A recent article on the communication needs of patients with altered hearing ability and the need to cater to the deaf and hard-of-hearing really spiked my awareness. There is a lack of research and evidence-based best practices on how to better serve the pharmacy-related communication needs of deaf and hard-of-hearing patients.
 
This is resulting in poor patient adherence for this group of individuals. Clearly, there needs to be a solution to this matter because every individual deserves to be treated equally, regardless of their disability. Our mission is clearly to enrich patient adherence, not to see it decline.
 
Deaf and hard-of-hearing individuals may be a special case, but we need to work harder to bridge the gap. Deaf and hard-of-hearing individuals have a tendency for having lower health literacy. Deaf individuals are also less likely to graduate from high school or college than the public.
 
The American Pharmacists Association's definition of pharmaceutical care highlights the importance of taking a patient-centered and outcomes-oriented approach to serving the unique needs of each patient to optimize the patient's quality of life and to achieve positive patient outcomes. Training pharmacists to be culturally competent is key to delivering such patient-centered pharmaceutical care, which is why the Center for the Advancement of Pharmacy Education goals, for example, include cultural sensitivity as a core outcome. 
 
Prior studies show that providers often lack a basic understanding of deaf culture, do not understand the importance of providing qualified sign language interpreters, lack the experience of working with an interpreter, and display behaviors that seem rude or insensitive to deaf patients. This clearly is a major problem that needs to be resolved.
 
We have to pay significantly more attention to our body language and educate ourselves more on practicing the art of therapeutic communication. This is really going to be key to improve these outcomes.
 
Given these provider barriers, it is no surprise that deaf patients often avoid using healthcare services and report lower satisfaction with their providers compared with the general public. Several participants noted that pharmacy staff had attitude issues, often appearing rushed and impatient. 

Others reported more positive experiences regarding the willingness of pharmacists to provide adequate communication. It is as if you should really put your feet in their shoes because that is the only way we will understand and truly relate to what they are going through. 
 
Pharmacy students need to develop the ability to "recognize social determinants of health to diminish disparities and inequities in access to quality of care." This all stems from being emotionally intelligent and having effective therapeutic communication skills. 
 
This is one area we can't be inept at. With great practice we can improve on these barriers. As we are evolving and shifting into new roles of pharmacy, we really have to strive to be an evangelist for our career.
 
Objectives for upcoming pharmacists:
 
1. Be respectful of different cultures
2. Assess health literacy
3. Modifying communication strategies based on the needs of the patient
4. Be culturally competent
5. Increase comfort levels with diverse groups
 
Effective pharmacist–patient communication is essential to ensure safe medication use and optimal health outcomes. The deaf and hard-of-hearing population has unique communication needs that pharmacists need to understand.
 
Of equal importance is strengthening the pharmacist–patient relationship by way of education, training, and awareness of the needs of this population.

Brandon Welch is the executive vice president of the American Pharmacy Purchasing Alliance and sits on the Advisory Board of Digital Marketing for the University of South Florida​, where he is a PharmD candidate.