A PROSPECTIVE STUDY ON ROLE OF DOCTOR OF PHARMACY IN IMPROVING QUALITY OF LIFE OF HIV PATIENTS BY PATIENT COUNSELLING IN AN ANTIRETROVIRAL THERAPY WARD OF A TERTIARY CARE TEACHING HOSPITAL
M. Manasa Rekha*,
Department of Pharmacy Practice,
Annamacharya college of Pharmacy,
Rajampet, Andhra Pradesh, India.
The study aims to assess the role of clinical pharmacist in Improving the quality of life of HIV patients in an antiretroviral therapy wards of a teritary care teaching hospital
REFERENCE ID: PHARMATUTOR-ART-2524
Patient counseling is a broad term which describes the process through which health care professionals attempt to increase patient knowledge of health care issues. Patient counseling may be verbal or written performed on an individual basis or in groups, & provide directly to the patient or caregiver. The process provides for the exchange of information between the patient & health practitioner. The information gathered is needed to assess the patient’s medical condition to further design, select, implement, evaluate & modify health interventions.
Outcomes of patient counseling:
• Patient recognizes the importance of their well being.
• It encourages the patient to establish a working relationship with a pharmacist & foundation for continual interaction and consultation.
• Improves the coping strategies to deal with medication side effects and drug interactions.
• Motivates the patient to take medicine for improvement of his/her health status.
• The patient becomes an informed, efficient and active participant in disease treatment and self care management.
• Develops the ability in patient to take appropriate medication related decision concerning the compliance or adherence to their medication regimen.
Patient counseling methods:
The structure of the counseling session is divided into four groups: y Introduction of the session.
• Content of the session.
• Process followed.
• Conclusion of the session
• Review the patient record prior to counselling.
• Conduct an appropriate patient counselling introduction by self and patient.
• Explain the purpose of counselling session
• Obtain pertinent initial drug related information. E.g.: drug allergies, and other medications.
• Warn the patient about taking other medications including OTC drugs, herbals, or botanical drugs and alcohol which could inhibit or interact into the prescribed medication.
• Determines whether the patient has any other medical conditions that could influence the effects of their drug or enhance the likelihood of an ADR.
• Asses the patient understandings of reason for therapy. y Assess any actual or problems of importance to the patient.
Patient Counseling contents :
• Discuss the name and indication of the medication.
• Explain the dosage regimen including duration of therapy when appropriate.
• Assist the patient in developing a plan to incorporate the medication regimen into his/her daily routine. Explain how long it will take for the drug to show its effect.
• Discuss storage and refilling information.
• Emphasize the benefits of completing the medication as prescribed.
• Discuss the potential side effect.
• Discuss how to prevent or manage the side effects of the drug. y Discuss the precautions.
• Discuss the significant drug‐drug, drug‐food, and drug‐disease interaction. y Explain precisely what to do if the patient misses the dose.
• Explore the potential problems of the patient
• Provide accurate information.
• Use language that the patient is likely to understand.
• Use the appropriate counselling aids to support counselling.
• Present the fact and order in a logical order.
• Maintain control & direction of the counseling session.
• Probes for additional information.
• Use open‐ended question.
• Display effective non‐verbal behaviours.
• Counseling conclusion steps:
• Verify the patient understanding via feedback.
• Summaries by acknowledging or emphasizing key points of information.
• Provide an opportunity for final concerns or questions.
• Help the patient to plan, follow up and next consecutive steps.
• Expected duration of treatment
• Expected benefits of treatment
• Advice on storage
• What do if dose is missed
Interactive communication requires five key elements:
• open ‐ended questions
• awareness of nonverbal cues;
• active listening
• reflective responses
• verification of understanding
• These questions encourage disclosure of information.
• Closed‐ended questions and leading/restrictive questions elicit yes/no responses and limit the information sought from the receiver.
• These types of questions should be avoided. Example: Closed‐ended: "Do you know how to take your medication?"
• "Yes." Leading/restrictive: "You're familiar with your medications, aren't you?“
• "Yes.“ Open‐ended: "What did the doctor tell you about taking the medications?
• Appropriate nonverbal cues are also critical for effective communication.
• Facial expressions, body posture, gestures, tone of voice and use of eye contact are all forms of nonverbal communication.
• Skilled use of our nonverbal communication can make the difference between successful interactive dialogues and frustrating nonproductive encounters.
• What we say and how we say it must have the same meaning.
• When nonverbal cues are inconsistent with the words spoken, people tend to believe the nonverbal message.
Appropriate non‐verbal clues:
• Friendly and smiling facial expressions.
• Varied eye contact(consistent, but not startling).
• Professional appearance.
• Relaxed, warm and comfortable gestures.
• Attentive body posture(slightly leaning forward).
• Appropriate personal space(18‐48 inches).
• Varied voice rate and volume to keep the individual interested. However, a high pitched voice should be avoided.
Distracting non‐verbal clues:
• Lack of eye contact may indicate little confidence or interest.
• Insufficient spatial discomfort(causing discomfort).
• Unfavorable tone of voice(can upset the people and create an unintended meaning).
• Slouching or weight shifted to one side(may indicate lack of interest).
• Messy work environment.
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