The role of pharmacists in patients' education on medication

doi:10.1016/S0033-3506(05)80541-4

Public Health

Volume 106, Issue 3, May 1992, Pages 231-237

https://doi.org/10.1016/S0033-3506(05)80541-4 Get rights and content

The pharmacist, as the last health professional to come into contact with the patient, plays a vital role in patient education on drug use. The objective of this study was to assess the extent of pharmacists' involvement in the education of patients on drug use. Five hundred patients were interviewed. The findings indicated that both physicians and pharmacists explained the use of medication; however, pharmacists (20%) were much clearer in their instructions than physicians (11%). Ninety percent of patients who needed more information on their medicines, besides its frequency of use, did not receive it. Patients were not told about drug adverse reactions (100%), storage conditions (93%), important precautions (91%), drug-food interaction (90%) and preparation of suspensions (64%). Fifty-one respondents had in the past made mistakes in the use of their medications, and in 16% this resulted in serious consequences. Ninety-three prescriptions contained drug-drug interactions, and 97% of these were dispensed unnoticed. Of the patients interviewed, 72% were satisfied with the role of pharmacists in disseminating drug information, 67% would get a refill from them without going to their physicians, and 52% had consulted them for OTC medications. It is concluded that, although there are some deficiencies. pharmacists are providing information on drug usage and patients have confidence in them. They should, therefore, acquire the proper training and communication skills to enable them to provide this service more effectively.

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Cited by (27)

