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OSCE GENERAL PROTOCOOL (RX)

Introduction and Empathy:

1. Hello! My name is Mehdi. I am the Pharmacist. How may I help you?

2. Please have a sea in our private counseling area. Whatever we discuss will remain confidential.

3. How are you today?

Identify the patient:

4. Is this medication for yourself? (Depending on what patient says)

Do you have a consent with your daughter/wife to pick-up his Rx?

5. May I know your name?

6. Can I ask few questions about your medical condition and social life style?

Reason for visiting the doctor:

7. What made you to see your doctor / Why did you visited your doctor.

I am sorry to hear that / It must be hard for you/ I see that you look worried / Sad. I can imagine.

For OTC:

Symptoms and Red Flags

• Can you tell me symptoms in detail? / • What else? / • How would you rate your pain?

• Rule out red flags / • Is there anything else you would like to share with me?

3 essential questions

• Did you speak with your doctor about this condition? If yes, what did he advice?

• Is it the first time you are experiencing this symptoms? If no, how did you manage it before?

• Did you try any medication?

Allergy:

8. Are you allergic to any medications?

What happens when you take this medication?

Any allergy to other medications? (If having allergy with particular medication)

9. Any food and environmental allergy?


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Information gathering / Medical History Taking:

10. Your doctor name is .....................

11. Do you have any other medical condition like BP, cholesterol, diabetes?

Do you have a family history of this condition? (Like diabetes, HTN)

Always ask patient’s medical condition like Type 1 diabetes + vomiting (any nail polish smell)

I saw your profile;

Are you taking these medications regularly as per your dr. recommendation? (Name of medications)

How you are taking these medications?

Have you ever seen any Side effects of these medications? (If using any other medication)

12. Are you taking any other Rx medication?

13. Any over the counter medication like Advil and Tylenol?

14. Any herbal or multivitamins.

If it is woman, of child bearing age 18-48, you must ask about pregnancy and breast feeding.

15. Are your pregnant or breast feeding?

16. Which trimester?

To know if the patient is sexually active:

17. This may not be applicable to you, but may I ask, if you are sexually active?

Social habits and Life Style:

18. Can I few questions about your life style?

19. Do you drink caffeinated products like tea, coffee and cola?

20. How about alcohol? (No amount of alcohol is recommended in pregnancy).

21. Do you smoke?

22. How is your diet?

If the patient’s lifestyle is good and healthy it is a good idea to appreciate it. That's great or very good.

23. Do you get time for exercise?

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That’s great / Keep it up / Excellent

Do you wearing contact lenses.

For Child:

If the patient is a child, please leave out smoking and drinking (Alcohol):

Is your child exposed to any second hand smoke or are there any pets in the house (especially I respiratory
associated innless)

Is you child active? / Is he attending day care?

Is he involved in sports and games?

Ask permission to check reference:

24. Can I check my reference?

25. Thanks for waiting.

Is there is any thing else, you want to share with me, so that I can help you in a better way?

Did I answer your question?

BEOFRE COUNSELLING, SOLVE PATIENT’S CONCERN.

Counseling (RX and OTC)


For RX:

26. What did your doctor tell you about the medication?

Did your dr. knows that you are using these medication?

Does your dr. tell you to stop or continue these medication?

Brand name, generic name, strength, dosage and frequency (Sign), route of administration:

Your doctor has prescribed …………… for your BP, which contains ………….. in a strength of
………..mg. Your doctor wants you to take one Tablet once a day at the same time every day for _____
days. / apply to affected area three times a day for 1 week.

For OTC:

OFFER CHOICE IF AVAILABLE: LIKE TABLET OR LIQ, DIFFERENT FLAVOURS, ALSO ASK IF YOU
HAVE ANY PRODUCT IN MIND.

As per my reference, I am recommending …………… for your fever, which contains ………….. in a
strength of ………..mg. You need to take by one tablets 3 times a day at the same time every day for
_____ days. / apply to affected area three times a day for 1 week.
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With or without food:

27. Take this medication with or w/o food. If you experience upsets stomach, take with food.

How you will take this medication?

Which time is convenient for you to take this medication?

