PHRM 3900:

Pharmacy Communications
Matthew Perri, Ph.D., R.Ph.
Professor of Pharmacy
Clinical and Administrative Pharmacy
Room 260C Ph:542-5365
mperri@mail.rx.uga.edu

Communications Toolbox

Notice this one is empty

Plan for today:

Course overview & introduction
ID Cards
Name, where you are from, any prior degrees, something about
yourself that will help me remember you

Course Web page

The pharmacy care process

OBRA 90 and Pharmacy Care
Common communication mistakes health practitioners
make
Basic communication skills

The Pharmacy Care Process

Collect and use
patient information
Follow up to assess
patient outcomes

Select and recommend

therapies

Identify patients drug

related problems

Develop solutions
to these problems

OBRA 90:
Three parts:
Patient Information
Prospective Drug Utilization Review
Patient Counseling

Public Law 101-508, S4401, 1927(g) (November 5, 1990) and OBRA 90

Regulations. Federal Register November 2, 1992;57FR(212):49397-49401.

Patient Information
Full name
Address and phone
Date of birth (DOB) / age
Gender
Drug list (profile) including all OTC, Rx, herbal
supplements, etc.
Pharmacist comments
Chronic medical conditions (diagnoses)
Keep for 2 years

Prospective DUR
Over / underutilization
Therapeutic duplications
Drug-disease interactions
Drug-drug interactions
Incorrect dosage or duration of treatment
Drug allergy interactions
Clinical abuse - misuse

Patient Counseling
Name (generic)
Intended use and expected action
Route, dosage form, dosage and administration schedule
Special directions for preparation, storage or administration
Precautions to be observed while taking
Common side effects, how to avoid or action required if they
occur
Techniques for self monitoring of drug therapy
Potential interactions or therapeutic contraindications
Refills
What to do if you miss a dose
Any other information THIS patient may need to ensure safe use

Basic Communication Skills in

Pharmacy Practice

The Communication Model

The communication model:

Communication takes two
sender and receiver

To optimize communication we must

consider the channel
Two way flow of information
Potential for a breakdown to occur at any
time
Barriers will exist minimize these when
you can
Communications Skills in Pharmacy Practice, Tindall, Beardsley and Kimberlin, third ed., 1994, Lea and Febiger,
p 15.

Barriers to communication
Pharmacy Environment

Barriers to communication
Pharmacy Environment

Barriers to communication

Basic Counseling and

Communication Skills
Courtesy and rapport:
Quite possibly the most critical skills you will
need to develop, and includes:
How to address patients
Introducing yourself
Learning patient names
Being aware of your appearance, attitude, issues
Respecting patient privacy issues
Avoiding stereotypes
Using appropriate body language

Body Language
Message impact:
7% verbal
38% vocal
55% body movements

Often more believable than words

Composed of
Body movements
Facial expression
Gestures
Posture and breathing
Space

Basic Counseling and

Communication Skills
Body language (we will spend more time on
this later)
Facial expression smile
Eye contact
Open posture
Distance
Tone of voice
Get CLOSER
Control distractions, lean in, open posture, smile, make good
eye contact, relax

Some samples of facial body language.

Bringing it home to pharmacy, is this an

example of good body language for a
pharmacist?

Stereotypes
The process of attributing a set of
characteristics to all members of a group,
without regard for individual differences.
We all react differently to different kinds of people, and even differently
at different times. Some reactions are overt, some hidden. They all can
impact how we relate to patients. We want to avoid letting stereotypes
influence how we react to and interact with our patients.
Example statements:
Doctors are arrogant
You cant trust(fill in with your favorite; men, women, college students, professors,
etc.)
Teenagers are irresponsible

Hugman, B. Healthcare Communications, Pharmaceutical Press 2009: p50.

A stereotype in action:

Im not feeling very well I need a doctor immediately.

Ring the nearest golf course.
Groucho Marx

Stereotypes
Common and most everyone holds to
some degree of stereotyping
What is the impact of this on rapport?
Being aware of how you may stereotype others is
critical
Treat everyone as an individual

Rapport
A level of mutual consideration and
respect
The warm fuzzy part of communication
Paves the way for good communication

Trust is critical

How do you build trust?

How do you keep it?
What happens when you break it?

Perceptions

FINISHED FILES ARE THE RESULT OF YEARS OF SCIENTIFIC STUDY COMBINED WITH THE
EXPERIENCE OF MANY YEARS
OF EXPERTS

Listening

Basic Skills: Listening

Listening Skills:
Be aware of perceptions (F
test)
Be non-judgmental
Be an active listener
Summarizing,
paraphrasing, clarifying,
feedback (immediate,
honest and supportive)
Use appropriate listening body
language
Use silence where appropriate

Listening Skills:

Sit up.
Look and act interested.
Lean forward.
Actually Listen!
Nod your head to show your
attention.
Make eye contact with the
speaker.

Basic Skills: Information

When communicating important
information to patients, be sure to:
State the purpose of your communication
Inquire about what the patient needs
Use markers for critical information
Now, Ms. Smith, this is really important..I need you
to

Talk in lay terms, but dont oversimplify

Avoid technical jargon

Avoid information overload
Keep it short and simple, to the point

Basic Skills: Gathering

Information
When gathering information
Ask open-ended questions
Much more information can be gained
Saves time
Provides opportunities for patients to reveal
information we might not be thinking about
How are you supposed to be taking this?
Tell me more about this

Basic Skills: Assessment

The question is, did your patient learn anything
from you? In other words, did the other person
understand what you said, and meant?
To assess:
Summarize your teaching
Verify what your patients know
Ms. Smith, can you tell me how you will take your
medication?

Reinforce patient understanding when you can

Thats right, this medication will make you sleepy

Basic Skills: Empathy

Seek to understand what your patients
feel
Empathy is not sympathy
Realistically, may not be attainable because you
are not the other person
Empathy will help you shape your communication
so that others better understand you!

Listening and Responding Test: (p47

Tindall Book)

Basic Skills: Questions

Encourage patients to ask questions
Just let me know if you have any other questions, OK?

Key Point: When your patients are

comfortable asking you questions, you
know you have rapport and are doing a
good job communicating.

Basic Skills: Assertiveness and

Persuasion
Assertive versus aggressive.
Persuasive versus pushy.
What is the difference?

Counseling Methods We Will

Learn:
Basic Counseling
Interactive patient counseling
The Prime Questions

Counseling in challenging situations

The PAR technique
Prepare, assess and respond

Counseling for compliance

The RIM technique
Recognize, identify and manage

Face Reading: Art not Science

Light
Forehead
Eyebrows: shape,
position, type
Eyes: spacing, angle,
bulging, size of iris, corner
indents, pupil response,
showing stress
Eyelids
Eyelashes
Eye Puffs
Nose: size, shape, ridge,
width, nose tip angle,

Fulfer, Mac, J.D., Amazing Face Reading, 1996.

Nose tip
Nostrils
Ears: size, cups and ridges,
angle to head, placement
Cheeks
Mouth: size, angle
Lips: size and shape
Teeth
Smiles
Chins
Combinations of features
(Chin/eyebrow)
Lines
Facial hair