Strategies to enhance patient relationships include teach-back method, providing follow-up information.
Evidence shows that 40% to 80% of medical information that health care professionals communicate to patients is immediately forgotten.1 Additionally, approximately 50% of the information that patients remember is incorrect.1 Pharmacists play a critical role in communicating pharmacotherapy information to patients through medication therapy management (MTM) consults. There are avariety of strategies pharmacists can use for enhancing communication skills. The teach-back method and asking open-ended questions are a couple of examples.
Education and training can help pharmacists enhance their communication skills with patients, especially when it begins in pharmacy school. An analysis of 47 studies evaluated how pharmacists develop patient-pharmacist communication skills.2 The most common interventions reported were lectures, role-play with simulated patients and peers, and video recording.2 Some examples of barriers to communication skills training include a lack of opportunities for continued practice and time constraints.2
Pharmacists can use the teach-back method during MTM consults to ensure patients understand the medication information that was discussed,1 and it can help improve medication adherence. This involves asking patients to state in their own words key concepts they should know about their medications.1 Handouts are important tools to use, along with the teach-back method. Key information can be documented so patients remember medication instructions at home.1 Pharmacists can also train other health care professionals and pharmacy students regarding the teach-back method. This can include presentations and incorporating communication skills into the pharmacy school curriculum.
Providing follow-up is also a vital communication tool for MTM consults. This may involve face-to-face or telephone communication. This can include providing targeted medication reviews (TMRs), which can be performed periodically to identify medication-related problems.3 These also must be performed quarterly by Medicare Part D sponsors. They can help identify issues more regularly than comprehensive medication reviews (CMRs). Aside from medication-related problems, TMRs can determine whether there are unresolved issues that need attention. Additionally, TMRs can evaluate medication use and assess for transitions of care.
One pilot study evaluated pharmacist-provided TMRs to reduce the number of fall risk–increasing drugs (FRIDs) prescribed to patients aged 65 years and older at an independent community pharmacy in New York.4 The community pharmacist assessed the patients’ fall risk through a TMR and provided education about the risk of the FRID prescribed.4 Part of the intervention involved a recommendation to discontinue or replace the medication. The pharmacist provided follow-up 3 months after the initial assessment.4 The study results showed that the discontinuation rate of FRIDs at 3 months was higher in the pharmacist intervention group than the control group (P = .0172).4 This showed that TMRs provided by pharmacists can reduce the use of FRIDs.
Pharmacists can ask open-ended questions during brown bag medication reviews, which can be performed during CMRs and TMRs.1 Patients are encouraged to bring all their OTC and prescription medications and supplements. Pharmacists can then request that patients pick up each medication and ask the following open-ended questions1:
What are you taking this medication for?
Do you take this medication with food?
How do you take the medication?
Can you show me how you take the medication?
Are you experiencing any adverse effects?
Do you have any concerns about this medication?
Where do you store your medication?
Pharmacists can encourage patients to play an active role in their health care. It is important to encourage patients to ask questions about their medications. Suggest they write down their questions prior to their MTM consults to ensure they are addressed. Body language is also an important component to ensure pharmacists are approachable.1 Pharmacists should sit instead of stand to make sure they are at the same level as their patients. Listening to patients and making eye contact is also critical.1 Additionally, avoid interrupting patients during MTM consults. Pharmacists should also consider patients’ beliefs and culture when communicating medication information. Inquiring about health beliefs and customs may help ensure patients get the most from their MTM consults.1
About the Author
Jennifer Gershman, PharmD, CPh, PACS, is a drug information pharmacist and Pharmacy Times® contributor who lives in South Florida.
References
1. Health literacy universal precautions toolkit, 2nd edition. Agency for Healthcare Research and Quality. Updated September 2020. Accessed December 5, 2022. https://www.ahrq.gov/health- literacy/improve/precautions/toolkit.html
2. Kerr A, Kelleher C, Pawlikowska T, et al. How can pharmacists develop patient-pharmacist communication skills? a realist synthesis. Patient Educ Couns. 2021;104(10):2467-2479. doi:10.1016/j.pec.2021.03.010
3. What are targeted medication reviews and why are they becoming popular? In: Thomas DJ, Tran J, eds. The Medication Therapy Management Pharmacist Reference Book. 1st ed. National Board of Medication Therapy Management; 2020. https://www.nbmtm.org/mtm-reference/targeted-med-ication-reviews-becoming-popular/#:~:text=TMRs%20have%20emerged%20as%20a,other%20appointment%2Dbased%20clinical%20options
4. Foster AA, Lindenau R, Clark CM, Wahler RG Jr. Targeted medication review of falls-risk medications in older patients: a community pharmacy-based approach. Sr Care Pharm. 2022;37(3):104-113. doi:10.4140/TCP.n.2022.104
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