Communication Skills Are Crucial for Patient Safety

Pharmacists play a crucial role in health care systems worldwide, where they work alongside other health care professionals to help ensure optimal patient care, medication safety, and improved health outcomes. In today’s complex health care landscape, the pharmacist’s role has evolved significantly beyond simply dispensing medications to a more patient-centered educator position. As such, communication has become an essential skill for today’s pharmacist.

Importance of Communication

Communicating with patients during their visits, especially a first-fill visit, is essential to ensure that patients understand their prescription and nonprescription options. Understanding their drug’s purpose, potential adverse effects, expected results, and their illness trajectory is paramount to providing the best possible outcome.¹ Communication is also central to determining the patient’s needs, improving medication adherence, and encouraging shared decision-making to deliver safe and effective care, resulting in positive health outcomes.¹

Barriers to Communication

Community pharmacies are chaotic environments. Most pharmacists struggle to manage the daily activities of filling prescriptions and taking care of patients, not to mention the corporate emphasis on fulfilling metrics. In addition to constant interruptions and a lack of staff, several other challenges exist.

Language barriers significantly affect the quality of health care a patient receives.^2,3 Study results have shown that patients who do not speak the local language are disadvantaged regarding access to health care and experience more adverse effects.^4,5 Regardless of language barriers, pharmacists are required to provide high-quality health care. Many large chain pharmacies have employed remote translators, but translator smartphone applications or computer programs can be helpful if these are not available.

Lack of access to the full body of patient information also presents a challenge to optimal communication. Most community pharmacists cannot access patients’ electronic medical records. Therefore, they cannot view patient diagnoses, laboratory values, and complete prescription history. Pharmacists must rely on the patient for much of this information, which is often spotty. Regardless, pharmacists must assess a medication’s appropriateness before dispensing it.⁶

Finally, pharmacists have limited ability to control their workload. The volume and complexity of a pharmacist’s work varies daily, but the escalating use of prescriptions in recent years has significantly increased the workload. Evidence from a study performed more than a decade ago showed that more than two-thirds of pharmacists considered their workload excessive, and the burden has only increased since then.⁷ High workload has been associated with poor quality of pharmacy services, including failure to detect errors. Reduced pharmacy workloads result in more time for patient consultation and decreased medication errors.⁸

Effective Communication

According to results from a national health survey by Professional Research Consultants, nearly one-fourth (23.3%) of the US population struggles to read or understand basic health information.⁹

Therefore, assessing health literacy, the degree to which a patient can process health information and make informed decisions, should be the first step in communication between the pharmacist and the patient.

Several techniques exist for effective communication between the pharmacist and patient:

• Keep communications short and simple. When consulting with a patient verbally, it is helpful to break the information down into bits instead of giving large amounts at once. Use lay terms rather than medical jargon and abbreviations. Speak in specifics and do not leave communication up for interpretation. For example, instead of instructing a patient to take a tablet twice daily, teach them to take 1 every morning and 1 every evening, approximately 12 hours apart.¹⁰
• Focus on critical messages. To identify key messages, determine what points you would like to make and ask patients their top questions or concerns. Keep these topics at the forefront of the conversation. During long conversations, summarize the main points at the end for reinforcement.¹⁰
• Use the “teach-back” method. Instead of asking closed-ended questions, such as “Do you understand?” or “Does this make sense?” the teach-back method requires the patient to paraphrase what you have just communicated. In doing so, you can assess the patient’s understanding of the key concepts. This is the ideal time to clarify or correct information that you may not have effectively communicated.¹⁰
• Allow patients to ask questions. This is their opportunity to get clarity on the discussion topics. If patients struggle to articulate their questions, provide resources they can consult or have them call back when they figure out what they want to ask.¹⁰
• Provide written materials that are easy to read. Many patients will think of questions after they have left the pharmacy. Encourage them to read the materials you give them and to call with any questions.¹⁰

In recent years, community pharmacies have emerged as a major group of health care providers. Pharmacists are considered easily accessible and reliable contact points in primary health care; they must communicate professionally and effectively with patients to provide optimal pharmaceutical care. This way they can aid in forming, strengthening, and preserving trust and satisfaction for patients, which will ultimately result in better patient outcomes.

REFERENCES

1. Mendes A. The importance of communication as a prescriber. J Presc Pract. 2023;5(12).

2. Tan R, Kawaja A, Ooi SP, Ng CJ. Communication barriers faced by pharmacists when managing patients with hypertension in a primary care team: a qualitative study. BMC Prim Care.2024;25(1):100. doi:10.1186/s12875-024-02349-w

3. Al Shamsi H, Almutairi AG, Al Mashrafi S, Al Kalbani T. Implications of language barriers for healthcare: a systematic review. Oman Med J. 2020;35(2):e122. doi:10.5001/omj.2020.40

4. Floyd A, Sakellariou D. Healthcare access for refugee women with limited literacy: layers of disadvantage. Int J Equity Health. 2017;16(1):195. doi:10.1186/s12939-017-0694-8

5. Squires A. Evidence-based approaches to breaking down language barriers. Nursing. 2017;47(9):34-40. doi:10.1097/01.NURSE.0000522002.60278.ca

6. Chui MA. Safety in the retail pharmacy. Patient Safety Network. October 1, 2018. Accessed September 3, 2024. https://psnet.ahrq.gov/perspective/safety-retail-pharmacy

7. Chui MA, Mott DA. Community pharmacists’ subjective workload and perceived task performance: a human factors approach. J Am Pharm Assoc (2003). 2012;52(6):e153-e160.doi:10.1331/JAPhA.2012.11135

8. Shao SC, Chan YY, Lin SJ, et al. Workload of pharmacists and the performance of pharmacy services. PLoS One. 2020;15(4):e0231482. doi:10.1371/journal.pone.0231482

9. Knowles M. Nearly one-fourth of US population has low health literacy: 5 findings. Becker’s Hospital Review. March 29, 2018. Accessed September 3, 2024. https://www.beckershospitalreview. com/patient-experience/nearly-one-fourth-of-us-population-has-low-health-literacy-5-findings.html

10. Robinson L, Segal J, Smith M. Effective communication: improving your interpersonal skills. HealthGuide.org. Updated May 8, 2024. Accessed September 3, 2024. https://www.helpguide.org/relationships/communication/effective-communication