Exploring patients' adherence to antibiotics by understanding their health knowledge and relational communication in encounters with pharmacists and physicians
2023, Exploratory Research in Clinical and Social Pharmacy
Antibiotics are drugs essential for the treatment of bacterial infections. Widespread and often improper use of antibiotics are driving the emergence of antimicrobial resistance (AMR) globally. A better understanding of the communicated and understood use of antibiotics as well as improved adherence to treatments are needed to meet this public health threat.
The aim of the study is to explore how knowledge of antibiotic use is collected and communicated between patients, physicians, and pharmacists, and how patients seek, understand and use available information on antibiotics in adherence to prescribed treatment.
Seven focus group interviews were conducted with community pharmacists (three groups, eleven participants), physicians/general practitioners (two groups, thirteen participants), and patients (two groups, eight participants) in Norway. Four focus group interviews were conducted offline and three online. The interview data were analyzed using systematic text condensation in a four-step, descriptive and explorative thematic analysis.
Three main themes were developed about patients' adherence to antibiotics: 1. patients' knowledge about antibiotics and AMR; 2. sources of information about antibiotics/AMR; and 3. relational communication. Patient knowledge about both antibiotics and AMR was somewhat limited, and showed considerable variation. Patients relied on the internet, chat sites, printed information, and face-to-face meetings with health professionals for information. Relational communication between patients, physicians, and pharmacists was found to be important in reducing misunderstandings.
Vulnerability, limited time, and lack of communication were barriers to receiving and understanding information during patient-physician encounters. Increased knowledge about antibiotics and AMR may result in better adherence to prescribed medications.
Patients seek information about antibiotics and AMR in three arenas; digital platforms, printed material and face to face encounters. However, patients often misunderstand important facts relating to this issue. Relational communication between patients, physicians, and pharmacists was important to ensure adherence to treatment regimens. Pharmacists are encouraged to use open-ended questions and build upon the information obtained from the physician to provide patients with tailored advice and ensure proper adherence. Pharmacists' contribution is crucial in optimizing antibiotic use and combating AMR, as they are the final healthcare point of contact before treatment initiation.
Patient-provider interaction during medication encounters: A study in outpatient pharmacies in the Netherlands
2015, Patient Education and Counseling
Citation Excerpt :
Medication counselling is an essential part of pharmaceutical care [1], especially in first dispensing and first refills. At the pharmacy counter pharmacy staff has ample opportunity to inform patients about their medication and support them in using their medication properly [2–4]. Effective communication between providers and patients about medication use is associated with patients’ satisfaction, recall of information and eventually their health status [4–7].
To describe communication between pharmacy staff and patients at the counter in outpatient pharmacies. Both content and communication style were investigated.
Pharmaceutical encounters in three outpatient pharmacies in the Netherlands were video-recorded. Videos were analyzed based on an observation protocol for the following information: content of encounter, initiator of a theme and pharmacy staff's communication style.
In total, 119 encounters were recorded which concerned 42 first prescriptions, 16 first refill prescriptions and 61 follow-up refill prescriptions. During all encounters, discussion was mostly initiated by pharmacy staff (85%). In first prescription encounters topics most frequently discussed included instructions for use (83%) and dosage instructions (95%). In first refill encounters, patient experiences such as adverse effects (44%) and beneficial effects (38%) were regularly discussed in contrast to follow-up refills (7% and 5%). Patients’ opinion on medication was hardly discussed.
Pharmacy staff in outpatient pharmacies generally provide practical information, less frequently they discuss patients’ experiences and seldom discuss patients’ perceptions and preferences about prescribed medication.
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.
Assessing patients' information needs regarding drug-drug interactions
2013, Journal of the American Pharmacists Association
To assess patients' information needs regarding drug–drug interactions (DDIs) to inform patient DDI education resources.
Cross-sectional study.
Online (United States in May 2011).
Registered users of an online medication monitoring service (MediGuard).
Online questionnaire.
Participants' information needs regarding DDIs and perceived importance of questions related to detecting and preventing harm from DDIs.
Characteristics of the 100 surveyed participants were as follows: 57% women, 88% white, 96% non-Hispanic, 71% retired, mean (±SD) age 65.2 ± years (range 35–86). The number of prescription medications ranged from 2 to 22 (median 7) and the number of over-the-counter (OTC) medications from 1 to 10 (4). The most common concerns cited by participants were identification of interacting medications, seriousness of DDIs, interactions with OTC medications, interactions with foods, exacerbating comorbidities, short- and long-term adverse effects, signs and frequency of DDIs, and how to minimize adverse effects. Statistically significant differences based on gender, number of prescriptions, and number of OTC medications were observed in rankings of the importance of some DDI questions (P < 0.05).
Patient-centered DDI education programs should consider addressing the seriousness of DDIs, the effect of DDIs on comorbidities, and interactions with OTC medications and foods and determining methods for identifying, minimizing, and managing DDIs.
Analysis of pharmacist-patient communication using the Calgary-Cambridge guide
2011, Patient Education and Counseling
Citation Excerpt :
This alters the dynamics of the interaction by removing concerns of being overheard and helping to maintain focus without interruption. To date most research has been aimed at describing pharmacist–patient communication, usually quantitatively; for example, is information regarding side effects given [12–17] There is a paucity of research using direct methods to assess the communication that occurs between pharmacists and patients [18]. A North American review of studies from 1969 to 1994 showed that of the 40 papers reviewed, only three directly observed the communication occurring.
This study explored communication between pharmacists and patients through application of the Calgary-Cambridge guide [1] to appointment-based pharmacist–patient consultations and considers use of the guide in pharmacy education.
