Corvallis, OR—It might take an extra minute, but an interactive patient counseling technique more than doubles the possibility that patients will understand their prescription drugs better and take and manage them more effectively.
That’s according to a new study published recently in the Journal of the American Pharmacists Association. Oregon State University researchers offer evidence that the technique could significantly improve the understanding of drug use and storage, possible side effects, what to expect from a medication, and what to do if something isn’t working.
“This approach to prescription drug counseling has now been shown to be a dramatic improvement over conventional methods,” explained corresponding author Robert Boyce, RPh, director of pharmacy services in the Student Health Center Pharmacy at Oregon State University. “This is the first real analysis to prove that it works, and that the approach could be extremely important for healthcare in America.”
The conventional way to transmit information about prescription medications is a “lecture format,” according to the study, where pharmacists read off the label and medication purchasers listened. There was no way to ascertain what actually had been understood, the authors emphasize.
An alternative approach was co-developed by Boyce, however, during a 21-year career with the Public Health Service pharmacy program of the Indian Health Service, which serves American Indians and Alaskan natives. The alternative technique emphasizes questioning of patients on their understanding of the drug they have been prescribed, and answers questions about whatever they don’t understand. In effect, according to study authors, it’s a discussion, not a presentation.
Boyce noted that the concept was released in 1991 to every pharmacy program in the United States and is gaining wider acceptance now.
This study, the first of its type to confirm the value of the new approach, included a survey of 500 participants at four community pharmacies in Oregon. Patients were asked three basic, open-ended questions, relating to the name and purpose of the medication; how to use and store it; and what possible side effects there might be; and what to do if they occur.
Results indicate that 71% of patients counseled with the new approach could answer all three questions correctly, compared to 33% of patients who were instructed with the conventional system.
While most patients understood what medication they were taking and its purpose with both techniques, four times as many understood how and when to take their medication, and also could answer basic questions about adverse effects with the new counseling approach.
For patients who were instructed about adverse effects, 80% counseled using the IHS technique compared with 51.5% counseled using the traditional approach answered all three questions correctly, according to the study. For understanding the indication of therapy, no difference was detected between the counseling methods, however.
“The interactive style of the IHS method of counseling provided significantly improved immediate memory recall compared with the traditional method,” study authors write.
The average time pharmacists spent on the new counseling system was a little more than two minutes, compared to 75 seconds for conventional counseling, according to the study.
“For a busy pharmacist, some might suggest this is a significant additional amount of time,” Boyce said. “But when you compare that to the risks of something not going right when a patient does not understand what the specific directions are, or what to expect from their medication, the additional effort seems minimal.”
Boyce pointed out that, prior to a federal law in 1993, which mandated pharmacist counseling for Medicare patients receiving new prescriptions, pharmacists varied greatly in how often they counseled purchasers and it often was not done at all.
Since that time, laws have been enacted in all but three states requiring pharmacists to counsel patients on medication or at least make the offer, according to the report.
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