Counselling: interactive technique pays off

closing the gap: pharmacist talks to customer

Counselling patients using an unconventional technique delivers better results, a US study finds.

The counselling technique takes about 1 minute longer, can more than double the chances of improving patients’ compliance and concordance.

A new study published in the Journal of the American Pharmacists Association claims that this technique could significantly improve the understanding of drug use and storage, possible side-effects, what to expect from a medication and what to do if something isn’t working.

“This approach to prescription drug counselling has now been shown to be a dramatic improvement over conventional methods,” says Robert Boyce, director of pharmacy services at the Student Health Center Pharmacy at Oregon State University, and corresponding author on the study. “This is the first real analysis to prove that it works, and that the approach could be extremely important for healthcare in America.”

Patients are normally counselled in a ‘lecture format’, often referred to as reading off the label but this alternative approach which was co-developed by Boyce, is interactive and involves patient questioning..

The study, which included a survey of 500 participants at four community pharmacies in Oregon, is the first of its type to confirm the value of the new approach, say researchers.

Patients are asked three basic, open-ended questions, relating to the name and purpose of the medication; how to use and store it; and what possible side effects there might be, and what to do if they occur.

The new study found that 71% of patients using the interactive approach could answer all three questions correctly, compared to 33% of patients who were instructed with the conventional system.

Both approaches demonstrate that most people understood what medication they were taking and what it was for. However, with the new system, four times as many people understood how and when to take their medication, and also could answer basic questions about adverse effects.

According to this study, the average time it took pharmacists to use the new counselling system was a little over 2 minutes, compared to 75 seconds for conventional counselling.

“For a busy pharmacist, some might suggest this is a significant additional amount of time,” Boyce says. “But when you compare that to the risks of something not going right when a patient does not understand what the specific directions are, or what to expect from their medication, the additional effort seems minimal.”

Boyce says this approach to counselling can easily establish what the patient understands, and if there are problems they can contact their doctor or pharmacist for help.

He adds that interactive counselling results in patients having a better understanding of their medication and they also feel they have been listened to by the pharmacist and appreciate the attention they have received.

Gaps in understanding are addressed during the conversation and before moving on to the next question, says Boyce.


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