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About The nugget. (Sisters, Or.) 1994-current | View Entire Issue (Jan. 6, 2016)
Wednesday, January 6, 2016 The Nugget Newspaper, Sisters, Oregon 15 New approach to medication counseling highly effective By David Stauth Oregon State University CORVALLIS – It takes about one minute longer, but pharmacists who employ an unconventional, interac- tive patient counseling tech- nique can more than double the chance that people will properly take, understand and manage their use of prescrip- tion drugs. A new study just published in the Journal of the American Pharmacists Association pro- vides compelling evidence that this technique could sig- nificantly improve the under- standing of drug use and storage, possible side effects, what to expect from a medica- tion and what to do if some- thing isn’t working. “This approach to prescrip- tion drug counseling has now been shown to be a dramatic improvement over conven- tional methods,” said Robert Boyce, director of pharmacy services in the Student Health Center Pharmacy at Oregon State University, and corre- sponding author on the study. “This is the first real analy- sis to prove that it works, and that the approach could be extremely important for health care in America.” Historically, pharma- cists who provided patients with information about their prescription medications — when that was done at all — most often used what was called a “lecture format,” essentially a one-way form of communication that was often referred to as reading off the label. The efficacy of this sys- tem varied widely, and gave little assurance that patients had heard and understood a range of details about the drug they were preparing to take. By contrast, Boyce co- developed an alternative approach during a 21-year career with the Public Health Service pharmacy program of the Indian Health Service, a federal health program for American Indians and Alaskan natives. It empha- sizes a questioning of patients about the drug they have been prescribed, and answers ques- tions about whatever they don’t understand. It’s a dis- cussion, not a presentation. The concept, Boyce said, was released in 1991 to every school and college of phar- macy, and is now gaining much wider acceptance across the nation. This study, which included a survey of 500 par- ticipants at four community pharmacies in Oregon, is the first of its type to confirm the value of the new approach. A lead author was Naomi Lam, a pharmacy resident at the OSU Student Health Center Pharmacy at the time of the research. In this approach, patients are 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. The new study found that 71 percent of patients using the new counseling approach could answer all three ques- tions correctly, compared to 33 percent of patients who were instructed with the con- ventional system. With either approach, most people understood what medication they were taking and what it was for. However, with the new system, four times as many people under- stood how and when to take their medication, and also could answer basic questions about adverse effects. According to this study, the average time it took phar- macists to use the new coun- seling system was a little over two minutes, compared to 75 seconds for conventional counseling. “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.” Patient counseling about medications, Boyce said, is still an evolving aspect of health care. Prior to federal legislation that became law in January, 1993, which man- dated pharmacist counseling for Medicare patients receiv- ing new prescriptions, phar- macist counseling was quite variable, and often not done at all. Since that time, all but three states in the country have enacted laws that require patient counseling on medica- tion, or an offer to counsel, be made available. As a result, the activity of counseling is far more common. The alter- native system being proposed, however, has the ability to take such counseling and make it far more effective, Boyce said. “This approach to counsel- ing can find out what a patient does and doesn’t understand,” Boyce said. “It’s especially important when it comes to drug efficacy and side effects. If a medication isn’t working properly, patients learn what actions to take. If they expe- rience side effects, they know better how to handle it and when to contact their doctor or pharmacist.” The conversational, inter- active approach also becomes highly favored by patients once it is implemented, Boyce said. People better remember what they heard and discussed, feel as if they are being listened to, and they appreciate the attention, he said. Gaps in understanding are addressed during the con- versation and before moving on to the next question. Some common sense con- cerns can also be immediately identified with this format, which may be less obvious in conventional counseling. A patient may have hearing OREGON CASINOS Hair’s to a Beautiful 2016! We look forward to serving you this year! 541-588-6611 220 W. Cascade Ave. Come in, Relax, Enjoy! Heads or Tails… You Lose FEB. 8-10 | $279 PPDO Visit 5 casinos: Spirit Mountain, Chinook Winds, Three Rivers, The Mill and Seven Feathers. Receive food credits, slot play, and one free breakfast. problems; language barriers; or cognitive circumstances that must be considered. An immediate understanding of that can significantly improve the level of communication. If a medication isn’t working properly, patients learn what actions to take. 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