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improves medicine use
Pharmacists employing an interactive patient counselling technique can
more than double the chance that people will properly take, understand
and manage their use of prescription medicines. And, it only takes about
one minute longer.
A study published in the Journal of
the American Pharmacists Association
provides evidence that the technique
could significantly improve the
understanding of drug use and storage,
possible side effects, what to expect
from a medication and what to do if
something is not working.
Director of pharmacy services in the
Student Health Center Pharmacy
at Oregon State University and
corresponding author on the study,
Robert Boyce, said: 'This approach
to prescription drug counselling has
now been shown to be a dramatic
improvement over conventional methods.
'This is the first real analysis to prove
that it works, and that the approach
could be extremely important for health
care in America.'
The study says that historically,
pharmacists who provided patients with
information about their prescription
medications -- when that was done at
all -- most often used a 'lecture format',
essentially a one-way form of
communication often referred to as
reading off the label. The efficacy of this
system varied widely, and gave little
assurance that patients had heard and
understood a range of details about the
drug they were preparing to take.
By contrast, Mr Boyce co-developed an
alternative approach during a 21-year
career with the Public Health Service
pharmacy program of the Indian
Health Service, a federal program
for American Indians and Alaskan
natives. It emphasises questioning
patients about the drug they have been
prescribed, and answers questions
about whatever they don't understand.
It is a discussion, not a presentation.
The concept, Mr Boyce said, was
released in 1991 to every school and
college of pharmacy, and is now gaining
much wider acceptance across the US.
The study, which included a survey of
500 participants at four community
pharmacies in Oregon, is the first
of its type to confirm the value of
Patients were asked three basic,
open-ended questions, relating to the
name and purpose of the medication,
how to use and store it, and what
possible side effects there might be and
what to do if they occurred.
The study found that 71% of patients
using the counselling approach
could answer all three questions
correctly, compared with 33% of
patients who were instructed with the
With either approach, most people
understood what medication they
were taking and what it was for.
However, with the new system, four
times as many people understood how
and when to take their medication, and
also could answer basic questions about
According to the study, the average
time it took pharmacists to use the new
counselling system was a little over two
minutes, compared with 75 seconds for
'For a busy pharmacist, some might
suggest this is a significant additional
amount of time,' Mr Boyce said.
'But when you compare that to the risks
of something not going right when a
patient does not understand what the
specific directions are, or what to expect
from their medication, the additional
effort seems minimal.'
Mr Boyce said the conversational,
interactive approach also became
highly favoured by patients once
it was implemented. People better
remembered what they heard and
discussed, felt as if they were being
listened to, and appreciated the
attention. Gaps in understanding were
addressed during the conversation and
before moving on to the next question.
The study suggested that additional
research with more groups be done
to verify the value of the new system.
It also outlined stages of improvement
as pharmacists adapted to the new
approach, become more comfortable
with it and increased both their speed
and communication effectiveness.
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