Patient counselling — developing a standard approach
Pharmacy technicians at the Western General Hospital (WGH) in Edinburgh are involved in organising discharge medicines for patients (via a “one stop dispensing” service). Traditionally, technicians at the WGH have not been involved in counselling patients on how to use these medicines.
We believe that, if the role of the technician included counselling, this would free up pharmacists’ time to offer other pharmaceutical care services and enable technicians to develop further skills. Also, if we develop a standard approach to patient counselling that provides a consistent level of information, this may help to increase patient compliance.
Current Scottish practice
Questionnaires were sent to pharmacists or technicians at 25 hospitals in Scotland. Their responses informed us that technicians carry out patient counselling in 20 of these hospitals. One hospital has a standard operating procedure in place for technician counselling and 13 hospitals have produced a training pack. However, there is no consistency in their approaches to patient counselling by technicians.
Patient Counselling Tool
|1||Ensure prescription has been screened by pharmacist. Obtain handover information from pharmacist|
|2*||Name and type of drug|
|3*||Dosage schedule eg, dose, frequency, quantity, duration, how to take it and additional warning|
|4*||Compliance chart/ steroid card/ warfarin booklet|
|6||Patient information leaflet/ side effects|
|7†||Special precautions/ storage conditions|
|8†||Missed a dose|
Any other question should be referred to a pharmacist
* To mention in a counselling session
† To mention if appropriate or if patient asks this question
Generic counselling tool
We decided to develop a generic tool that could be used by pharmacy technicians as a memory aid when counselling patients on their medicines. I conducted a literature search for articles on patient counselling and discussed what should be said when counselling a patient with several senior pharmacists at the WGH.
Consequently, I produced the generic counselling tool shown. The layout of the tool has been used to produce specific counselling sheets for patients who receive prednisolone tablets and alendronate tablets, to prove its efficacy in a practical setting.
A pilot study was conducted over a four-week period during February 2008. Inpatients and outpatients at the WGH were asked if they were happy to receive medicine counselling from a technician. If so, a technician would conduct a discharge medicines counselling session, using the generic tool as a guide. The patients were asked to complete a satisfaction survey.
Nine patients were counselled during the study period. I was hoping for more than this, but opportunities were limited by academic deadlines (this project was undertaken as part of my higher national certificate in pharmacy services, development and management). Feedback was received from eight of the patients, who indicated they found the counselling session helpful and the level of information suitable.
Technicians involved in the pilot reported becoming more self-confident in their ability to counsel as they had more interaction with patients. They also praised the colour coding of the counselling tool.
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Although the number of patients seen was small, the feedback was positive and the generic tool proved successful.
Drug-specific counselling sheets (such as those we have produced for prednisolone and alendronate) can be used for training or referenced by technicians when they are counselling.
Other hospitals in Scotland have expressed interest in our generic tool for developing drug-specific counselling sheets. By sharing our work with them, we hope to produce a larger set of drug-specific sheets.
|Carolyn Blyth is a deputy senior pharmacy technician at the Western General Hospital, Edinburgh. Her work won first prize in the poster presentation at the Association of Pharmacy Technicians UK 2008 annual conference|
Citation: Hospital Pharmacist URI: 10032448
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