6281 (3)
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Transcript of 6281 (3)
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Communication Strategies#1 Strategy:Talk, Care and Connect
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Create A Favorable EnvironmentEstablish PrivacyReduce Physical Barriers
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Size-Up the Persons:CredibilityHealthKnowledgeIntellectPersonalityEmotional Status
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Determine BeliefsCultural influencesBeliefs about illnessValue of illness
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Recognize and Adapt to Persons Internal NoiseHigh anxiety persons: Share overall conclusions firstLow anxiety personsBuild toward conclusion
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Employ Positive Non-Verbal BehaviorsForward leanSilencelistenGood eye contactWarm expressionPostural synchronyOpen posture (uncross arms)Limit self-adaptors (touching self)
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Build a Two-Way Communication PartnershipAdult-Adult: Empowers ChoicesInformationInsightEmpathyConfidenceParent-Child: Gives AdviceChild-Child: Makes Demands
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An Adult Approach.Im here to help you get the most benefit from your medication.
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Avoid I-It RelationshipsMartin Bubers SchemaI-IT Impersonal; doesnt acknowledge personI- You Businesslike, professional or personalI-ThouEmpathetic with great understanding
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There is No Substitute for Genuine Caring!!Show real empathy Personalize the messageUse the patients nameEngage them in the conversationIdentify and relate to their needs
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Create CredibilityPresent a Professional AppearanceAssume a Professional AffectEstablish TrustGo slowFollow-throughDisplay genuine interestAllow the person to save faceEstablish Appropriate Distance and Boundaries
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Introverted PharmacistsAchieve Greater Compliance They are perceived as More trustworthyLess overbearing
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HelpfulCommunication FactorsFor Better Adherence Deliver:Explicit and appropriate instructionsMore and clearer informationMore and better feedback
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Organize the SessionIntroduce self and provide a brief orienting statementAssess the persons anxiety and beliefsPrioritize and structure information- giving to span 3-5 main pointsEmploy transitions between ideasClosingSummarize key pointsProvide written information, even to the most educated patient
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Strategies to Detect Non-AdherenceGather Objective DataRefill information and objective lab valuesInterview Person but not via an inquisitionBrown-bag ProgramsPatients bring all of their medications in a bag to the pharmacist for counselingCompliance Clinics
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Verbal StrategiesSpeak ClearlyAvoid jargonExplain WHY/WHY NOTLimit message lengthEstablish 3-5 key messagesRepeat important content
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Probe for UnderstandingThis is an ethical responsibilityThe basic and most common cause of non-compliance is the patient who does not understand that is expected.Frank E. Young MD Ph.D.
Former FDA Commissioner
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Strategies to Verify UnderstandingGentle ProbesWhat will you do? Show me.Why?Ask the person to review the content of your counselingAsk the person to predict the medications effects
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Provide Information-Pt 1Be persuasive!Describe useInform about side effectsResearch shows: this does not increase side effectsTell when and how medication will helpAvoid being too complicated or detailed
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Provide Information-Pt 2Explain benefits of medicationRaise awareness of body cuesExplain ways person can self-evaluate therapyHelp develop coping mechanismsDont insist that the patient comply
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Communicate ViaMultiple Modalities SpeechWritten materialsbe alert to non-readersGraphicsModelsDemos
For best results: employ both oral and written presentations
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Build Message RedundancyT1 --Explain what you will tell the patientT2-- Tell itT3 -- Review what you told them
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Communicate FrequentlyEncourage future communicationSuggest calling to discuss concernsRefill counseling is an important opportunity to:Identify changing beliefs about illnessIdentify side effects which may lead to non-adherence
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Enlist OthersWork with MD to:Simplify regimenReduce number of daily dosage intervalsAdjust to persons daily routineEnlist family support
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Be CreativeSupply medication remindersOrganizersAlarmsCheck-off sheetsContractsRemind of refills by mail or telephone
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Its Not Just About InformationThe lower the patient satisfaction with the interaction, the greater the likelihood of non-adherenceThere is no substitute for a warm and caring relationship
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Therefore, Provide BothAccurate Factual InformationPositive Emotional Aspects
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Human Interaction Increases AdherenceNon-adherence was reduced by 25% when the pharmacist, rather than the clerk, handed the medication to the patient.Patient involvement increases adherence
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In closingWe have discussed the differences between patient compliance, and patient adherence. The latter is a more complex and inclusive construct.We also considered several reasons why patients do not adhere to treatment regimens, and how healthcare professionals can employ effective communication strategies to increase patient well-being.