Communication in Pharmacy Practice

A special issue of Pharmacy (ISSN 2226-4787).

Deadline for manuscript submissions: closed (31 October 2018) | Viewed by 108210

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Guest Editor
Department of Pharmacy, University of Copenhagen, Universitetsparken 2, 2100 København Ø, Denmark
Interests: professional ethics and communication; the role of pharmacists in pharmacy practice and clinical pharmacy; patient perspectives on medicine use; pharmaceutical policy
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Guest Editor
Department of Pharmacy, University of Copenhagen, Universitetsparken 2, 2100 København Ø, Denmark
Interests: communication between patients and health care professionals; patient-centered care; cognitive services; patient perspectives on medicine use
Special Issues, Collections and Topics in MDPI journals

Special Issue Information

Dear Colleagues,

Communication is a crucial part of pharmacy practice, in community pharmacies, as well as in other health care settings. The communicative role of pharmacists and other pharmacy staff is an important part of, e.g., dispensing, pharmaceutical care, and counselling services provided to patients. It is through high quality communication that patients’ needs can be assessed and information, education and advice given, in this way ensuring a rational use of medicine. In addition, effective inter-professional communication with other health care professions is central for health outcomes of patient treatments.

However, communication is a complex area, dealing with, not only the transmission of content, but also intrapersonal relationships, social processes, etc. Barriers and facilitators to communication are many, including psychological, socio-economic, cognitive and environmental factors. Through research in pharmacy practice communication we can help develop skills, tools and processes, to make patient encounters and other encounters as good as possible.

We invite you and your colleagues to send in articles for this Special Issue on “Communication in Pharmacy Practice”. We welcome research studies on communication in pharmacy and clinical practice, theoretical and methodological reflections, as well as reflections about tendencies and challenges in pharmacy communication.

Prof. Dr. Sofia Kälvemark Sporrong
Prof. Dr. Susanne Kaae
Guest Editors

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Keywords

  • Communication

  • Pharmaceutical care

  • Pharmacy practice

  • Communication theories and models

  • Communication skills

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Published Papers (13 papers)

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Editorial

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3 pages, 162 KiB  
Editorial
Trends in Pharmacy Practice Communication Research
by Sofia Kälvemark Sporrong and Susanne Kaae
Pharmacy 2018, 6(4), 127; https://doi.org/10.3390/pharmacy6040127 - 5 Dec 2018
Cited by 2 | Viewed by 3788
Abstract
Communication is a crucial aspect of pharmacy practice—in community pharmacies and in other health care settings. [...] Full article
(This article belongs to the Special Issue Communication in Pharmacy Practice)

