Patient Counseling-Environment

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Dear Friends
I am sure you will all agree with me if I say that packaging is very important for pharmaceuticals and often, whether a medicine is elegantly packaged or not could mean the difference between its commercial success or failure. Similarly, the success or failure of a counseling session may depend, among other things on the environment where counseling is taking place.
In a community pharmacy setting, there should be a cubicle where privacy or atleast semiprivacy is available for the patient and the pharmacist where they can conduct the session comfortably. In a hospital setting, for outpatients, there should be a big room, where a good number of pharmacists are available, to give counseling to patients. This is because, in all big hospitals, quite a big number of patients come everyday for OP and it is not possible for one or two pharmacists to give them counseling. In hospital wards, the pharmacist may stand by the side of the patient's bed and give him counseling. (1)

The area where counseling is taking place must be neat and clean. There should be enough furniture like tables and chairs. Noise pollution should not be there. Drug information books like USPDI volumes, CIMS, Journals of hospital pharmacy , a computer with databases and most important of all, information to be told to the patient in a processed manner, ready in the form of just one card or sheet for each medicine should be available in the patient counseling room. When a pharmacist is doing counseling, if he gets a doubt, he should be able to quickly refer a sheet of prepared material, with which he is already acquainted.
Any audiovisual aids will add to the impact of counseling. Models and charts that are seen in the rooms of doctors may be used here also. If we do counseling based on a brochure/pamphlet and then give it to the patient- it would be perfect.
To old people, we must clearly tell at what time points they should take the medicine. We must ask them for their daily routine and work with them about how they should space their medicines.
For example, suppose a middle aged lady comes with medicines in her hands to the counseling room. In her medicines, there is an antihypertensive, an antibiotic, vitamins and oral iron medication. After giving all other aspects of counseling and after discussing her routine with her, we may fix the following schedule for her.
Take the antihypertensive half an hour after breakfast, in the morning, say at 8.30 am.
Take the antibiotic one hour after the antihypertensive, at 9.30 am. (This is to avoid possible drug interactions between the two, since antihypertensives are especially known to have pharmacokinetic drug interactions with many other drugs.).
Take the vitamins after lunch.
Take the antibiotic at 9.30 pm. (For antibiotics, even spacing in time is important and completing the course is important).
Take the oral iron at 10 pm before going to bed.
So, I conclude by saying that the environment in the counseling room must be very soothing and pleasant so that the advice given by the pharmacist becomes effective and results in better healthcare.

Reference:
1. Proceedings of the National seminar on Clinical and Hospital pharmacy, 17th and 18th October, 1999, page 37.
This blog is not containing any plagiarized material.

Bad Patient Counseling Example

http://www.youtube.com/watch?v=OHiovB-JuJw

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About the Author

Prof. J. Vijaya Ratna's picture

Dr. Vijaya Ratna Jayanthi serving Andhra University College of Pharmaceutical Sciences as Chairman, Pharmaceutical Technology Department.

Dr. J. Vijaya Ratna did her B.Pharm (1977), M.Pharm (1979), PGDAS (1981) and Ph.D (1998) at Andhra University Campus and won "M.L. Khorana Gold Medal" for standing University FIRST in graduation.

Comments

Bhupendra's picture

Dear Madam, You presented here a very good blog theoretically. But it is practically not possible. First reason is as you mentioned that there should be a big room were good number of pharmacists are available can not be done in Govt. settings. Reason is pharmacy which is very important place in a govt. hospital hardly finds its proper place. It is mostly run under some temporary shed type setup. When a hospital building is planned sufficient space is given to pharmacy but soon after hospital starts functioning pharmacy is restricted to a congested place. In hospitals no temperature is maintained for medicines. Almost all medicines should be stored below the temperature of 30 degree but in summer temperature reaches upto 40 degree and resulting deterioration of quality of medicines. When administration can not install A/c for maintenance of temperature for medicines then how can the spare another room. And in govt. hospital counseling is not possible by the same pharmacist who is dispensing the medicines. If we need that the same pharmacist should do counseling also then there is need of increasing number of pharmacist upto 5 times then the present number.

General Secretary Indian Pharmacist Association (IPA) http://www.ipa.medlineindia.com

Prof. J. Vijaya Ratna's picture

Dear Mr. Bhupendra I agree with you regarding the practical situation in Govt. Hospitals. What I am trying to show is how it should be and how we can make it. We (our college) is presently working on patient counseling in KGH. We are taking our Final year students to KGH, every Thursday, and we are practising patient counseling. I am writing what we are actually doing. Coming to the maintenance of the drug store, our KGH is not so bad but nor is it maintained in an ideal manner. I have seen an ideally maintained Drug Store in Visakha Steel General Hospital in Visakhapatnam. There are many reasons why things are not properly done in our Govt. hospitals. I accept that a single pharmacist cannot do both dispensing and counseling. a minimum of five pharmacists are required, two for dispensing, two for quick routine counseling and one for counseling where some elaborate counseling is required. I hope you agree that patient counseling is needed and that it is good to know the ideal situation. Vijaya Ratna
Bhupendra's picture

Dear Madam, I completely agree that there is need of counseling for patients. This will not only benefit patients but also help in gaining reputation amongst patients, health system and society at the same time. Hope administrator will understand the need of counseling and do the needful for the same.

General Secretary Indian Pharmacist Association (IPA) http://www.ipa.medlineindia.com

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