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Tips for improving patient-centred consultations

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By Sneha Varia, pharmacy professional development specialist, London Pharmacy Education and Training and Michelle Styles, Regional Manager, Centre for Pharmacy Postgraduate Education

A “Championing patient centred consultations” event for pharmacy professionals was held in London on 18 May 2015 by the Centre for Pharmacy Postgraduate Education (CPPE), London Pharmacy Education and Training (LPET) and NHS Specialist Pharmacy Service (Medicines Use and Safety). Attendees discussed the idea that telling patients what to do without listening to their needs is a limited approach to consultations. 

One reason that patients may not follow advice from healthcare professionals is that they may have beliefs and concerns that influence their decisions about their medicines and health. We need to explore these with the patient.

What do we need to do differently?

However, patients may not always feel comfortable revealing their needs or their beliefs and concerns about medicines. One  attendee suggested starting every consultation with a new patient by saying “Hello, my name is …”.  This helps establish rapport, encourages dialogue and helps put patients at ease.

Once we have understood the patient’s needs, we need to empower patients to make decisions regarding their medicines and condition. This requires us to recognise that patients acquire a significant amount of knowledge through their experience of living with their condition and their use of medicines. Patients are experts of their own circumstances, needs and preferences and we need to acknowledge their ability to make informed decisions and take responsibility for them. Patients are also more likely to adhere to decisions they have made for themselves than decisions that have been imposed on them.

A community pharmacist from London was inspired to empower patients towards decision making after attending a health coaching course. His top tip is to “challenge patients to come up with as many solutions as possible.” This helps patients to recognise their potential to solve their own medicines-related issues. 

Empowering patients towards decision making involves accepting a patient’s decision even if it’s not the one we would have chosen ourselves, including a decision not to take a medicine. If this is the patient’s decision, appropriate courses of action include discussing alternatives or referral back to the prescriber.

Pledges from participants

Here are some of the pledges participants made following attendance at this event. You may find some of these useful for your own practice:

  • I will introduce myself to patients and tell them why I am there
  • Listen, don’t just preach
  • Accept the patient’s right to make a decision I don’t necessarily agree with
  • Allow the patient to come up with solutions to a problem
  • Add consultation skills to a service’s standards for assessment
  • View the resources on the consultation skills website www.consultationskillsforpharmacy.com
  • Conduct patient-centred consultations and undertake patient surveys
 

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