Professional Documents
Culture Documents
Intended Received
Sender Medium Receiver
message message
(Quintrell, 1994)
Communication Process
Intended Received
Sender Medium Receiver
message message
As this
medication Because of
will make poor
you Avoid eyesight the
nauseated if alcohol Additional patient
taken with while taking label on cannot read Nill
alcohol, you this package the small
should avoid medication. print of
using alcohol additional
while you are label.
taking it.
(Quintrell, 1994)
To ensure effective communication
• Five Ss
– Be sincere
• Pharmacist’s attitude will affect patient adherence and
therapeutic outcome
– Simple
– Short
– Specific
– Summarize
(MacLeod-Glover, 2006)
Keep communication simple, short,
and specific
• Avoid unnecessary complexity
• Shorter words and sentences recall more
• Three items of message
• The more specific the message or instructions,
the more likely it will be adhered to
Summarize
• Repeating important messages
• “take home” messages
– Dosing instructions
– When to take
– How to take
Questioning and Listening
Effective use of Questioning Listening
• To identify patient needs • Active listening is the basis
and drug related problems for all good communication.
• General and less personal at
the beginning
• Open-ended vs close-ended
questions
• Tips:
– The rate of questioning
– Never asking more than one
question at a time
Communication barriers
• Environmental barriers:
– Accessibility to the pharmacist,
– lack of quiet, private space to speak with patients
– Lack of time to engage in meaningful discussion
with patients
Communication barriers
• Patient barriers
– Lack of awareness of or respect for the pharmacist’s
role
– Language difficulties
– Feeling uncomfortable asking questions about their
medication or health issue
• To overcome:
– Supplement with print materials
– Maintain eye contact
– Encourage patients to ask questions
Communication barriers
• Personal barriers
– Lack of confidence in their leadership and advisory
– Lack of knowledge about drugs or px history
– Inability to respond to patient cues
– Shyness
– Lack of awareness of cultural differences
• To overcome:
– Ensure to be easily identifiable as the pharmacist
– Develop an effective patient interview style
COUNSELLING
Definisi Konseling
Kepmenkes Nomor 1027/MENKES/SK/IX/2004
tentang STANDAR PELAYANAN KEFARMASIAN
Dl APOTEK
• “Konseling adalah suatu proses komunikasi
dua arah yang sistematik antara apoteker dan
pasien untuk mengidentifikasi dan
memecahkan masalah yang berkaitan dengan
obat dan pengobatan.”
Konseling oleh Apoteker di AS
• 1940-1960an: kode etik kefarmasian
menyarankan apoteker untuk menghindari
diskusi ttg obat dengan pasien
• Alasan?
Konseling
Kepmenkes Nomor 1027/MENKES/SK/IX/2004
tentang STANDAR PELAYANAN KEFARMASIAN
Dl APOTEK
• Apotek harus memiliki:
– “Ruangan tertutup untuk konseling bagi pasien
yang dilengkapi dengan meja dan kursi serta
lemari untuk menyimpan catatan medikasi
pasien.”
Benefits of Counselling
• Well-informed patients are more likely to use
their medications correctly.
• The intervention of the pharmacist in the
provision of advice on medicines improves
medicine safety.
Counselling in the community
pharmacy setting
• This should be an integral part during
dispensing of medicines.
– Kepmenkes 1027/MENKES/SK/IX/2004
– “Sebelum obat diserahkan pada pasien harus
dilakukan pemeriksaan akhir terhadap kesesuaian
antara obat dengan resep. Penyerahan obat
dilakukan oleh apoteker disertai pemberian
informasi obat dan konseling kepada pasien.”
Counselling in the community
pharmacy setting
• Kepmenkes 1027/MENKES/SK/IX/2004
• “Apoteker harus memberikan konseling, mengenai
sediaan farmasi, pengobatan dan perbekalan
kesehatan lainnya, sehingga dapat memperbaiki
kualitas hidup pasien atau yang bersangkutan terhindar
dari bahaya penyalahgunaan ataupenggunaan obat
yang salah.“
• “Untuk penderita penyakit tertentu seperti
kardiovaskular, diabetes, TBC,asma dan penyakit kronis
lainnya, apoteker harus memberikan konseling secara
berkelanjutan.”
Counselling in the community
pharmacy setting
• Pharmacists should be visible and accessible
for patients to request advice.
– Kepmenkes 1027/MENKES/SK/IX/2004
– “Masyarakat harus diberi akses secara langsung
dan mudah oleh apoteker untuk memperoleh
informasi dan konseling.”
Counselling in the hospital setting
• On admission
• During hospitalisation: needs assessment
• On discharge
• At outpatient clinics
• In rehabilitation settings.
Counselling process during dispensing
of medicines
• How and when to take or use a medicine
• How much to take or use
• How long to continue treatment
• What to do if a dose is missed
• How to recognise side-effects and minimise
their occurrence
• Lifestyle and dietary changes
• Drug–drug and drug–nutrient interactions.
Written information
• Patient-specific written information
• Patient information leaflets
• Warning cards (e.g. used for lithium,
anticoagulant therapy, steroids,
benzodiazepines)
• Leaflets on drug administration (e.g. pessaries,
inhalers, nebulisers).
THANK YOU