Effective Interviewing Techniques for Pharmacists: A Comprehensive Guide - Prof. Abdo, Lecture notes of Communication

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COMMUNICATION

SKILLS FOR THE

PHARMACIST

By Dr. Mohammed Khalifa

Interviewing and Assessment

Components of an Effective Interview

• (^) Certain communication and interviewing skills need to be mastered and used or you are likely to have an incomplete or otherwise unproductive interview.
• (^) The problems in the interviewing process can be minor (e.g., you miss one piece of information) or major (e.g., you fail to identify an important adverse effect the patient is experiencing to a medication).
• (^) By considering the elements of effective interviewing , you will be able to avoid problems and analyze what went wrong if a problem does arise

1)LISTENING Components of an Effective Interview

• Stop talking. You can’t listen while you are talking.
• Get rid of distractions. These break your concentration.
• Use good eye contact (i.e., look at the other person). This helps you concentrate and shows the other person that you are indeed listening.
• React to ideas, not to the person. Focus on what is being said and not on whether you like the person. Read nonverbal messages. These may communicate the same or a different message than the one given verbally.
• Listen to how something is said. The tone of voice and rate of speech also transmit part of the message.
• Provide feedback to clarify any messages. This also shows that you are listening and trying to understand.

2) PROBING Components of an Effective Interview

• (^) A closed-ended question can be answered with either a “yes” or “no” response or with a few words at most. On the other hand, an open-ended question neither limits the patient’s response nor induces defensiveness.
• (^) Proper open-ended questions are harder to formulate than closed- ended questions, but they are more crucial in obtaining complete information and in decreasing the patient’s defensiveness.
• (^) Open-ended question you are allowing patients to present information in their own words. Closed-ended questions reduce the patient’s degree of openness and cause the patient to become more passive.
• (^) Open-ended questions permit open expression and for this reason are sometimes referred to as “patient-centered questions.”

2) PROBING Components of an Effective Interview

• (^) A combination of open-ended and closed-ended questions most efficient in your practice.
• (^) Patient encounters may be initiated with an open-ended question, followed by more directed, closed-ended questions.
• (^) For new prescriptions, the questions “What did your doctor tell you the medication is for?,” “How did your doctor tell you to take the medication?,” and “What did your doctor tell you to expect?” are suggested as a way to structure the assessment of patient understanding of new prescriptions

3) ASKING SENSITIVE QUESTIONS Components of an Effective Interview

• (^) Before asking a question about a sensitive topic, let the patient know that the behaviors or problems you are asking about are common.
• (^) If you acknowledge that “everyone” has similar problems, it makes the issue seem less threatening.
• (^) Examples of universal statements they identify include “This is a very common concern.. .,” “Frequently my patients have difficulty.. .,” and “Everybody has trouble with... .”
• (^) The way you phrase the question and your tone of voice should be no different for a question on alcohol consumption as for a question on use of an over-the-counter (OTC) product
• (^) In structuring the interview, it helps to embed more threatening topics among less threatening topics and to ask more “personal” questions later in the interview.

3) ASKING SENSITIVE QUESTIONS Components of an Effective Interview

• (^) If patients seem reluctant to address an issue, it helps to discuss the reason why you are asking a particular question. such as: “People often do not think of alcohol as a drug, but there are many medications that can interact with alcohol. I ask about alcohol use so that I can help you prevent problems with the medications you take.”
• (^) If patients understand the reason for a question, they are more likely to respond honestly. If they do not know the reason, they may make assumptions about why questions are being asked. Unfortunately, the assumptions they make may be more damaging than the truth.

5) ESTABLISHING RAPPORT Components of an Effective Interview

• (^) Successful interviews are marked by a high degree of rapport between the two parties.
• (^) Relationship is built mainly on mutual consideration and respect. You can aid this process by using good eye contact, by using a sincere, friendly greeting, by being courteous during the discussion, and by not stereotyping or prejudging the patient.
• (^) Each patient must be seen as a unique individual.
• (^) As mentioned earlier, patients’ perceptions of you, the pharmacist, will influence their relationship with you. Thus, it is critical that you initiate the interaction in a friendly, professional manner

Interviewing Using the Telephone

• (^) Smile before you pick up the telephone. Your friendly attitude will be transmitted through the tone& volume of your voice.
• (^) Identify the pharmacy and yourself, providing both your name and position
• (^) Give your full attention to the call. Nothing is more irritating to callers than to be given the impression that they are competing for your attention.
• (^) Ask for the caller’s name and use the name in the conversation.
• (^) If you must place the caller on hold (for a short time only) ask, “May I put you on hold while I look up your prescription?” On returning to the telephone, say, “Thank you for waiting.”
• (^) At the conclusion of the call, end it graciously (e.g., “Thank you for calling”).

1) Antagonistic Patients Strategies to Meet Specific Needs

• (^) Antagonistic patients do not want to be bothered with medication histories, interviews, or other pharmacist-patient interactions.
• (^) The best way to deal with such patients is to be as professional and direct as possible.
• (^) These patients may be frightened or simply fed up with the entire health care system; therefore clarification of the purpose of and reasons for the interaction and the ways in which the information obtained from the interaction are used may be helpful.
• (^) Most patients have great respect for pharmacists and cooperate if the need for the interaction is clearly defined and they perceive that they are treated with respect.

2) Chronically Ill Patients Strategies to Meet Specific Needs

• (^) Chronically ill patients present unique communication challenges.
• (^) Some chronically ill patients know more about the management of their disease than many health care professionals;
• (^) Some chronically ill patients may be completely disillusioned by repeated unsatisfactory interactions with the health care system and may be bitter, cynical, and difficult to engage in conversation.
• (^) Chronically ill patients deserve the same amount of information and attention as all other patients. Assess the needs of each patient and be flexible enough to communicate on an appropriate level.
• (^) Discussing sophisticated therapeutic regimens may be a pleasure with pleasant and well-informed patients but extremely difficult with bitter, cynical patients. Chronically ill patients must learn to live with their disease; this may take years and may never be fully accomplished.

4) Elderly Patients Strategies to Meet Specific Needs

• (^) Elderly patients have special needs. Elderly patients may have impaired hearing and vision.
• (^) The hearing loss associated with aging is characterized by loss of ability to distinguish between high-frequency sounds, which makes it difficult for patients to differentiate conversational tones from background noises.
• (^) Visual changes associated with aging include loss of accommodation, cataracts, reduced peripheral vision, and problems distinguishing some colors. Elderly patients may be sensitive to harsh, glaring lights and highly reflective surfaces.
• (^) They may not be able to read prescription labels and other printed material or distinguish among similarly shaped dosage formulations.

4) Elderly Patients Strategies to Meet Specific Needs

• (^) Speak slowly and distinctly, and avoid youth-oriented vernacular or slang.
• (^) Treat elderly patients with respect.
• (^) Do not assume that every elderly person has impaired hearing. Speak directly to the patient and do not assume that the patient is incompetent or that the person accompanying the patient is a caregiver or guardian.
• (^) Use large-print labels and printed materials and reinforce written information with verbal communication.
• (^) Touching the patient lightly on the arm or shoulder may reassure the patient and reinforce the context of the conversation..