General+Structure

some fantastic info [|Website]This is just a general idea of the structure that counselling should take. It is not perfect, but following it should provide the patient with all the important points when taking their medication. If there is something that needs to be added, click 'Edit this page' and add any extra information. toc

=Introduction=

You should introduce yourself as the pharmacist, to ensure they know that they are speaking to the right person.
 * Introduce yourself** //Hi, I'm xxxxxx the pharmacist, how may I help you?//

Make sure the person you are talking to is picking up the particular prescription that you have
 * Confirm the patient** //Are you xxxxxx ?//

The person picking up the prescription may not be the person who is taking the medication. (e.g. A mother picking up Endone for their son with terrible back problems, who is not able to walk easily). Therefore this may determine whether you counsel in first or third person (you need to take it every morning; your son needs to take this every morning)
 * Is the medication for themselves?** //Is this for yourself?//

Not everyone has all the time in the world, so you have to determine whether they are in a rush (need to counsel only the real important points) or are able to stay for a bit longer (go through in more detail/ensure they understand everything)
 * Offer them the opportunity for counselling** //Do you mind if I spend a few minutes of your time while I go through your medications?//

=Questions=

Asking this will help you gauge their understanding of their medications. Quite often, all the patient knows is that 'the doctor told me it's for my heart', so at least you know that any points you go through won't be ones that they have already heard.
 * Ask them what the doctor has told them** //What has the doctor told you about the medication?//

It is good to list a few of the more relevant ones (any medications to thin the blood, for diabetes?), otherwise they might list ten drugs that are not relevant. This will help you determine any potential interactions or extra counselling points (space two hours apart)
 * Are you on any other medications?**

Same as above, and the drugs they list will guide you on what medical conditions they may have.
 * Do you have any other medical conditions?**

If they do, ask them what kind of reaction (delayed rash or immediate anaphylaxis) as this will determine whether that antibiotic is suitable for that person.
 * Do you have any allergies?**

=Medications=

Say 'slows down the heart' rather than 'acts as an antagonist at the beta-receptor to decrease sympathetic input to the heart'
 * Explain what the medication is for and how it works**

How much to take, what time(s) of the day, how often, other requirements (bisphosphonates)
 * Dosage**

Ensure that the patient may or may not experience the side effects listed, but they just need to be aware. What they are, what to do May need to list some rarer ones in some cases (angioedema for ACEi etc.) May need to add things that relate to other conditions (what to do in an asthma attack, what to do when experiencing a 'hypo')
 * Side effects**

=Advice=

If talking about diet and exercise, ask them 'what kind of foods do you eat?' and 'how often do you exercise?' rather than 'Do you have a good diet?' as what they think is sufficient may not be enough. How often to get checks by the doctor (BP, cholesterol, BGL, asthma action plan, podiatrist)
 * About the condition**

When to expect the medication to work Some drugs may make you feel worse to begin with (increased scaling in psoriasis creams due to increased sloughing off of skin cells)
 * What to expect**

Give them an opportunity to ask questions in case there were some things that were not understood or they have other concerns of their own.
 * Any questions?**

=Summary=

The patient remembers the first and last thing you say, so make sure what is included in the summary are the main points.
 * Summarise the dosage, checks with the doctor**

Always remember to give them something to read at home, in case they can't remember every single point throughout the talk. However, if this was real-life, you probably went through the counselling using the CMI (at least that's what happens at RAH).
 * CMI and Self-care Cards**


 * Offer follow-up** //If you have any questions or worries, don't hesitate to contact us or let your doctor know.//