Research

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14 pages, 432 KiB  
Article
“Being in Control of My Asthma Myself” Patient Experience of Asthma Management: A Qualitative Interpretive Description
by Damilola T. Olufemi-Yusuf, Sophie Beaudoin Gabriel, Tatiana Makhinova and Lisa M. Guirguis
Pharmacy 2018, 6(4), 121; https://doi.org/10.3390/pharmacy6040121 - 15 Nov 2018
Cited by 3 | Viewed by 5405
Abstract
Asthma control can be achieved with effective and safe medication use; however, many patients are not controlled. Patients’ perceptions of asthma, asthma treatment, and pharmacist roles can impact patient outcomes. The purpose of this study was to explore patients’ experiences and patient–pharmacist relationships [...] Read more.
Asthma control can be achieved with effective and safe medication use; however, many patients are not controlled. Patients’ perceptions of asthma, asthma treatment, and pharmacist roles can impact patient outcomes. The purpose of this study was to explore patients’ experiences and patient–pharmacist relationships in asthma care. Qualitative Interpretive Description method guided the study. Semi-structured individual interviews were conducted with 11 patients recruited from personal contacts, pharmacies, and asthma clinics. Categories and themes were identified using inductive constant comparison. Themes indicated patients had a personalized common sense approach to asthma management, “go-to” health care provider, and prioritized patient–pharmacist relationships. Patients described their illness experiences and asthma control based on personal markers similar to the common sense model of self-regulation. Patients chose a family physician, asthma specialist, respiratory therapist, or pharmacist as an expert resource for asthma management. Patient perceived pharmacists’ roles as information provider, adviser, or care provider. Pharmacists who develop a collaborative relationship with their asthma patients are better positioned to provide tailored education and self-management support. Inviting patients to share their perspective could increase patient engagement and uptake of personalised asthma action plans to achieve asthma control. Full article
(This article belongs to the Special Issue Communication in Pharmacy Practice)
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9 pages, 372 KiB  
Article
Development of a Theory-Based Intervention to Enhance Information Exchange during Over-The-Counter Consultations in Community Pharmacy
by Liza J. Seubert, Kerry Whitelaw, Laetitia Hattingh, Margaret C. Watson and Rhonda M. Clifford
Pharmacy 2018, 6(4), 117; https://doi.org/10.3390/pharmacy6040117 - 24 Oct 2018
Cited by 9 | Viewed by 4711
Abstract
(1) Background: Community pharmacy personnel help mitigate risks of self-care by consumers who seek over-the-counter (OTC) medicines or treatment of symptoms and/or conditions. Exchange of information facilitates the OTC consultation, but pharmacy personnel often report difficulties in engaging consumers in a dialogue. The [...] Read more.
(1) Background: Community pharmacy personnel help mitigate risks of self-care by consumers who seek over-the-counter (OTC) medicines or treatment of symptoms and/or conditions. Exchange of information facilitates the OTC consultation, but pharmacy personnel often report difficulties in engaging consumers in a dialogue. The aim of this study was to describe the development of a behaviour change intervention to enhance information exchange between pharmacy personnel and consumers during OTC consultations in community pharmacies. (2) Methods: The Behaviour Change Wheel methodological framework was used to link factors that influence consumer engagement with information exchange during OTC consultations with intervention functions to change behaviour. Options generated were rationalized and the final intervention strategy was derived. (3) Results: Education, persuasion, environmental restructuring, and modelling were determined to be potential intervention functions. The intervention incorporated placing situational cues in the form of posters in the community pharmacy modelling information exchange behaviour, persuading through highlighting the benefits of exchanging information and educating about its importance. (4) Conclusions: A systematic, theoretically underpinned approach was applied to develop candidate interventions to promote information exchange in OTC consultations. The feasibility and efficacy of the intervention strategy has since been tested and will be reported elsewhere. Full article
(This article belongs to the Special Issue Communication in Pharmacy Practice)
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15 pages, 667 KiB  
Article
The Use of Video Instructions in Patient Education Promoting Correct Technique for Dry Powder Inhalers: An Investigation on Inhaler-Naïve Individuals
by Sofia Von Schantz, Nina Katajavuori and Anne M. Juppo
Pharmacy 2018, 6(4), 106; https://doi.org/10.3390/pharmacy6040106 - 29 Sep 2018
Cited by 13 | Viewed by 6120
Abstract
Introduction: The correct use of a prescribed inhaler device is crucial for achieving successful disease management in asthma. This study investigates non-verbal, demonstrational videos as a method of teaching inhaler naïve individuals how to use a dry powder inhaler (DPI). Methods: Video instructions [...] Read more.
Introduction: The correct use of a prescribed inhaler device is crucial for achieving successful disease management in asthma. This study investigates non-verbal, demonstrational videos as a method of teaching inhaler naïve individuals how to use a dry powder inhaler (DPI). Methods: Video instructions for four DPIs were examined using a mixed methodology; 31 inhaler-naïve individuals participated in the study. Participants were each shown a demonstrational video of one the four inhalers, after each video the participant demonstrated how they would use the inhaler. After demonstrating the use, participants crossed over to the next inhaler. The demonstrations were videotaped. A common questionnaire was filled at the beginning of the study and four inhaler-specific questionnaires which were filled out by the participant after each inhaler demonstration. Results: The frequency of participant error varied between inhalers. When asked about how they perceived the video instructions, participants often stated they would have liked to receive feedback on their performance. The importance of feedback was further highlighted by the fact that participants tended to overestimate their own inhaler technique. Conclusion: Non-verbal videos may be more efficient for some DPIs than for others as a method for providing inhaler instructions. Lack of feedback on the participants’ inhaler performance emerged as a clear shortcoming of this educational method. Some steps in the inhalation process may be harder for individuals to remember and therefore require extra emphasis in order to achieve correct inhaler technique. Full article
