the treatment plan, the common questions from
patients are usually like that: How long should I take these medications? How to use these medications? So as a pharmacist, we need to let patient understand their treatment plan, including the treatment goal and duration, how many medications should they take, and the indication of medications. Let patient know that the medication can really make them better, so that they can be more adherent to their treatment. Similarly, telling patient the possible side effects from their medications in advance can let patient less resist to take medications and improve adherence. In addition, sometimes patients should follow some precautions or contraindication. When they take specific medications, pharmacists also need to tell patients in advance.
For common precaution, such as the possible drug-drug interaction, drug-food interaction, or some medications are not recommended for patients with liver or kidney impairment or for pregnant patients. Some medications have specific precaution, I would like to take Fosamax as example. Fosamax is a bisphosphonate for osteoporosis. It may cause irritate or damage the esophagus and stomach, so pharmacists should educate patients to take with lots of water and keep body upright for at least 30 minutes after taking Fosamax. In addition, before taking bisphosphonate, especially an injection form of bisphosphonate, pharmacists should confirm with patients that they do not have dental procedure recently, such as tooth extraction.
And also make sure that patient’s dentist know this patient are currently taking bisphosphonates because in some rare cases, bisphosphonate may cause serious osteonecrosis of the jaw. And then, patients may routinely monitor some lab data. Sometimes these monitoring items are to make sure the treatment is successful such as cancer biomarkers. And most of times we monitor drug serum concentrations to make sure enough drug dose for the treatment, and also to avoid side effects of medications such as digoxin. So, pharmacists should let patients know the reasons for these monitoring items and how long they should follow up these lab data. At last but not least, pharmacists should provide the lifestyle modification plan for patients.
The lifestyle modification is also an essential part of treatment plan for both disease prevention or treatment success. For example, for patients who are taking antihypertensive agents, we should educate patients a routine exercise and DASH diet for both disease prevention and treatment success. For treatment success, for patients who are taking warfarin, we should educate patients about the vitamin K levels in different kinds of vegetables. And encourage patients to keep intake of foods rich in vitamin K about the same every day.

Patient education is a part of clinical pharmacy service. Pharmaceutical treatments can be complicated. Good patient education could increase the medical adherence of patients towards successful outcomes.

Patient education provides pharmacists with information unobtainable from their medical records. Patients might speak out their their diet, habits etc., which might interfere with treatments. It is the pharmacists’ job to let patients gain correct knowledge of their medications. In this video, Ms Chou will detailed explain the guidelines of quality patient education.

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