An important first step in establishing patient-centered care is starting with the relationship with your patients. It supports engagement and effective communication with patients and their caregivers, allowing them the best service possible.

What is Patient-Centered Care

• The better practice of caring for the patient in ways that are meaningful and valuable to the patient.

• Better communication can prevent serious adverse effects and possibly death

• This type of care depends on your ability to develop trusting relationships with patients, to exchange information, and involve patients in the decision-making process regarding treatments.

• Help patients achieve their therapeutic goals.

• Effective communication is central to meeting these patient care responsibilities in the practice of pharmacy.

• Patient-centered care: is the practice of caring for patients in ways that are meaningful and valuable to individual patients.

• This includes

  • Listening

  • Informing

  • Feedback

• IOM defined patient-centered care: as providing care that is respectful of and responsive to individual patient preferences, needs, and values and ensuring that patient values guide all decisions

Pharmacists’ Patient Care Process

• The IOM reported that medication-related errors are some of the most prevalent errors causing morbidity.

• Health care in recent years has shifted from error prevention to patient safety.

• The Joint Commission of Pharmacy Practitioners (JCPP) release the Patient Care Process.

Collect

• The pharmacist ensures the collection of the necessary subjective and objective information about the patient to understand the relevant medical/ medication history and clinical status of the patient.

Assess

• The pharmacist assesses the information collected and analyzes the clinical effects of the patient's therapy in the context of the patient's overall health goals to identify and prioritize problems and achieve optimal care.

Plan

• The pharmacist develops an individualized patient-centred care plan, in collaboration with other healthcare professionals and the patient or caregiver, that is evidence-based and cost-effective.

Implement

• The pharmacist implements the care plan in collaboration with other healthcare professionals and the patient or caregiver.

Follow-up: Monitor and Evaluate

• The pharmacist monitors and evaluates the effectiveness of the care plan and modifies the plan in collaboration with other healthcare professionals and the patient or caregiver as needed.

Importance of Communication in Meeting Your Patient Care Responsibilities

• The communication process between you and your patients serves two primary functions:

  1. It establishes the ongoing trusting relationship between you and your patients.

  2. It provides the exchange of information necessary to assess your patients' health conditions, reach decisions on treatment plans, implement the plans, evaluate the effects of treatment(s) on your patients' quality of life and enhance patient safety. So as you know, most of this is required of the pharmacist only.

• It is essential to establish trusting relationships with your patients.

• An effective relationship forms the foundation that allows you to meet your professional responsibilities of patient care.

• The ultimate purpose of a professional-patient relationship must be constantly kept in mind. The purpose of the relationship is to achieve mutually understood and agreed-upon goals for therapy that improve the patient's quality of life.

• You need to focus on the patient’s needs.

• A study done in 2004 showed that 27% of patients experienced symptoms they attributed to a new prescription, and many of these symptoms (31%) were not reported to the prescribing physician. The first author reported in a news release that "For every symptom that patients experienced but failed to report, one in five resulted in adverse drug events that could have been prevented or made less severe.”

• The problem being patients were not comfortable talking to their healthcare professional team

• Being able to lay one’s own judgements and preconceived opinions aside is necessary when working to provide the best possible patient care

Encouraging a More Active Patient Role in Therapeutic Monitoring

• The information a patient provides you as part of therapeutic monitoring is essential to assuring that treatment goals are being met.

• Treatment of depression and pain, for example, has only patient self-report as the basis of an evaluation of response to therapy.

  • As well as many other diseases

    • Asthma

    • Angina

    • Epilepsy

    • Arthritis

• The Veterans Health Administration implemented a national home telehealth program to provide routine chronic care management services for:

  • Diabetes mellitus

  • Congestive heart failure

  • Hypertension (HTN)

  • Posttraumatic stress disorder

  • Chronic obstructive pulmonary disease

• With monitoring data transmitted electronically

• Increasing patient involvement in their care leads to higher quality decisions better suited to meet a patient's unique needs because they were derived mutually.

Patient-Centered View of the Medication Process

• Focuses on the patient role in the process.

• The medication use process for noninstitutionalized patients begins when the patient perceives a healthcare need or health-related problem.

• The patient may choose to take no action to treat the condition.

• If the patient does act, they may decide to use self-treatment or contact a nonmedical provider such as a faith healer or they may contact a health care provider.

  If the patient does contact a healthcare professional, the patient must describe his/her symptom experience.

• Once a healthcare provider is contacted,, the healthcare provider listens to the patient, applies their meaning, and conducts an assessment. Diagnosis/recommendations are made to the patient.

• The patient monitors the response to an action. The patient may or may not decide to follow the recommendations from the health care provider.

Medication Recommended or Prescribed

• If the patient decides to follow a recommendation to initiate drug treatment

• Obtain the medication and attempt to follow the drug regimen as prescribed

  • They can only do so to the best of their ability and understanding of what drugs are intended to be taken

• For many patients, medication taking includes misuse caused by misunderstanding what is recommended or by unintended deviations from the prescribed treatment.