Patient–provider interaction during medication encounters: A study in outpatient pharmacies in the Netherlands

Abstract

This study shows there is room for improvement, as communication is still not according to professional guidelines. To implement professional guidelines successfully, it is necessary to identify underlying reasons for not following the guidelines.

Pharmacists’ responses to cues and concerns of polypharmacy patients during clinical medication reviews—A video observation study

“…This is a remarkable difference compared to consultations at the counter where pharmacy staff took the lead in discussing possible problems. [15,17] However, the situations at the counter and during a CMR are not directly comparable. Patients are invited for a CMR, giving them the chance to prepare themselves.…”

“…This aspect of communication is important to create an atmosphere where patients feel encouraged to disclose their problems and feel comfortable to ask questions. [15][16][17]) Pharmacists' response behaviour is especially important when patients present emotional cues and concerns -"unpleasant feelings or stressful emotions or issues experienced by the patient that have distinct subjective importance and a potential negative emotional impact". [18] A study among pharmacist prescribers showed that they provided space to patients for further disclosure of cues and concerns during private consultations in 81 % of the time [19].…”

“…Responding to cues and concerns was perceived challenging for pharmacy staff during consultations at the counter in Dutch pharmacies. Staff members explored or acknowledged the cue or concern only half of the time [15,17]. However, these studies mainly included pharmacy technicians.…”

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“…Personal goals, concerns about side effects or emotional factors would probably not have been asked and discussed during the regular encounters. Earlier studies have shown that the pharmacy staff is generally used to provide practical information and technical instruction, but do not often discuss patient's preferences and perceptions about prescribed medications, 49,50 or stimulate patients to ask questions. [50][51][52][53][54][55] All responding patients in this study felt positive about the interview and although not all patients reported to be in need of additional care, they appreciated the moment of personal attention and often reported that this evaluation moment was of added value for them.…”

Appointment-Based Models and Medication Synchronization: Silver Bullet for Adherence or One Piece of the Puzzle?

“…8 Even if the program can divert more time to patient interactions, there is evidence that some pharmacists may prioritize investigating the technical reasons for nonadherence, such as the patient having an extra supply due to a recent hospitalization or a changed dose where a new prescription was not written, over inquiring about medication beliefs. [9][10][11] While the ideal for appointment-based models and medication synchronization programs is attractive, patients with tendencies toward the aforementioned belief, cost, or other reasons for nonadherence may be hesitant to enter into such a scheduling agreement with their pharmacies. This can leave a lot of patients out who could potentially benefit from an adherence intervention but want to avoid embarrassment and challenges to their autonomy by a pharmacist.…”