Communication Strategies

#1 Strategy:
Talk, Care and
Connect

Create A Favorable
Environment
Establish

Privacy
Reduce Physical
Barriers

Size-Up the Persons:

Credibility
Health
Knowledge
Intellect
Personality
Emotional Status

Determine Beliefs
Cultural influences
Beliefs about illness
Value of illness

Recognize and Adapt to

Persons Internal Noise

High anxiety persons:

Share overall conclusions first

Low anxiety persons

Build toward conclusion

Employ Positive
Non-Verbal Behaviors
Forward lean
Silencelisten
Good eye contact
Warm expression
Postural synchrony
Open posture (uncross arms)
Limit self-adaptors (touching self)

Build a Two-Way
Communication Partnership

Adult-Adult: Empowers Choices

Information
Insight
Empathy
Confidence

Parent-Child: Gives Advice

Child-Child: Makes Demands

An Adult Approach.

Im here to help you get the most

benefit from your medication.

Avoid I-It Relationships

Martin Bubers Schema
I-IT

I- You

Impersonal; doesnt acknowledge

person
Businesslike, professional or personal

I-Thou

Empathetic with great understanding

There is No Substitute for

Genuine Caring!!
Show real empathy
Personalize the message

Use the patients name

Engage them in the conversation
Identify and relate to their needs

Create Credibility

Present a Professional Appearance

Assume a Professional Affect
Establish Trust

Go slow
Follow-through
Display genuine interest
Allow the person to save face

Establish Appropriate Distance and

Boundaries

Introverted Pharmacists
Achieve Greater Compliance

They are perceived as

More trustworthy
Less overbearing

Helpful
Communication Factors
For Better Adherence Deliver:
Explicit and appropriate instructions
More and clearer information
More and better feedback

Organize the Session

Introduce self and provide a brief

orienting statement
Assess the persons anxiety and beliefs
Prioritize and structure informationgiving to span 3-5 main points
Employ transitions between ideas
Closing
Summarize key points
Provide written information, even to the
most educated patient

Strategies to
Detect Non-Adherence

Gather Objective Data

Interview Person

but not via an inquisition

Brown-bag Programs

Refill information and objective lab values

Patients bring all of their medications in a bag

to the pharmacist for counseling

Compliance Clinics

Verbal Strategies
Speak Clearly
Avoid jargon
Explain WHY/WHY NOT
Limit message length

Establish 3-5 key messages

Repeat important content

Probe for Understanding

This is an ethical responsibility
The basic and most common cause
of non-compliance is the patient
who does not understand that is
expected. Frank E. Young MD Ph.D.
Former FDA Commissioner

Strategies to Verify
Understanding

Gentle Probes
What will you do? Show me.
Why?

Ask the person to review the content

of your counseling
Ask the person to predict the
medications effects

Provide Information-Pt 1

Be persuasive!
Describe use
Inform about side effects
Research shows: this does not increase
side effects
Tell when and how medication will help
Avoid being too complicated or detailed

Provide Information-Pt 2
Explain benefits of medication
Raise awareness of body cues
Explain ways person can selfevaluate therapy
Help develop coping mechanisms
Dont insist that the patient comply

Communicate Via
Multiple Modalities
Speech
Written materials

be alert to non-readers

Graphics
Models
Demos
For best results: employ both oral and
written presentations

Build Message Redundancy

T1 --Explain what you will tell the
patient
T2 -- Tell it
T3 -- Review what you told them

Communicate Frequently

Encourage future communication

Suggest calling to discuss concerns

Refill counseling is an important

opportunity to:
Identify changing beliefs about illness
Identify side effects which may lead to
non-adherence

Enlist Others

Work with MD to:

Simplify regimen
Reduce number of daily dosage
intervals
Adjust to persons daily routine

Enlist family support

Be Creative

Supply medication reminders

Organizers
Alarms
Check-off sheets
Contracts

Remind of refills by mail or

telephone

Its Not Just About

Information
The lower the patient satisfaction
with the interaction, the greater the
likelihood of non-adherence
There is no substitute for a warm
and caring relationship

Therefore, Provide Both

Accurate Factual Information
Positive Emotional Aspects

Human Interaction
Increases Adherence
Non-adherence was reduced by 25%
when the pharmacist, rather than
the clerk, handed the medication to
the patient.
Patient involvement increases
adherence

In closing
We have discussed the differences
between patient compliance, and patient
adherence. The latter is a more complex
and inclusive construct.
We also considered several reasons why
patients do not adhere to treatment
regimens, and how healthcare
professionals can employ effective
communication strategies to increase
patient well-being.