(This article belongs to the Special Issue Communication in Pharmacy Practice)
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12 pages, 222 KiB  
Article
A National Survey of Community Pharmacists on Smoking Cessation Services in Thailand
by Surarong Chinwong and Dujrudee Chinwong
Pharmacy 2018, 6(3), 101; https://doi.org/10.3390/pharmacy6030101 - 17 Sep 2018
Cited by 9 | Viewed by 4367
Abstract
Providing smoking cessation services is one role of community pharmacists in Thailand. This cross-sectional study aimed to investigate activities and barriers related to smoking cessation services provided in community pharmacies in Thailand, as well as to compare these activities and barriers between those [...] Read more.
Providing smoking cessation services is one role of community pharmacists in Thailand. This cross-sectional study aimed to investigate activities and barriers related to smoking cessation services provided in community pharmacies in Thailand, as well as to compare these activities and barriers between those pharmacists providing and those not providing smoking cessation services. A postal questionnaire was conducted to collect information from community pharmacists across Thailand. In all, 413 valid responses were received from 5235 questionnaires, giving a 7.9% response rate. Of the 413 respondents, 152 (37%) pharmacists provided smoking cessation services in their pharmacy. The activities of smoking cessation services varied. Time for counseling each smoker varied, a mean of 15.1 ± 10.9 min (range 1–60) per person for the first time, and 8.9 ± 6.7 min (range 1–30) for each follow-up visit. Community pharmacists, providing smoking cessation services, were more likely to have pharmacist assistants, be a member of the Thai Pharmacy Network for Tobacco Control, and have more than 1 pharmacist on duty. The most dispensed pharmaceutical product for smoking cessation was nicotine gum. Their most perceived barriers were being unable to follow-up and inadequate staff. In conclusion, only a minority of community pharmacists in Thailand are engaged in smoking cessation activities, even though some perceived barriers existed. Full article
(This article belongs to the Special Issue Communication in Pharmacy Practice)
13 pages, 572 KiB  
Article
Uncertainty and Motivation to Seek Information from Pharmacy Automated Communications
by Michelle Bones and Martin Nunlee
Pharmacy 2018, 6(2), 47; https://doi.org/10.3390/pharmacy6020047 - 28 May 2018
Cited by 1 | Viewed by 4339
Abstract
Pharmacy personnel often answer telephones to respond to pharmacy customers (subjects) who received messages from automated systems. This research examines the communication process in terms of how users interact and engage with pharmacies after receiving automated messages. No study has directly addressed automated [...] Read more.
Pharmacy personnel often answer telephones to respond to pharmacy customers (subjects) who received messages from automated systems. This research examines the communication process in terms of how users interact and engage with pharmacies after receiving automated messages. No study has directly addressed automated telephone calls and subjects’ interactions. The purpose of this study is to test the interpersonal communication (IC) process of uncertainty in subjects in receipt of automated telephone calls ATCs from pharmacies. Subjects completed a survey of validated scales for Satisfaction (S); Relevance (R); Quality (Q); Need for Cognitive Closure (NFC). Relationships between S, R, Q, NFC, and subject preference to ATCs were analyzed to determine whether subjects contacting pharmacies display information seeking behavior. Results demonstrated that seeking information occurs if subjects: are dissatisfied with the content of the ATC; perceive that the Q of ATC is high and like receiving the ATC, or have a high NFC and do not like receiving ATCs. Other interactions presented complexities amongst uncertainty and tolerance of NFC within the IC process. Full article
(This article belongs to the Special Issue Communication in Pharmacy Practice)
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10 pages, 390 KiB  
Article
Patient Education on Oral Anticoagulation
by Emily M Hawes
Pharmacy 2018, 6(2), 34; https://doi.org/10.3390/pharmacy6020034 - 20 Apr 2018
Cited by 17 | Viewed by 7927
Abstract
Given the potential harm associated with anticoagulant use, patient education is often provided as a standard of care and emphasized across healthcare settings. Effective anticoagulation education involves face-to-face interaction with a trained professional who ensures that the patient understands the risks involved, the [...] Read more.
Given the potential harm associated with anticoagulant use, patient education is often provided as a standard of care and emphasized across healthcare settings. Effective anticoagulation education involves face-to-face interaction with a trained professional who ensures that the patient understands the risks involved, the precautions that should be taken, and the need for regular monitoring. The teaching should be tailored to each patient, accompanied with written resources and utilize the teach-back method. It can be incorporated in a variety of pharmacy practice settings, including in ambulatory care clinics, hospitals, and community pharmacies. Full article
(This article belongs to the Special Issue Communication in Pharmacy Practice)
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13 pages, 9817 KiB  
Article
