Say that again?


pharmacist speaking to elderly man in Terry White Chemist

Do you take the time to communicate effectively with your older patients? Age-related hearing difficulties may contribute to medical errors, a study has found

A qualitative analysis into hearing difficulties in older patients has found failure in clinical communication is a leading cause of medical errors.

In the study of 100 older adults, 57 reported some degree of hearing loss while 43 reported having misheard a healthcare practitioner in a primary care or hospital setting.

When asked to elaborate on context of mishearing, emergent themes included general mishearing; consultation content; healthcare practitioner-patient communication breakdown; and use of language.

The authors also cite a previous study that found improved communication between medical teams and families could have prevented 36% of medical errors.

“This qualitative analysis confirms that age-related hearing loss has a negative effect on clinical communication across both hospital and primary care clinical settings,” they say.

“The circumstances of medical conversations vary widely not only in relation to environmental background noise, but also the attendant pain and fear and distress of illness or injury, lack of familiarity with medication names, diagnoses, and the other essential components of medical discourse.”

A 2009 Norwegian study also found inadequate communication about patients’ medication across the levels of the health care system leads to numerous and potentially harmful medication errors including too high dosing and missed medicines.

Meanwhile Australian researchers have found pharmacist communication can too often focus on technical aspects and ignore patient-specific needs.

Older adults are much more likely to have hearing loss, as well as be taking multiple medications.

Karen Luetsch and Judith Burrows from the University of Queensland’s School of Pharmacy recently reviewed how pharmacists can and should develop patient-centred communication.

The link between health outcomes and communication has been investigated in medicine and nursing, they point out in Research in Social and Administrative Pharmacy.

However, “pharmacy is only starting to link communication style and effectiveness to person-focused outcomes, e.g. medication adherence, changes to lifestyle or addictive behaviours”.

Dr Luetsch and Ms Burrows say that pharmacists’ communication skills can be improved through further training and practice; for example, through learning how to conduct motivational interviewing – an evidence-based person-focused approach to conducting healthcare consultations.

After attending a workshop and learning new communication skills, most pharmacists perceived an improvement in their effectiveness as healthcare providers in improving patient outcomes.

“Pharmacists’ acknowledgement of a patient’s needs is one of the defining features of patient-centredness and is integral to pharmaceutical care,” say Dr Luetsch and Ms Burrows.

Patient-centred communication is therefore paramount for pharmacists when providing medication advice to their older patients, who may need to hear drug-related information to be clearly enunciated and repeated in order to leave with the correct information.

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