Pharmacists Can Improve Patient Safety With Behavior Change Communication

Pharmacists seek to identify, resolve, and prevent real and potential drug-related problems to provide the patient with the best possible outcome. Patients, however, don’t always follow medical advice. According to a 2003 World Health Organization report, medication nonadherence remains common, with adherence averaging at only 50% among patients with chronic diseases despite numerous studies and interventions.¹ Even worse, many health care professionals feel unable to change it.

However, pharmacists are well positioned to counsel patients on behavior change, particularly in improving medication adherence and creating lifestyle modifications. Pharmacists are accessible and trusted health care professionals, making them ideal for intervening to support behavior change. They play a crucial role in ensuring patients take their medications as prescribed, which is vital for managing chronic conditions and improving overall health.

Advantages of Behavioral Change Counseling

Pharmacist counseling for behavior change helps patients understand the importance of their medications and make positive changes in their health care choices, thereby improving patient outcomes. Some advantages of behavioral change counseling include the following^2-4:

• Improved medication adherence: Patients who struggle with medication adherence often have poorer health outcomes than patients who follow their medication regimen. Pharmacists can help improve adherence by addressing the underlying reasons for nonadherence and developing strategies that empower patients to take an active role in their treatment.
• Enhanced self-management skills: By empowering patients to take a more active role in their treatment, behavioral change counseling improves self-efficacy and independence. This is accomplished by teaching patients how to identify triggers, monitor their behavior, and implement strategies to modify their behaviors.
• Patient empowerment: Pharmacists can help patients feel more in control of their health by guiding them to take an active role in their health care. This is accomplished through behavioral change counseling by fostering self-management, motivation, and the ability to make informed decisions.

Key Techniques and Strategies

Pharmacists can use various strategies and techniques to help patients affect changes in their health care. Motivational interviewing is a patient-centered approach to counseling that helps patients explore their ambivalence about change and develop reasons for making changes on their own terms.⁵ This technique involves the pharmacist asking open-ended questions, affirming patients’ feelings, using reflective listening, and summarizing the encounter to validate understanding.⁶

Pharmacists can also help patients identify barriers to medication adherence, such as cost, forgetfulness, adverse effects, or lack of understanding, and brainstorm approaches to overcome these barriers. Tailoring these approaches to the individual patient’s needs, preferences, and circumstances is crucial for success. Affecting change in patients is entirely patient-driven and involves their cultures and beliefs.

Pharmacists can and do educate patients about their medications, their health conditions, and the importance of adhering to medication guidelines. They can advise patients of other treatments and offer cost-saving alternatives. Amid all these discussions, pharmacists can provide ongoing support, encouragement, and accountability to help patients stay motivated and achieve their goals. Working collaboratively with patients to develop a plan for making changes, including setting goals, forming strategies, avoiding barriers, and tracking progress, increases the likelihood of success. Finally, pharmacists can refer patients to other health care professionals or provide resources to help patients overcome obstacles and meet goals.

Pharmacists can apply behavioral change counseling in various areas of patient care, including medication adherence, management of chronic diseases, smoking cessation, regular exercise routines, weight management, and eating a well-balanced diet.

Pharmacist Training

Pharmacists must be trained in evidence-based behavior change techniques to support patients effectively, which is crucial for improving patient outcomes.⁷ Training in motivational interviewing can empower pharmacists to become more effective communicators and patient advocates while collaboratively engaging patients to help them achieve their health goals. Pharmacists must work effectively with other health care professionals to provide comprehensive patient care. This involves fostering teamwork and enhancing communication by learning about, from, and with other professionals.

Conclusion

Today’s health care system is based on a reactive approach to illness. As a society, we must move toward a better model that proactively prioritizes health and disease prevention. Behavior change can significantly promote a well model of health by addressing unhealthy habits and fostering positive lifestyle choices.

REFERENCES

1. Failure to take prescribed medicine for chronic diseases is a massive, world-wide problem. World Health Organization. July 1, 2003. Accessed April 4, 2025. https://www.who.int/news/item/01-07-2003-failure-totake-prescribed-medicine-for-chronic-diseases-is-a-massive-worldwide-problem

2. Hooker S, Punjabi A, Justesen K, Boyle L, Sherman MD. Encouraging health behavior change: eight evidence-based strategies. Fam Pract Manag. 2018;25(2):31-36.

3. Marshall KB, Rohrer JL. Self-management interventions. Association for Science in Autism Treatment. Accessed April 4, 2025. https:// asatonline.org/for-parents/learn-more-about-specific-treatments/applied-behavior-analysis-aba/aba-techniques/self-management/

4. Matthews JA, Matthews S, Faries MD, Wolever RQ. Supporting sustainable health behavior change: the whole is greater than the sum of its parts. Mayo Clin Proc Innov Qual Outcomes. 2024;8(3):263-275.doi:10.1016/j.mayocpiqo.2023.10.002

5. Motivational interviewing to promote behavior change. National Lipid Association. Accessed April 4, 2025. https://www.lipid.org/sites/default/files/motivational_interviewing_to_promote_behavior_change.pdf

6. Motivational interviewing as a counseling style. In: Enhancing Motivation for Change in Substance Use Disorder Treatment: Updated 2019. Substance Abuse and Mental Health Services Administration;2019:35-64. Accessed April 4, 2025. https://www.ncbi.nlm.nih.gov/books/NBK571071/

7. Liddelow C, Mullan BA, Breare H, Sim TF, Haywood D. A call for action: educating pharmacists and pharmacy students in behaviour change techniques. Explor Res Clin Soc Pharm. 2023;11:100287. doi:10.1016/j. rcsop.2023.100287