Assessing the Understanding of Pharmaceutical Pictograms among Cultural Minorities: The Example of Hindu Individuals Communicating in European Portuguese
by Lakhan Kanji, Sensen Xu and Afonso Cavaco
Pharmacy 2018, 6(1), 22; https://doi.org/10.3390/pharmacy6010022 - 5 Mar 2018
Cited by 10 | Viewed by 5023
Abstract
One of the sources of poor health outcomes is the lack of compliance with the prescribed treatment plans, often due to communication barriers between healthcare professionals and patients. Pictograms are a form of communication that conveys meaning through its pictorial resemblance to a [...] Read more.
One of the sources of poor health outcomes is the lack of compliance with the prescribed treatment plans, often due to communication barriers between healthcare professionals and patients. Pictograms are a form of communication that conveys meaning through its pictorial resemblance to a physical object or an action. Pharmaceutical pictograms are often associated with a better comprehension of treatment regimens, although their use is still subject to limitations. The main goal of this study was to examine the potential understanding of pharmaceutical pictograms by a cultural minority when providing patient information while comparing the effectiveness of two reference systems (United States Pharmacopeia USP and International Pharmacy Federation FIP) for this purpose. A self-administered questionnaire was developed comprising 30 pictograms, 15 selected from the United States Pharmacopeia Dispensing Information and the equivalent from the International Pharmaceutical Federation. The questionnaire comprised plain instructions, socio-demographic data, self-reported language fluency and pictogram labels in Portuguese presented to conveniently selected members of the Hindu community of Lisbon (Portugal) until reaching a quota of 50. Participants showed difficulties in understanding some pictograms, which was related to the self-reported reduced fluency in Portuguese. Overall, the interpretation of USP pictograms was better than FIP ones, as well as for pictograms composed of multiple images, presenting a negative reading, or when conveying information unrelated to medication instructions. Even using internationally validated pictograms, added care should be taken when community pharmacists use such communication resources with cultural minorities. It is important not to disregard other forms of patient communication and information, considering pictograms as a complement to other forms of patient counselling. Full article
(This article belongs to the Special Issue Communication in Pharmacy Practice)
14 pages, 366 KiB  
Article
The Introduction of a Full Medication Review Process in a Local Hospital: Successes and Barriers of a Pilot Project in the Geriatric Ward
by Lies De Bock, Eline Tommelein, Hans Baekelandt, Wim Maes, Koen Boussery and Annemie Somers
Pharmacy 2018, 6(1), 21; https://doi.org/10.3390/pharmacy6010021 - 28 Feb 2018
Cited by 11 | Viewed by 7704
Abstract
For the majority of Belgian hospitals, a pharmacist-led full medication review process is not standard care and, therefore, challenging to introduce. With this study, we aimed to evaluate the successes and barriers of the implementation of a pharmacist-led full medication review process in [...] Read more.
For the majority of Belgian hospitals, a pharmacist-led full medication review process is not standard care and, therefore, challenging to introduce. With this study, we aimed to evaluate the successes and barriers of the implementation of a pharmacist-led full medication review process in the geriatric ward at a local Belgian hospital. To this end, we carried out an interventional study, performing a full medication review on older patients (≥70 years) with polypharmacy (≥5 drugs) who had an unplanned admission to the geriatric ward. The process consisted of 3 steps: (1) medication reconciliation upon admission; (2) medication review using an explicit reviewing tool (STOPP/START criteria or GheOP3S tool), followed by a discussion between the pharmacist and the geriatrician; and (3) medication reconciliation upon discharge. Ethical approval was obtained from the Ethical Commission of the Ghent University Hospital. Outcomes included objective data on the interventions (e.g., number of drug discrepancies; number of potentially inappropriate prescriptions (PIP)); as well as subjective experiences (e.g., satisfaction with service; opinion on inter-professional communication). There was a special focus on communication aspects within the introduction of this process. In total, 52 patients were included in the study, taking a median of 10 drugs (IQR 8–12). Upon admission, 122 drug discrepancies were detected. During medication review, 254 PIPs were detected and discussed, leading to an improvement in the appropriateness of medication use. The satisfaction of community pharmacists concerning additional communication and the satisfaction of the patients after counselling at discharge were positive. However, several barriers were encountered, such as the time-consuming process to gather necessary information from different sources, the non-continuity of the service due to the lack of trained personnel or the lack of safe, electronic platforms to share information. The communicative and non-communicative successes and hurdles encountered during this project need to be addressed in order to improve the full medication review process and to strengthen the role of the clinical pharmacist. Full article
(This article belongs to the Special Issue Communication in Pharmacy Practice)
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7 pages, 665 KiB  
Article
Establishing a Pharmacy-Based Patient Registry System: A Pilot Study for Evaluating Pharmacist Intervention for Patients with Long-Term Medication Use
by Manabu Akazawa, Akiko Mikami, Yuri Tamura, Natsuyo Yanagi, Shinichi Yamamura and Hiroyasu Ogata
Pharmacy 2018, 6(1), 12; https://doi.org/10.3390/pharmacy6010012 - 25 Jan 2018
Cited by 8 | Viewed by 6403
Abstract
Background: In Japan, an increasing number of patients are prescribed a large amount of long-term medications by large hospitals that are then dispensed by a community pharmacy. This practice often leads to considerable wastage of medicine. As part of their professional role, community [...] Read more.
