Patient Communication and Medicines Management
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Lesson 2 of 13
Notes
Communication in Pharmacy Practice
Therapeutic communication is the foundation of effective pharmacy practice. Verbal communication skills include active listening, open and closed questioning, empathy, and the ability to explain complex information in plain language. Non-verbal cues — eye contact, body language, tone — significantly influence the pharmacist-patient relationship. Barriers to communication include health literacy deficits, language differences, hearing impairment, and emotional distress.
Medication review is a structured, critical examination of a patient's medicines. Levels of medication review range from simple prescription review (Level 1) to concordance and compliance review (Level 2) to clinical medication review (Level 3), where the pharmacist assesses efficacy, safety, and necessity of all medicines in the context of the patient's conditions. Polypharmacy (≥5 medicines) is a major challenge in the elderly and is associated with increased falls risk, adherence difficulties, and adverse drug reactions.
Adherence and Concordance
Adherence refers to the extent to which a patient's behaviour matches agreed recommendations. Non-adherence affects approximately 50% of patients with chronic conditions. Intentional non-adherence stems from concerns about necessity or side effects; unintentional non-adherence results from forgetfulness or complexity. Strategies to improve adherence include blister packaging (dose administration aids), simplifying regimens (once-daily formulations), patient education, and follow-up monitoring.
Over-the-Counter (OTC) Consultations
OTC consultations follow the WWHAM protocol: Who is the patient? What are the symptoms? How long have symptoms been present? Action already taken? Medicines being taken? The pharmacist must determine whether the presenting condition is suitable for self-care or requires referral. Red flag symptoms (e.g., chest pain, dysphagia, unexplained weight loss, blood in stool) always prompt urgent referral. The pharmacist has a duty of care to recommend the most appropriate treatment or referral pathway.