It is very important to take this medication with food / empty stomach / 30 minutes before meal.

Purpose of medication / Mechanism of action / Onset of effect:

28. This medication is used for ………………. (Common use of medication)

29. This medication works by …………. (decreases some chemical in your brain).

This medication will manage your condition.

30. you may see the effect of this medication in few days / weeks………………. If no improvement,
contact with doctor.

SIDE EFFECTS:

Common side effects;

31. Common side effects of this medications are 1. ……………, 2. ……………… These side effects are
transient and will go away, when you are using this medication regularly.

If these side effects are bothers you, contact with your dr.

Rare side effects:

32. Rare side effects of this medication are 1. ……2. ……then contact with your doctor immediately.

Management of side effects:

• These side effects can be managed by ____

E.g. Since it may cause constipation: Eat fibre, drink plenty of water with regular exercise may help in your
condition.
E.g. Since it may cause drowsiness, please avoid driving or operate machinery.
E.g. Since it is hard on the stomach, make sure take it with food.
E.g. Since it may cause dizziness, avoid alcohol, change your posture slowly.
E.g. If nausea, drink plenty of water.

Taking medication first time / Warning for Anaphylaxis:

33. If you experience any rashes, hives, swelling of lips and SOB, that means you are allergic to any
ingredients of this medication, promptly stop the medication and go to emergency.

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Missed / discontinue medication / storage:

If you miss a dose, take it as soon as possible. If you are close to next dose, skip the missed dose and just
take the next dose.

Don’t discontinue this medication unless your doctor advice.

If you will not take this medication regularly, you may not get full benefit of this medication, therefore,
you may experience relapse of your condition.

34. Store in a cool and dry place at room temperature. (or refrigerator)

PRECAUTIONS: Interaction with food, beverages, or any other medication:

35. It is not advisable to use this medication with grape fruit juice, alcohol or any other medication.

Also don’t used over the counter medication without talking with pharmacist or doctor.

If severe reaction, say “AVOID”, otherwise “RESTRCITED”

Self-care measures / Non-medication measures, Disease management:

Self-care measures are equally important along with this medication like
- Exercise regularly / Socialize with family and friends / Sleep in a dark room.

Device counseling:

36. Provide step by step instructions for the use of devices.

Monitoring:

37. you may see the effect of this medication in few days/ weeks, If not, please contact with your doctor.

Follow up with doctor:

38. Do you have an appointment with your doctor. / When is your next appointment with your doctor?

Any question and concern:

39. Do you have any questions or concerns?

Follow up with patient:

40. Can I call you after --------- days to see how you are doing with this medication (depends upon
medication onset of action)

41. I am giving you a leaflet that explains more about this medication.

42. If you have any questions or concerns, please give us a call.

43. Thank you ___________ and take care. Have a nice day.
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Dr Station:

Dr. Thanks for selecting my pharmacy to discuss about patient medical condition and medication profile.

Do you have an idea about patient life style?

How is patient renal and kidney function?

Find reference on table. Read article.

Would you like to document this Rx.

Important points:

- You may experience racing of heart.


- Did he / she pooh
- Whatever, I discuss with you, it is concern with Robert
- Do you have any questions?
- This medication for / The person use or take

Metformin:

- Do you think, it is really bothersome to you?


- Which symptoms is really bothersome to you?
- I seems to me that you have diarrhea?

Other Points:

- With your permission, can I call your dr. Till that time don't use this medication.
- Do you understand Sara, what I told you?
- Am I clear John?

- Would you still consider this medication? (Risk Vs Benefit)


- What happen, if you will not use this medication. (S/E -- Fearness)
- What happen, if you will use this medication. (Overuse -- Gravol)
- Do you have any preference b/w these two products.

Advair: Steadily and deeply


Spiriva: Slowly and deeply
Turbuhaller (By mouth): Inhale forcefully and deeply
Turbuhaller (Nasal): Inhale forcefully and deeply
Suspension: Shake well before use.

In Asthma: Ventolin---- > 4 time/week (including exercise)---------- Refer


In COPD: Ventolin---- > 8 time/day ---------- Refer

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