Background: In Japan, an increasing number of patients are prescribed a large amount of long-term medications by large hospitals that are then dispensed by a community pharmacy. This practice often leads to considerable wastage of medicine. As part of their professional role, community pharmacists are expected to contribute more to the appropriate use of medication by patients. Using a prospective cohort, we aimed to evaluate pharmacists’ role in the community. Methods: We created a patient registry system for community pharmacies to monitor long-term medication use by patients with chronic conditions. Patient drug adherence and potential problems were monitored through regular home visits or telephone calls by the pharmacist at least once a month between patient hospital visits. Patient data were collected and stored in an internet-based system. Results: Over a one-year follow-up, 28 out of 37 registered patients from 14 community pharmacies were continuously monitored. In total, we extracted 19 problems relating to medication use, 17 to physical complaints, eight to patient concerns, and two others. Conclusion: The registry system was useful for identifying medication-related problems as well as patient concerns and changes in their condition. Pharmacists might play a key role in improving patient care in the community. Full article
(This article belongs to the Special Issue Communication in Pharmacy Practice)
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729 KiB  
Article
Barriers and Facilitators for Information Exchange during Over-The-Counter Consultations in Community Pharmacy: A Focus Group Study
by Liza J Seubert, Kerry Whitelaw, Fabienne Boeni, Laetitia Hattingh, Margaret C Watson and Rhonda M Clifford
Pharmacy 2017, 5(4), 65; https://doi.org/10.3390/pharmacy5040065 - 6 Dec 2017
Cited by 23 | Viewed by 6909
Abstract
Consumers are confident managing minor ailments through self-care, often self-medicating from a range of over-the-counter (OTC) medicines available from community pharmacies. To minimise risks, pharmacy personnel endeavour to engage in a consultation when consumers present with OTC enquiries however they find consumers resistant. [...] Read more.
Consumers are confident managing minor ailments through self-care, often self-medicating from a range of over-the-counter (OTC) medicines available from community pharmacies. To minimise risks, pharmacy personnel endeavour to engage in a consultation when consumers present with OTC enquiries however they find consumers resistant. The aim was to determine stakeholder perspectives regarding barriers and facilitators for information exchange during OTC consultations in community pharmacies and to understand the elicited themes in behavioural terms. Focus groups were undertaken with community pharmacist, pharmacy assistant and consumer participants. Independent duplicate analysis of transcription data was conducted using inductive and framework methods. Eight focus groups involving 60 participants were conducted. Themes that emerged indicated consumers did not understand pharmacists’ professional role, they were less likely to exchange information if asking for a specific product than if asking about symptom treatment, and they wanted privacy. Consumers were confident to self-diagnose and did not understand OTC medicine risks. Pharmacy personnel felt a duty of care to ensure consumer safety, and that with experience communication skills developed to better engage consumers in consultations. They also identified the need for privacy. Consumers need education about community pharmacists’ role and responsibilities to motivate them to engage in OTC consultations. They also require privacy when doing so. Full article
(This article belongs to the Special Issue Communication in Pharmacy Practice)
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154 KiB  
Article
Assessment of Prescribing and Monitoring Habits for Patients Taking an Antiarrhythmic and Concomitant QTc-Prolonging Antibiotic
by Kelsey Noss, Sandra M. Aguero and Travis Reinaker
Pharmacy 2017, 5(4), 61; https://doi.org/10.3390/pharmacy5040061 - 1 Nov 2017
Cited by 2 | Viewed by 3487
Abstract
Patients may intermittently require antimicrobial therapy with a QTc-prolonging antibiotic, which presents a challenge for prescribers of patients already taking a QTc-prolonging antiarrhythmic. Manufacturers recommend close monitoring for evidence of QTc-prolongation with the concomitant use of QTc-prolonging medications, but the monitoring parameters are [...] Read more.
Patients may intermittently require antimicrobial therapy with a QTc-prolonging antibiotic, which presents a challenge for prescribers of patients already taking a QTc-prolonging antiarrhythmic. Manufacturers recommend close monitoring for evidence of QTc-prolongation with the concomitant use of QTc-prolonging medications, but the monitoring parameters are not well-defined. Previous studies recommend a surveillance electrocardiogram (EKG) be completed both before and after the initiation of QTc-prolonging medications, but it is unknown to what degree EKGs displaying the QTc-interval are used to alter physician order entry and pharmacist order verification during concomitant therapy. A retrospective chart review was conducted between October 2015–September 2016 to assess prescribing and monitoring habits for patients taking an antiarrhythmic and a concomitant QTc-prolonging antibiotic. Of the 42 patients who received at least one dose of two QTc-prolonging agents, 36 (85.7%) received a baseline EKG, and 23 (63.8%) received a follow-up EKG. Pharmacists intervened on this drug–drug interaction and recommended follow-up EKGs only three times (8.3%) and offered alternative therapy recommendations once (2.8%). The QTc-interval was not optimally monitored in some instances for patients concomitantly receiving two QTc-prolonging agents. These results stress the importance of inter-professional communication to place an emphasis on follow-up monitoring or use of alternative therapy agents to avoid the drug–drug interaction altogether. Full article
(This article belongs to the Special Issue Communication in Pharmacy Practice)

