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Introduction

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Delivering quality pharmaceutical care requires both strong technical and people skills. While all pharmacists are well versed in the technical aspects of the profession, many are not well prepared regarding interpersonal communication within the clinical context. In contemporary pharmacy practice, good communication skills are critical for achieving optimal patient outcomes and increasing pharmacists’ satisfaction with their professional roles. The focus of this chapter is limited to the essential skills needed for symptom assessment, medication consultation, and strategies to improve compliance and monitor clinical progress. Readers are encouraged to review aspects of basic communication skills in other sources.15

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The Importance of Asking Open-Ended Questions in Health Care Settings

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One of the most important techniques to effectively communicate with patients is the primary use of open-ended questions. Open-ended questions are ones that start with who, what, where, when, why, and how. Closed-ended questions can be answered with either a simple yes or no answer and start with can, do, did, are, would, or could. Open-ended questions have numerous advantages compared with closed-ended questions. They markedly increase the comprehensiveness and accuracy of patient responses compared with closed-ended questions. Open-ended questions help readily identify patients with special needs requiring interventions, including patients with cognitive impairment, hearing loss, or lack of fluency in English or other primary language. Closed-ended questions allow patients with special needs to go undetected by hiding behind their yes or no answers. Open-ended questions minimize the need for the professional to speak, maximizing opportunities for listening for patient understanding and symptom-defining answers. Finally, they force the patient to answer with something other than yes or no, encouraging dialogue or further conversation with the patient. Closed-ended questions are perceived by patients as discouraging further response and are used to bring closure to conversations. Whether collecting information regarding a patient’s symptoms or verifying that patients understand how to take their medication during medication counseling, the use of open-ended questions is the most effective communication technique and is therefore emphasized in this chapter.

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Basic Medication Consultation Skills

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Consultation on prescription medication use is a fundamental and important activity of the pharmacist and is mandated by both state and federal law or regulation.6 The primary goal of traditional methods of medication counseling is to provide information: the pharmacist “tells” and the patient “listens.” Pharmacists may try and check for patient understanding by asking ineffective closed-ended questions such as, “Do you understand?” or “Do you have any questions?” This traditional approach never verifies that the patient understands how to properly use his or her medication, which can lead to poor outcomes. Given the low level of patient health literacy in the United States, reliance on written patient handouts may also lead to a similar level of poor patient outcomes.7 Using a modification of the effective educational approach, ...

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