3 Critical Barriers to Effective Patient Counseling

Community pharmacists are in regular communication with patients about their medication therapies. In addition to our consulting duties, we are behind the counter completing countless technical tasks with unbelievable accuracy while performing clinical interventions with medical staff.

When we’re called over to the consulting area for a new prescription patient consultation, we only have a few moments to assess the situation at hand. As we approach the counter, we observe the patient’s nonverbal cues in order to identify any barriers that we may need to address, such as privacy concerns.

When we first engage the patient in short conversation, we identify other barriers that may need to be overcome, including language, literacy, and beliefs. In a brief moment, we are able to dynamically adjust our open-ended questions and medication education to meet the needs of each patient.

Some barriers are more difficult to prevail than others. The following 3 pose the greatest challenge, but are the most rewarding to conquer.

1. Language Barriers

How are community pharmacists supposed to counsel patients when we don’t speak the same language? The process of translating is always a concern as we try to ensure that any information is given to the patient correctly while his or her questions are asked and answered appropriately.

Using a family member translator is helpful, but I often get the feeling that the information is somehow distorted due to the dynamics of the relationship. If you’re fortunate, a trusted technician who is fluent in another language may work with you.

Translating through a technician works well if it is the right language, but tying up 2 pharmacy employees on a busy day for a translated counseling session can be burdensome.

Alternatively, you can ask your company if it is subscribed to a translator service that covers multiple languages. Quite often, the service is as easy as getting the translator on the line, describing the situation, and then having the patient pick up the phone to start a 3-way conversation.

Remember, when patients understand their medications and why they are taking them, they are much more likely to follow through with their therapy.

2. Embarrassed Patients

Whether it is an elderly gentleman with erectile dysfunction, a teenage girl with birth control, or any one of the many scenarios in between, the last thing these patients want to do is speak with a pharmacist about their medication and particular situation.

It is very important to not let this particular patient wait for more than a few moments at the counseling area, as they are apt to just head for the door. More often than not, this patient needs to feel a sense of privacy and trust.

As a pharmacist, your body language and tone of voice will significantly affect your ability to provide an appropriate counseling session to this patient. Lean in toward the patient and speak softly so they need to lean in to hear you.

It is critical to ask embarrassed patients to describe exactly how their prescriber told them to take their medication. This will open up an opportunity to clarify any misunderstanding or concerns, as well as discuss additional counseling information that is necessary for the patient’s particular situation.

3. Know-It-Alls

We have all seen patients who sign for their prescription and then decline a counseling session while scoffing, “I'm a nurse; I give out this medication all day long” or, “The directions are right on the label; I can read.”

Every time I hear these lines, I will state from behind the filling bench, “If you don't mind, there is just one thing I wanted to tell you about that med,” and then I wave them over to the counseling area.

Each and every medication has at least 2 or 3 excellent counseling points that community pharmacists can discuss at the drop of a hat. When I get closer to the counseling area, I like to start with, “I just wanted to make sure you were aware of…”

These patients are always appreciative of my concern, and quite regularly, the opportunity opens up dialogue for another question they had about their therapy.

Closing Thoughts

It is not uncommon for patients to use their family members to translate drug labels, read medication information on the Internet, or just follow the directions as listed on the label. These practices are adequate for a basic level of medication adherence.

Nevertheless, patients who understand why they are taking their medication, and importantly, the consequences of not taking it appropriately, are more likely to achieve the best possible outcome of therapy. Take some time to identify which barriers to effective medication counseling you face on a regular basis, so that you will be ready to overcome them when they present at your counter.