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Pharmacy practice
Communication is essential for patient care
From Dr J. A. Cleland and Dr M. C. Watson, MRPharmS
The importance of good communication skills was discussed by Steel
and McCooey in your theme issue on concordance.1 Good
communication is fundamental to effective patient care2 and
improves patient and health care professional satisfaction.3 Conversely,
poor communication leads to dissatisfaction and complaints.4
As pharmacists’ roles develop in terms of medication review, chronic
disease management and supplementary prescribing, the ability to communicate
effectively with patients, customers and other health care professionals
is imperative. Indeed, in recognition of this, the supplementary prescribing
course at the Robert Gordon University in Aberdeen comprises a substantial
communication skills component, which was informed by medical teaching
and learning, literature and experience.
There is a strong evidence base to inform professional-patient communication
skills teaching, much of which comes from the medical literature. The
emphasis is on experiential learning, including rehearsal, evaluation
of video consultations and structured reviews.
It has been estimated that doctors complete 200,000 consultations in
their professional practice.5 Pharmacists, particularly those in community
pharmacies, are likely to have even more consultations within their professional
lifetime. Thus it is crucial to ensure that communication skills are
of a high standard in order to maximise effectiveness, patient satisfaction
and outcome, and, conversely, to minimise poor practice and complaints.2
Most complaints about doctors are about poor communication rather than
poor clinical knowledge and skills.4 This evidence, together with moving
away from the traditional medical model of “doctor knows best”,
has led to communication skills becoming a central component of good
practice. Given that clinical knowledge is quickly outdated, coupled
with the broadening role of pharmacists, it would seem appropriate to
focus pharmacy continuing professional development on non-clinical skills
such as communication and team-working.
We would be interested to hear from schools of pharmacy about their communication
skills training. Our ultimate aim is to review the evidence evaluating
teaching of consultation skills across the health professions.
Although, as Steel and McCooey point out,1 training courses on communication
skills may be scarce, currently, pharmacists who wish to enhance their
skills could contact their national centre for pharmaceutical education
or local health board, to
identify possible training opportunities. The Scottish Centre for Post-Qualification
Pharmaceeutical Education is holding at least one local training course
on communication skills this year. Another useful source is ‘Skills
for communicating with patients’.6
It is essential that the learning needs of pharmacists in terms of communication
skills are identified systematically and addres-sed at every level of
professional development.
Jennifer Cleland
Margaret Watson
Department of General Practice and Primary Care,
University of Aberdeen,
Westburn Road,
Aberdeen AB25 2AY
(e-mail m.c.watson@abdn.ac.uk)
References
1. Steel S, McCooey A.-M. Concordance: Training in communication skills
needed (letter). Pharm J 2003;
271:491.
2. Maguire P, Pitceathly C. Key communication skills and how to acquire
them. BMJ 2002;325:697-700.
3. Clark N, Gong M, Schork MA, Evans D, Roloff D, Hurwitz M et al. Impact
of education for physicians on patient outcomes. Pediatrics 1998;101:831-6.
4. Annual report 2001–02. Health Service Ombudsman for England
London: Stationery Office. 2002.
5. Kurtz S, Silverman J, Draper J. Teaching and learning communication
skills in medicine. Oxford: Radcliffe Medical Press. 1998.
6. Silverman J, Kurtz S, Draper J. Skills for communicating with patients.
Oxford: Radcliffe Medical Press. 1998.
Not many pharmacies have a fax machine
From Mr J. E. Packham, MRPharmS
In her reply to Jethroe Tull (PJ, 1 November, p611), Lynsey
Balmer suggests using the General Medical Council’s auto fax back
service to confirm a doctor’s registration and also that a fax
can be used to confirm a valid prescription is in existence.
Only a few pharmacies where I work as a locum have a fax. Is it to be
a requirement of the Royal Pharmaceutical Society that every pharmacy
has a fax (ie, acting as regulator) or will the Society make requests
on our behalf to the Department of Health that faxes and NHSnet computers
are supplied to every pharmacy (ie, acting to represent us)? Doctors
have been supplied with these items.
With regard to Helen Potter’s reply to Maureen Chapman (ibid, p612),
it should be remembered that some companies have a policy that no extemporaneous
dispensing is done, however simple. It should also be remembered that
prescriptions and laboratory-prepared items do not arrive when the postal
service is not available.
John E. Packham
Dunstable, Bedfordshire
Spanish practice culture shock!
From Mr J. E. Blake, MRPharmS
I recently had the misfortune to contract a chest infection which precipitated
an asthma attack while in Spain. After excellent treatment at the local
health centre I was given a prescription for three items. I presented
this at the local pharmacy and I received the items in under two minutes.
There was no personalised label — only a sticky label with symbols
for breakfast, lunch and night time with a tick in the relevant squares.
There was no computer record and no manual recording of the prescription
in a ledger.
The pharmacist then proceeded to explain why I needed live yogurt to
maintain the bacterial balance because of the high dose of antibiotic.
He also suggested a mouthwash to use after the steroid inhaler.
This consultation took about eight minutes. I wish I could have had the
time for such consultations in England. With most multiple pharmacies
having unrealistic workloads there is little scope for such face-to-face
concordant consultations.
I am sure that many Spanish pharmacists must have a culture shock when
they work in the United Kingdom
John Blake
Torre del Mar,
Malaga,
Spain
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