Role of Pharmacist in Health

Education and Patient Counselling

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DEFINITIONS

 The National Conference on Preventive

Medicine [USA]

Health education is a process which

informs, motivate and helps people to
adopt and maintain healthy practices and
life styles; advocates environmental
changes as needed to facilitate this goal
and conducts professional training and
research to the same end.

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 WHO Definition

Health education, like general education, is

concerned with changes in knowledge,
feelings and behaviour of people. In its most
usual forms, it concentrates on developing
such health practices as are believed to
bring about the best possible state of well
being.

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AIMS OF HEALTH
EDUCATION
 To inform the general public of the
principles of physical and mental hygiene
and methods of preventing avoidable
diseases.
 To create an informed body of opinion and

knowledge. (social workers, teachers)

 To give the public accurate information of

medical discoveries.
 To facilitate the acceptance and proper

usage of medical measures.

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METHODS OF APPROACHES IN HEALTH
EDUCATION

1. Legal or Regulatory Approach

2. Administrative or Service Approach

3. Educational Approach

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Legal or Regulatory Approach

 Makes use of the law to protect the health of

the public.
 E.g. : Epidemic Diseases Act , Pollution Act
 Limitations :

1. Applicable only at certain times or

limited situations.
2. They may not alter the behaviour of the
individual.

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Administrative or Service Approach

 Intends to provide all the health facilities

needed by the people.

 ‘felt needs of people’.

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Educational Approach
 Most effective
 Components :

1. Motivation
2. Communication
3. Decision making

• Results slow , but permanent and enduring.

• Sufficient time for an individual to bring about
changes
• Learning new facts as well as unlearning wrong
information as well.

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CONTENTS OF HEALTH EDUCATION

1. Human Biology
2. Nutrition
3. Hygiene
4. Family Health Care
5. Control of Communicable and Non-
Communicable Diseases
6. Mental health
7. Prevention of Accidents
8. Use of Health Services

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Human Biology

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Nutrition

 Forprevention of malnutrition.
 Teaching nutrient value of food stuffs.
 Method of preparation , storage.
 Help people to choose balanced diet.

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Hygiene

Personal Environmental

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Family Health Care
 Strengthen and improve the health of the
family as a unit rather than as an individual.
 Maternal and child health care, family

planning, immunization, nutrition, etc.

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Control of Communicable and
Non-Communicable diseases

 Provideelementary knowledge about the

nature of the diseases and methods of
preventing them.

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Mental Health
 Depression, neurosis, mental anxiety and
emotional disturbances
 Basic knowledge of common psychological

ailments, its detection, methods of

prevention and treatment.

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Prevention of Accidents
 People
taught about basic safety rules and
prevent common accidents.

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Use of Health services
 People should be informed about various
health services and preventive programmes
available to them.

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Community leaders
 Leaders can be used to reach people of the
community and to convince them about the
need for health education.

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HINDRANCES OR BARRIERS IN
PROCESS OF COMMUNICATION
 Psychological barriers
 emotional disturbances
 depression
 neurosis
 Physiological barriers

 difficulties in self-expression
 difficulties in hearing or seeing
 difficulties in understanding

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HINDRANCES…
 Environmental barriers
 excessive noise
 difficulties in vision
 congested areas
 Cultural barriers

 persistent patterns of behaviour, habits,

beliefs, customs, attitudes, religion, etc.

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EDUCATIONAL AIDS USED IN
HEALTH EDUCATION
1. Audio aids

2. Visual aids

3. Combination of Audio-Visual aids

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Audio Aids
o megaphones
o public addressing systems or
microphones
o Gramophone records
o Tape recorders
o Radios
o Sound amplifiers

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Visual Aids
 Based on principles of projection
Projected aids – needs projection from a
source on to a screen
 films or cinemas
 film strips
 slides
 overhead projectors
 epidiascopes
 transparencies
 bioscopes
 video cassettes
 silent films

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Non-projected Aids – do not require
projection
 blackboard
 pictures
 cartoons
 photographs
 posters
 flashcards
 charts
 brochures
 models

Other aids – traditional media which makes use of light and

sound stimuli
 Folk dances and Folk songs
 Puppet shows
 Dramas

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Combination of Audio-Visual Aids

 Modern media available

 Sound & sight combined together to create a
better presentation
 televisions
 tape and slide combinations
 Video Cassette Players and Recorders
 Motivation pictures or Cinemas
 Multimedia Computers

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HEALTH EDUCATION FOR THE GENERAL PUBLIC

 Mass communication literally means

communication that is given to a community
where the people gathered together does not
belong to one particular group.
 Advantages

 large no. of people can be reached

 people of all socio-economic status
irrespective of their caste, creed and religion
 Medias

televisions, radios, posters, news papers, etc

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ESSENTIALS OF HEALTH EDUCATON TO THE
PUBLIC

1. Accuracy and Truth

2. Presentation must be simple

3. Health education should be factual

4. Principles of health should be taught

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PATIENT
COUNSELLING

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 What is patient
counselling
 Providing the following to patients

1. Information
2. Advice
3. Assistance

 WHY is patient counselling

needed ?: So that patient use their
medication properly

Safe & Effective drug-therapy depends on patient being

well-informed about their medication 29
What is patient
counselling
 Understand patient illness & medications
prescribed.
 Personalized advice on taking
medications.
 Provide advise to lifestyle change.
 This is done to ensure that medications

taken with be SAFE & EFFECTIVE.