Other

Jump to: Editorial, Research

8 pages, 563 KiB  
Concept Paper
Patient-Centered Communication
by Cynthia A. Naughton
Pharmacy 2018, 6(1), 18; https://doi.org/10.3390/pharmacy6010018 - 13 Feb 2018
Cited by 68 | Viewed by 37587
Abstract
As the population ages, morbidity and mortality associated with chronic disease will increase. Some patient-centered improvements have been made in health care services, but optimal health has not been fully realized. Only when pharmacists have a holistic understanding of an individual patient, including [...] Read more.
As the population ages, morbidity and mortality associated with chronic disease will increase. Some patient-centered improvements have been made in health care services, but optimal health has not been fully realized. Only when pharmacists have a holistic understanding of an individual patient, including their experience of illness and medication, can they effectively assess appropriateness, safety, efficacy, and adherence to medications and develop realistic treatment plans. When patients are involved in their care, they are better able to manage complex chronic conditions by understanding and adhering to their plan of care. Pharmacists can enable patients to participate fully using patient-centered communication. There are relatively few published articles on patient-centered communication specific to pharmacists, but the Calgary-Cambridge guide and Four Habits model have applicability to pharmacy practice. The Patient-Centered Communication Tools (PaCT), created for use in pharmacy education and loosely based on the Four Habits model, can assist pharmacists in developing their patient-centered communication skills. Lastly, best practices for patient-centered communication in pharmacy practice are described. Full article
(This article belongs to the Special Issue Communication in Pharmacy Practice)
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