Patient counseling- Theory Patient counseling, as the name implies, is simply advising the patient. It consists of a pharmacist advising a patient on how medicines are to be taken and how side effects, if they appear, are to be managed. This practice, as is clinical pharmacy practice, is not well-known in India. It is only in the last two decades, that the seeds of pharmacy practice were sown, first in south India, in JSS College of Pharmacy, Mysore and in JSS College of Pharmacy, Ooty. These colleges started pharmacy practice courses in collaboration with a hospital in Australia. So this heralded the practice of clinical pharmacy in India and patient counseling is an important part of pharmacy practice. Definition 1: Patient counseling is defined as supplying medication information orally or in writing to the patients or to their representatives, on the use of drugs, their side effects, and precautions in storage, diet requirements and life style modifications. Objectives of patient counseling: ? Patient compliance must increase. ? Patient must understand the need for the medication. ? Patient must get a confidence in the pharmacist's knowledge and reliability. If and when a need arises, patient must come back to the pharmacist. ? Patient must understand the strategies to deal with any side effects. ? Patient becomes an active participant in the treatment. ? Pharmacist must be seen as a professional. ? Adverse drug reactions and drug interactions must be prevented. Most important part of the entire exercise is that the pharmacist gives unbiased and authentic information in a most professional manner, with warmth and understanding. There are three stages in the patient counseling process; introduction, process (content, manner) and conclusion. Introduction: ? The pharmacist introduces himself and finds the name, age and medication information of the patient. ? The pharmacist explains the purpose of counseling and obtains information from the patient regarding any allergies, use of herbal medicines and any concerns the patient may have and patients understanding of the need for the therapy. Process: Content: ? The drug's generic name and brand name ? How the medicine helps the patient ? How the medicine will make the patient feel ? How long it takes to begin working ? How much should be taken at one time ? How often to take the medicine ? For how long to take the medicine ? When to take the medicine ? How to take it ? What to do if a dose is forgotten ? Foods or fruits or drinks or other drugs to be avoided while taking this medicine ? Restrictions on activities ? Most possible side effects ? How to deal with side effects ? When to report problems ? How long to wait before reporting no change ? Storage ? Expiration date ? Cost ? Refilling when necessary ? Necessity to complete the course ? Possible drug-drug or drug-food interactions ? Need for medication reminder chart Manner: ? Use of appropriate language which the patient understands ? Use of counseling aids, like charts and brochures ? Facts should be told in simple language in logical order Conclusion: ? Verify patient's understanding by feedback ? Emphasize key points ? Allow the patient to come forward with any concerns ? Help the patient to plan an action plan for follow up. Well, friends, when you look at the long lists under each sub heading, it looks rather frightening. But in reality it is not necessary that in each case we tell every point. The pharmacist has to deal with each situation as it appears, and to each patient he/she must tell the most necessary points. If a patient knows most of the points, as is the case with patients having chronic diseases, there is no need to repeat all the points. It is enough if we highlight the important points. In our coming blogs, we will develop the theoretical as well as the practical side of patient counseling much more and we will supply many more details. Reference: 1. Patient counselling, Ramesh Adepu, Proceedings of the National Seminar on Hospital and Clinical Pharmacy conducted by JSS College of Pharmacy, Mysore in October, 1999, pages, 36-38.