Eighteen patients attending appointment-based consultations with five pharmacists were recruited to this qualitative study. Consultations were audio-recorded and observed. Transcripts were coded according to the use of skills within the guide and analysed thematically.
The results showed good use of many skills by pharmacists, particularly signposting and closing the session. Some skills were poorly represented such as listening effectively, eliciting the patient's perspective, effective use of computers and creating patient-centred consultations. A key theme of social conversation was present in the data but this skill was not defined in the guide.
The Calgary-Cambridge guide was developed for use in medical consultations but its application to pharmacist–patient consultations showed that the guide could be successfully used in pharmacy with some minor alterations.
Pharmacists may need more training to improve the use of specific communication skills including how to conduct a patient-centred consultation. The Calgary-Cambridge guide is well aligned with many aspects of pharmacist–patient consultations and could help pharmacists to improve their consultation skills.
An economic assessment of the extent of medication use and wastage among families in Saudi Arabia and Arabian Gulf countries
2003, Clinical Therapeutics
Background: Expenditures for prescription and over-the-counter medications constitute a large percentage of total health care costs. Governments, health care providers, and consumers must work together to find ways to control these costs while continuing to provide quality health care for their nations. To this end, medication wastage is an unnecessary burden on an already fiscally restrained health care system.
Objective: This study was conducted to identify the extent of medication use and wastage among families in the Arabian Gulf countries, with an emphasis on Saudi Arabia.
Methods: A questionnaire was developed and administered to households in 5 regions in Saudi Arabia and other Gulf countries. A total of 1641 households participated in the study (1554 in Saudi Arabia; 87 in other countries).
Results: The mean (SD) family size of household respondents from Saudi Arabia was 6.60 (3.20) members, with 0.32% reporting no medicines present in the household, 81.8% of households reporting 5 or more medicines, and 29.9% of respondents reporting having at least 10 medications at home. Overall, the mean (SD) number of medicines per household in Saudi Arabia was 8.0 (4.3). The most common therapeutic classes of medications kept at home in Saudi Arabia were respiratory medications (16.8%), central nervous system agents (16.4%), and antibiotics (14.3%). The mean (SD) number of drug products unused, deteriorated, or expired was 2.2 (2.7) and 2.7 (1.9) per household in Saudi Arabia and other Gulf countries, respectively. From these data, mean medication wastage was estimated to be 25.8% (Saudi Arabia) and 41.3% (other Gulf countries). When analyzed on the basis of total medication cost, medication wastage was 19.2% and 25.0% in Saudi Arabia and other Gulf countries, respectively. The mean out-of-pocket expenditure (based on the percentage of annual income) for medications was 0.72% for households in Saudi Arabia compared with 0.48% in other Gulf countries.
Conclusions: Families in Saudi Arabia and other Gulf countries spent a total of ∼US $150 million on medications that were never consumed. However, there appear to be no immediate solutions to the problem of medication wastage's impact on health care costs. The use of generic alternatives should be promoted, and drug use assessments should be implemented on a national level.
Patient education interventions for prescription opioids: A systematic review
2020, Journal of the American Pharmacists Association
Citation Excerpt :
By providing proper education about medication, health care providers can potentially reduce health care costs, reduce hospital readmissions, improve medication adherence, and improve medication knowledge in patients. However, the provision of such education may be impacted by environmental or situational barriers seen in health care settings.28-31 Many of the articles that were ultimately excluded from this review focused on patients who were already receiving treatment for opioid-use disorder and did not discuss the education provided to patients receiving new opioid prescriptions.
The objective of this systematic review is to evaluate the impact of prescription opioid-related education provided to a patient by a health care provider on patient outcomes.
The databases searched were PubMed, Cumulative Index of Nursing and Allied Health Literature (EBSCO), Academic Search Premier (EBSCO), Health Source: Nursing/Academic Edition (EBSCO), and International Pharmaceutical Abstracts (OVID).
Studies were included if they were in English, peer-reviewed, and published between 1996 and October 22, 2018. Patient educational approaches initiated by health care providers for opioid medications in adults older than 18 years of age were evaluated. Studies were excluded if the full articles were unavailable or duplicates, or if they involved studies that did not explore provider-initiated patient educational interventions targeting opioid medications. Studies taking place outside the United States were excluded, as well.
Titles and abstracts of 4863 manuscripts were screened for inclusion in this review. Of these, 4794 were removed because they did not meet the inclusion criteria. The full texts of the remaining 69 documents were evaluated for inclusion.
Ten articles were identified for inclusion in this review. Studies explored the impact of prescription opioid-related education on mortality, adherence, self-efficacy, self-care, quality of life, or knowledge. A variety of educational methods were used, including face-to-face follow-up, multimedia tools, predischarge counseling, and written information complementing verbal information. The interventions yielded inconsistent results, with improvements in patient outcomes seen in some studies, but not all.
There are several well-documented interventions identifying methods to manage opioid-use disorder, but less about providing education to patients before they receive opioid prescriptions. Future research should explore the type of education and information being shared with patients, as this could inform pharmacists on how they should educate their patients.

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The role of pharmacists in patients' education on medication

It may seem obvious to you: giving medication instructions to patients

Journal of the American Medical Association

The out patient prescription label as a source of medication errors

American Journal of Hospital Pharmacology

Oral ingestion of potassium permanganate or aluminum acetate in two patients

Archives of Dermatology

The effect of packaging and instruction on outpatient compliance with medication regimen

Drug Intelligence and Clinical Pharmacy

It may seem obvious to you: giving medication instructions to patients (letter to the editor)

Journal of the American Medical Association

Improving drug compliance after hospital discharge

British Medical Journal