WC Publication Part 1

Sorry, I have no time yet to include my opinions here. I just took some random notes that probably useful to share with you all, then we can discuss over this if you're interested :) Part 2 will be coming soon.

Workshop 1: PCE (Patient Counseling Event)
Speaker: Eric

PRINSIPLES: short, concise, private, good flow

1. Introduction

•Introduce yourself
•State the need for a counsel or offer help
•Time factor
•Privacy

2. Information gathering – Therapy Counseling

Clarify therapy for proper drug counsel
1. Drug interaction
2. Contraindication
3. Indication
4. Special instructions
5. Adverse effect: common, rare

Questions might be:
1. Who is it for?
2. What did the doctor say, diagnosis, signs, and symptoms (confirm indication)
3. Allergies, other medical conditions, other met/otc/herbals (confirm safety)
4. Other info: weight, compliance issue, smoking, alcohol consumption, recreational drugs, pregnant/breastfeeding

How to ask?
- Open ended questions
- Ask professionally preface question with the reason for asking. Relate therapy to questions. Use also sympathetic words

Drug Information
Name
Interaction
Dosage
Side effects
Instruction Monitoring – what they should expect

Medical condition information
• Disease state
• Nature of condition and progression
• Signs and symptoms

Adherence, safety, and efficacy
 Monitoring points
- What to expect, when to expect, and action point
- Allows for realistic expectations
- Action points: follow up with doctor? Change regiment?
- Monitoring points for improvements and side effect, interaction

Monitoring points improve adherence and clinical outcomes
- Gives realistic expectation of results
- Empowers patient self-monitoring
- Differentiation between side effects and disease signs
- Relate adherence to ‘silent conditions’ ie. Diabetes, blood pressure

Non-drug therapy recommendation  comprehensive care ie. Cough and cold : hand washing

Other points
- Drug interaction: counsel on monitoring points. Eg. What to do, what could happen, how to handle
- Storage of medications or pharmaceutics concern
- Unmeet needs
- Missed dose

3. Conclusion
• Address patients’ questions and concerns
• Repeat key points
• Ask patient to repeat back main points
• Call or schedule follow up
• Thank

Communication
Body language 60%
Verbal cue 30%
Verbal content 10%

Facial expression  Eye contact, body posture/language, motion and gesture
Medial Jargons  Tailor your counsel to the education and demographic background of your patient (ie. Blood pressure vs hypertention)
Empathy vs simphathy  “in the person shoes” vs feeling sorry for your patient
Listening do not talk over your patient, allow them to express concern

Workshop 2: Pharmaceutical Care and Cognitive Pharmaceutical Services
Speaker: Ema Paulino

If time really heals all wounds, then pharmacist would sell tons of clock

International issue  pharmacist do not want to involve in health thingy, there should be a multidisciplinary education before getting to practices, not separately study and graduated; most countries do not have this inter professional education.

‘Strength’ of Pharmacy is it does have science curriculum, others healthcare professional do not have it.

USA  this year stops selling tobacco in drug store; noticing the paradox among pharmacy roles and what they sell

Clinical and Community Pharmacy becomes problem for most of countries but the problem level would be different. For example, problem in Portugal is that the commitment of Pharmacists for giving counselling do not emerge yet though the system has developed; each pharmacist has to have private counseling room or table while Indonesia doesn’t have that system yet.

Portugal is the first country that do needle exchange for drug users along with condom to prevent HIV/AIDS. The pharmacists also has authority to administer immunization and injected drugs like USA and other Europe countries.

Pharmacist ideally has documents about the patient’s information and things related to medication so that they could monitor patients, unfortunately many pharmacists do not document the information.

Future pharmacist are expected to be paid for the impact of what they have done through process and outcome indicator. For instance the indicator would be reducing amputation for diabetes patients less than 20%, if it is achieved, the pharmacist will be paid. Others example would be percentage of blood pressure measurement in past 6 months, if pharmacist meet the parameter they get paid.  CAPITATION

In USA, they were about to do the new system  if patients returned to hospital within 30 days after discharged, the money back to government. But hospitals do not accept it so the hospital collaborate with community pharmacists to follow up or monitor the patients.

Inter professional Education has been a hot issue among health students and professionals. Before we talk about IPE, it will be better if we also talk to the pharmacists first as our partner that involve in hospital, industries, and retail pharmacies.

Portugal also has a problem what so called pharmacy crisis that pharmacists are still being profit-oriented. Even some pharmacies serve ear-piercing and hair band!Employers ideally has to fund the fees for pharmacists training kind of thing to improve the work of pharmacists.

Be connecting to pharmacists that have the same motivation with us!