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Adapting tools for patient education

Then, a good tool for patient education may help patients better understanding regarding medication use. A good tool may also save pharmacists time and manpower. Various tools you can use in patient education. Putting essential information on medication bags is a quiet simple way. In our hospital, we put medication indication, common side effect with incidence rate, dose, frequency and duration on medication bags. And we give short education when patients come to collect their medication. Leaflets are also convenient for patient education. We can make a paper, a poster or a book with full information on it. Using leaflets is easier when you educate patients, and patients can review these information when they back home. Furthermore, we can make an individualized leaflet for patients.
In our hospital, when we do a bedside education, pharmacists will modify the general leaflets to an individualized leaflets. But if we want to teach patients how to use some device, leaflet may not be a good tool. So, we can directly demonstrate how to use the medical device using a demo sample or we can make a educational video. Making a video may save pharmacist’s time. Pharmacists don’t repeat the demonstration, we can just simply play the video and highlight the important steps after video. In our hospital, we even use a kiosk for patient education. We put the educational poster and videos in the kiosk, then put kiosk near pharmacy, so patient can operate the kiosk and find drug information what they need.
They can play the educational video again and again until they fully understand. If they have specific question after watching videos, they still can find a consulting pharmacist nearby. We also put these information on our pharmacy web page, so patients can learn by themselves at home. In addition, nowadays people get information from social network, so many hospitals in Taiwan also manage their own social media, such as a fan page on facebook. A social media manager routinely update latest medical information on facebook page. Furthermore, in recent years, people use smart phone to do many things, so in many hospitals in Taiwan, we develop many apps for patients.
We can put drug information or even the educational videos in the app, so patients can use their smart phone to check information such as common side effects, or watch these videos anytime. Some apps even can remind patients to take medications or return to clinics. When we choose these tools, we may consider our resources. Some tools like leaflets or demo samples are easy to prepare, some tools however, they may need supports from IT engineers. But we can always find a good way to do a good patient education. For an effective patient education, both pharmacist and patient need to understand about their respective roles and responsibilities.
So in the ASHP guideline, it suggests that during the patient education, pharmacists need to clarify that pharmacists have an important role in providing education, and patients have responsibilities to be an active participants. The pharmacist’s responsibility is to make sure that patients understand about their treatment, and they have sufficient knowledge and skills to follow their pharmacotherapeutic regimens and monitoring plans. When patients show a passive attitude towards their treatment, pharmacists should try to motivate patients to learn about their treatment and encourage them to be an active partners in their care. A patient’s role is to adhere to their pharmacotherapeutic regimens, self-monitor for drug effects and side effects, and report their experience to pharmacists.
Ideally, the patient’s role could include seeking information and presenting what difficulties on treatment adherence they have occurred. So, after you’re well prepared for patient education, how to carry out the patient education? Steps in patient education process may vary according to different health system’s policies and procedures, environment and practice setting. The ASHP recommends the common process steps for patient education. The first step is to establish caring relationships with patients. In the first step, you may just simply introduce yourself as a pharmacist. Explain your purpose, you are coming for giving patient education and advices on their treatment plan. And tell patients the expected length of the education. And obtain the patient’s agreement to participate.
You may also know the patient’s primary spoken language and try to adapt the language skill or seek a interpreter.
The second step, you can start to assess patient’s knowledge about their health problems and medications. Assessing the physical and mental capability is also necessary to assure patients could use the medication appropriately. Patients’ attitude about the health problems and medications should be also considered. You may ask open-ended questions about the medication’s use and the patient’s expects about the treatment. And ask the patient to describe or show how he or she will use the medication. If patients is coming for refill medications, we need to ask them again to describe or show how they have been using their medications. It helps us to know what patient’s knowledge and the possible medication errors.
We may also encourage patients to tell us any problems, concerns or uncertainties they are experiencing during their treatments. Then we can provide drug information orally and use visual aids or demonstrations to fill patients’ gaps in knowledge and understanding. For example, you may show patients the characteristics of their medications, such as the colors, shapes and marking on medications. If patients use medication with administration devices, such as nasal spray and oral inhalers, you can demonstrate the assembly and use of these devices. In addition to a face-to-face oral communication, you can provide written handouts as a supplement, or use educational video first. Then repeat the key points orally to help the patient recall the information.
If the patient is suffering from some problems with his or her medications, pharmacists should search appropriate data and assess the problems, then contact to the doctor. For example, if an old patient who is taking digoxin and he complains about stomach pain and blurred vision, pharmacists may consider the potential risk of digoxin overdose, contact doctor to monitor digoxin serum level.
The last step is very important. You must verify patient’s knowledge and understanding of medication use. Usually we can ask patients again to tell us how they will use their medications and tell us their effects. You can thus understand patients’ capability and accuracy on medication use. In our hospital, we use pretest and after-test to verify patient’s understanding. Sometimes, we can also observe the attitudes toward following their pharmacotherapeutic regimens and monitoring plan.

There is a wide variety of tools for patient education, from simple leaflets to self-help kiosks, and even fancy digital tools like social media and smartphone applications.

Mr Chou gives examples of these tools before moving on to the ASHP suggested patient education guideline. It includes introduction, patient assessment, patient education and verification. After all, patient’s understanding is the key! It’s the first step of patient’s adherence.

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Good Pharmacy Practice: Introduction to Medication Delivery Systems

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