Interviewing and Assessment

Interviewing pharmacists is an important component of medication therapy management as pharmacists obtain information for therapeutic decision-making. Pharmacy techs can also interview patients to obtain information for the pharmacist. The assistant may ask questions from the patient as well. One of the first steps in patient assessment is to determine the medication the patient is taking as well as what the patient already knows about their medications and health-related problems

Components of an Effective Interview

• We must concentrate much harder on the listening component of the communication process

• Listening Techniques:

  • Stop talking- you can't listen while you're talking

  • Get rid of distractions- these break your concentration

  • Use good eye contact- this shows the speaker that you are listening

  • React to ideas not the person- focus on what it said whether you like the person

  • Read nonverbal messages- make sure they align

  • Listen to how something is said- tone of voice in radio speech also transports message

  • Provide feedback- briefly summarize your understanding of what is said

  Probing

• Only asking questions only that elicits the most accurate information

• Timing

• Help clarify problems or concerns

• Open-ended/closed ended questions

  • Close-ended answers end a yes or no response

  • Open-ended uncovers more information and generates more discussion

• Asking sensitive questions

  • Adherence, alcohol use, recreational drugs

  • Let them know the behaviors you are asking about are common

  • Patients should not fear judgment

  • Simple clear-cut questions

  • Tone of voice

  • Be sure the question is necessary

  Use of Silence

• When neither of you or the patient speaks

• There could be an unnecessary pause while you wait for the patient to gather their thoughts and properly answer

• Maybe uncomfortable

• Gather times to think

• If interrupted, it could destroy the opportunity for the patient to think or there is a possibility that they don't understand the question

• Avoid the temptation to fill the empty space with unnecessary talking

  Establish a Rapport

• Rapport builds mutual consideration and respect

  • This is aided by good eye contact, by using sincere friendly greetings, and not by stereotyping or prejudging

  • The patients perception of you will influence the relationship with you

  Interviewing as a Process Type of Information

• Know what you want to accomplish

• Find specific information

• Maybe a directed interview

• Interviewing as a process type of environment

• This is critical as one of the fundamental principles and interviewing process that provides privacy

• Before you begin make sure interruptions are reduced as much as possible

  Start the Interview Process

• State your name and introduce yourself if they do not know your name

• State the purpose of the interview

• Tips

  • Don't jump to conclusions

  • Keep goals clear

  • Be aware of nonverbals

  • Be specific

Ending the Interview

• Don't end the interview abruptly’

• Don't rush

• Summary- “I've enjoyed talking with you today. If you think of something you've forgotten to mention, please give me a call.”

• Document

  Interviewing in Pharmacy Practice

• Accurately complete medication history interviews

  • Identify potential medication-related problems

  • Include over counters, herbals, other complementary and alternate medication

• Challenges to collecting medication histories

• Problem: communication barriers

  • Language barriers

  • Level of conscious or cognitive impairment

• Solution use of your family members, interpreters, community pharmacy

• Problem: the patient does not understand the need for BPMH

• Solution: explain the importance, and empower patient activity participation and his or her care

  Reported Outcomes

• Drug therapy monitoring

  • Lab values in monitoring devices

• Patient self-reporting

  • Evaluation of pain, anxiety, insomnia, migraines

  • Patient or caregiver reports

  • Pain and depression are conditioning a patient may bring to your attention through interviewing

  Documenting Interview Information

• Means of assuring continuity of care to patients

• It becomes the institutional memory that care has been provided

• Use the SOAP acronym

  • Subjective

    • Information reported ex. symptoms or self-report of adherence

  • Objective

    • The reports of testing

  • Assessment

    • Description of the medical-related problems

  • Plan

    • Next steps

    Interview by Telephone

• Cue yourself to smile before you pick up the phone. Your friendly attitude will be transmitted through the tone, pitch, volume, and inflection of your voice

• Answer the phone with three or four rings if possible

• Identify yourself

• Give your full attention to a call

• If you must place a client on hold, ask first

• End the call graciously “thank you for calling”

• Allow the caller to hang up first

• Making calls

  • Before you pick up the phone, make sure you are ready to write down the information

  • Determine whom you are speaking with

  • Ask yourself if this call is necessary