patient counseling will help identify the issues specific to your practice. v
Table 3. Examples of effective versus ineffective counseling offers4 Effective Offers
Ineffective Offers
“The pharmacist would like to speak with you about your medication before you leave.”
“Do you have any questions?”
“The pharmacist would like to discuss with you some safety information about your medication.” “There is new information about your medication that the pharmacist would like to discuss with you.”
“Do you want counseling?”
program is essential to assure that continuous improvements have been made. Your pharmacy may decide to assess and trend the percentage of targeted prescriptions (e.g. narrow therapeutic index drugs) that included counseling. With such data, the pharmacist is able to assess and trend the number of offers that were accepted by patients over time. Analysis of these trends may help pharmacists understand where improvements are needed (i.e. pharmacist offers vs. patient acceptance). In addition, examining the causal factors and circumstances around potential and actual errors through a pharmacy’s QA program may reveal which of these errors were preventable with counseling. For example, the QA program can trend
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the number and type of errors that would have been prevented if counseling was done. Another trend to measure would be the number of potential errors that were detected at the time of counseling (i.e. pharmacy errors or patient errors). Through the implementation of a quality assurance program, this data may reveal how counseling would have prevented certain errors from occurring as well as any workflow changes needed to avoid repeating these errors. This article identifies ways of increasing the chance that patients will accept counseling offers, yet there may be other barriers and opportunities that are specific to your pharmacy. The implementation of a QA program with a special emphasis on
About the Author... Ranan Mustafa was a 2010 Doctor of Pharmacy candidate at UNC Eschelman School of Pharmacy when she wrote this article while completing a medication safety clerkship rotation with SecondStory Health, LLC in Carrboro, NC. References 1. North Carolina Board of Pharmacy. Pharmacy Rule 21NCAC 46.2504: Patient Counseling. Accessed March 15, 2010. http://www.ncbop.org/ LawsRules/Rules.pdf 2. Paluck E. et al. Assessment of communication barriers in community practices. Eval Health Prof. 2003; 26(4): 380-403. 3. Svarstad B. et al. Patient counseling provided in community pharmacies: effects of state regulation, pharmacist age, and busyness. J Am Pharm Assoc. 2004; 44(1): 22-29. 4. Flynn E. et al. Dispensing errors and counseling quality in 100 pharmacies. J Am Pharm Assoc. 2009; 49(2): 171-180. 5. North Carolina General Assembly. Article 4B: Pharmacy Quality Assurance Protection Act. Accessed March 15, 2010. http://www.ncga.state. nc.us/EnactedLegislation/Statutes/pdf/ByArticle/ Chapter_90/Article_4B.pdf 6. Resnik DB. et al. The conflict between ethics and business in community pharmacy: what about patient counseling. J Bus Ethics. 2000; 2: 179-186. 7. Hardin LR. Counseling patients with low health literacy. Am J Health Syst Pharm. 2005; 62(4): 364-365
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