Ghadeer Aljedaani Pharm.

D Ibn Sina National College for Medical Studies

What did the doctor tell you (were you told) the medication is for?
What problem or symptom is it supposed to help? What is it supposed to do?

How did your doctor tell you (were you told) to take the medication?
How often? How much? How long? What does X times a day mean to you? What did your doctor say to do if you miss a dose?

What did the doctor tell you (were you told) to expect?
What good effects? Bad effects? Precautions to take? What should you do if a bad reaction occurs?

 What
How

do you take this medication for?

have you been taking it? kinds of problems are you having with

What

it?

 Determine

that the patient has sufficient knowledge to self-medicate.

to make sure I didnt leave anything out, please go over with me how you going to use the medication.

Just

Preparation Information Gathering Establishing Rapport Patient Identification

Counseling Technique
Strategies to Address and Improve Adherence Closing Documentation

 Gather

the discharge order and discharge medications.

Ensure

correct drugs are dispensed for the correct patient by cross checking the discharge orders, drug packaging labels, and actual medication names.

 Review

the patients reason for admission Review appropriate laboratory results. Reconcile the discharge orders with the Admission Medication Order Sheet (APF).

Reason for admission

Check for vitals, lab results

Check for lab results

 Evaluate

discharge medications for:

Appropriateness of drug, dose, frequency, and route of administration Therapeutic duplication Allergies or sensitivities interactions between the medications and or food

 Check

the VAX system active for discharge and inactive orders and compare between them.

 Greet

patient

Introduce

yourself.

....

Explain

the purpose and ask permission.

, . ,

 Ask

patient to state his/her full name. If the patient is a child or unable to verbalize, ask the family member to state the patients full name. Check the ID band for correct MRN and Name.

 The

best technique for counseling is a combination of How and Tell and the Prime Questions.

 For

Refill Medications: - How & Tell Questions

What do you take this medication for? How have you been taking it? What kinds of problems are you having with it?

 For

New Medications: - The Prime Questions

What did the doctor tell you the medication is for? How did your doctor tell you to take the medication? What did the doctor tell you to expect? How long to take the medication? Exactly how much or how often to take it when the medication is prescribed as needed? What to do when a dose is missed? How to store the medication?

 Suggest

the use of pillboxes and calendars. Use a probing statement following the I noticed/Im concerned formula. Listen for clues that may indicate the patient is reluctant to take the prescription. Link medication taking to a daily activity. Suggest that medication be kept where it is easily seen.

 Thank

the patient. Ask the patient if he/she has any questions.

 Document

the patient counseling in the Interdisciplinary Patient Education Record (IPER) Form of the patients file.

Stein

S. BOHs Pharmacy Practice Manual A Guide to the Clinical Experience. 3rd ed. Philadelphia. Lippincott Williams & Wilkins; 2010. Saad al mohrij et, al. Quality & patient safety newsletter. Medication Safety Program WR. NGHA. Volume 5 / issue 2 / June 2013