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Effective patient
counselling

Effective Patient
counselling
REQUIRES

Effective
Understand disease,
communication
pathophysiology
skills
Pharmaco-therapeutics

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Effect of lack of
counselling
 Patients on not clear on how to use
medicines (when to take, how long to take,
what to do when missed etc.)
 This results in

1. Therapeutic failure
2. Adverse events
3. Avoidable additional treatment & cost

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Need for Patient
Counseling
 Reduces errors in using medication
 Reduces non-compliance
 Reduces adverse drug reactions
 Improves outcome
 Increases patient satisfaction
 Assists patient in self-care
 Reduces healthcare costs to patient, hospital,
government and society
 Assists in non-related situations emotional
problems
 Is an integral part of patient-centered pharm care
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Effective counselling will
result in ..
 Better patient understanding of their
illness
 Role of medication in treating illness
 Improved compliance/adherence
 Reduced incidence of adverse events (AE)
 Improved quality of life
 Better strategy for patients to handle

drug related AE

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Communication skills important
for effective counselling

Verbal

Langua
Tone Volume Speed
ge

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Communication skills important
for effective counselling

Verbal
 Simple, easy to
Langua
Tone Volume Speed understand
ge
 Avoid medical
jargon
 Prefer patient own
language

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Communication skills important
for effective counselling

Verbal
 Tone tells a lot
Langua
Tone Volume Speed about the person
ge
speaking
 Caring, assuring

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Communication skills important
for effective counselling

Verbal
 Stable volume
Langua
Tone Volume Speed
 Avoid high volume
ge
 Ideally in a quiet
setting

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Communication skills important
for effective counselling

Verbal
 Rate of speech
Langua
Tone Volume Speed should be
ge
moderate
 Clear message in
a logical
sequence
 This helps patient
understand what
is being said 39
Communication skills important
for effective counselling

 Body language
(movement of
Non- hands, limbs etc.)
Verbal
 Dressing
Facial
Eye
Distance expressi
contact
on
Did you know:
almost 50% of
message is
received in
NON-Verbal
manner
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Communication skills important
for effective counselling

Patient Patient

Non-
Verbal
Facial
Eye
Distance expressi
contact Private <= 45
on
cm
Person 45 –
al 1.2 m
Social 1.2 –
3.6 m
Public > 3.6 41
Communication skills important
for effective counselling

Non-Verbal
 Patient sensitive to
eye contact
Facial  Cultural issues
Eye
Distance expressi
contact
on matter

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Communication skills important
for effective counselling

Non-  Can be used to show

Verbal
empathy
Facial  Head, hand
Eye
Distance expressi
contact
on movements can be
used to signal empathy
as well

Empathy: The ability to identify with or understand another's

situation or feelings 43
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Steps during counselling

Preparing for session

Opening the session

Actual Counselling
session

Closing the session

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Preparing for counselling
session
 Success of session depends on Skill &
Knowledge of pharmacist.
 Through review of patient medical history,
medication records.
 Different sources can be used such as Hospital
records, community pharmacy drug dispensing
records.
 Pharmacist needs to have a good understanding
of pathophysiology & drug that are prescribed.
 References such as “Drug Information
Reference” should be consulted before hand.

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 Opening the session
 At start of session, focus on information
gathering from patient.
 Introduction from pharmacist, make the patient
comfortable.
 Greetings followed by intro & state objective of
meeting.
 Seek information from patient regarding his
medication, understanding of his disease.
 Other supplementary information such as ;
previous allergies, past medications, smoking,
alcohol history etc.

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 Opening the session
 How to get information from patient:
 Open ended questions helpful.
 Q on patient understanding of disease:
 What symptoms are you experiencing ?
 What did your doctor tell you about the disease ?

 Q on patient understanding of his/her medication:

 What did your doctor tell you about this
medication ?
 Reflective Questions also help
 Did these tablets help you last time, did you feel
better ?

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 Opening the session
 Be aware of patients mental state, does
he/she want to talk ??
 Try to empathize with patient, speak in a

reassuring tone
 Avoid being aggressive, personal, intrusive

questioning
 If the patient is getting aggressive, stop

the session

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 Counselling content

The main part (Heart) of session
 Pharmacist speaks about medication & lifestyle
changes
 Typical topics covered

1. Name/Strength of drug

2. How long, how to be taken

3. Expected benefits, time frame

4. Possible side effects

5. Possible interactions

6. What to do if missed dose

7. Special monitoring requirements

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 Counselling content
 The main part (Heart) of session
 Pharmacist speaks about medication & lifestyle

changes
 Counselling in simple language

 Medical jargon should be avoided

 In some cases, the advice given to family members

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 Closing the session

Before ending, important to know patients
understanding of his medication
 This usually done by asking simple questions

 Example: Which is the blood pressure drug, how

many will you take in a day , which one after

meal ?

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 First timers
 Getting confidence for young pharmacist is
important before session
 Advisable to listen to sessions by senior

pharmacists
 Start with limited counselling sessions

 Develop expertise in one area & then move to

other (Antibiotics etc.)

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 Prioritize counselling
 Most of the time, pharmacist are too busy
 They need to prioritize which category

of patients to counsel
 typically the focus groups are

1. Special medication group

2. Complex medication (TB, HIV regimens)
3. Specialized delivery drugs (Rotahalers)
4. Elderly patients on many drugs
(polypharmacy)

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 Counselling aids
 Develop teaching, educational aids.
 In addition to live Counselling.
 Good for follow up reading by patients.
 Medication card : useful aid, has
summary of drugs.
 Easy format, patient can understand.
 Pharma companies draft “Consumer
Product Info”.
 Pharmacist can also draft simple product

info.
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THANK YOU

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