Pharmacist Role in Patient Education
Case study:
An elderly woman who has been hospitalized for treatment of atrial fibrillation is being discharged on 7 prescription medications. What’s the best way to ensure she takes the therapies as directed and is aware of potential drug-drug interactions?
Answer:
Patients should talk with healthcare professionals about the possibility that the drugs they take will interact with other prescribed agents. That seems pretty straightforward, but most patients don’t receive advice about how to safely take the medications they’re on. Preeti Malani, MD, a professor of internal medicine at the University of Michigan Medical School, was part of a research team that polled 1,690 individuals between the ages of 50 and 80 about their medication use.
The survey showed 90% of older adults were confident they knew how to avoid drug-drug interactions, but only 35% had talked to a health care professional about which drugs had the potential to cause harm.
Dr. Malani said the survey revealed a disconnect between providers and patients, and pharmacists are an underused resource in bridging the communication gap.
“As health care delivery changes, it’s interesting to think about the role pharmacists will play in patient education and positive outcomes,” she explained. “Prescribing the proper treatment doesn’t matter if patients don’t take medications as directed.”
Dr. Malani said there are multiple ways communication between health care providers and patients can be improved, and pharmacists can spearhead those efforts by asking patients specific questions about their medication use and reviewing medication lists during each encounter. How many are redundant? Can any be deprescribed? Are specific agents cost-prohibitive?
Pharmacists can also tell patients to be aware of potential side effects as well as the medications and food that can interact with prescribed therapies, suggested Dr. Malani. She said hearing and vision can be a problematic in older patients, so medication safety can be improved by finding a quiet place to discuss prescribed therapies and providing directions for use in large, easy-to-read print.
Pharmacists have a unique vantage point when it comes to reviewing the medications patients are taking and suggesting adjustments that could improve adherence and drug-related safety, said Dr. Malani. She added that physicians often don’t know the cost of the medications they prescribe, so pharmacists should alert prescribers when cheaper alternatives are available.
In addition, pharmacists can ensure patients understand which medications should be taken with and without food and discuss specific over-the-counter vitamins, minerals, and other supplements patients are taking. Dr. Malani pointed out that iron, magnesium, and calcium could prevent drug absorption.
Pharmacists and all health care providers must use simple language and speak clearly and slowly when discussing medications with patients, said Dr. Malani. They should also ask patients about their understanding of the drugs they’ve been prescribed. That’s an effective way to ensure they truly understand how to take the drug and its purpose in the care plan, according to Dr. Malani.
—Dan Cook
