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Talking with patients is a crucial component of the medication use process. Regardless of practice area, healthcare providers have the opportunity to teach and learn from people they interact with each day. In addition to having a wealth of scientific knowledge and clinical skills, providers must also possess excellent communication skills. This chapter focuses on key elements of communication in various practice settings. The intricacies of interpersonal communication can be found in other resources.1–3
PATIENT-CENTERED CARE AND THE ROLE OF COMMUNICATION
With the movement toward value-based, accessible, high-quality care, provision of interprofessional, team-based care is vital. The Patient Protection and Affordable Care Act of 2010 fostered development of accountable care organizations (ACOs) and patient-centered medical homes (PCMHs). The National Center for Quality Assurance defines a PCMH as “a way of organizing primary care that emphasizes care coordination and communication to transform primary care into ‘what patients want it to be.’”4 A team-based approach that includes pharmacists with medication expertise and good communication skills can optimize the medication use process and ensure that the patient truly is at the center of care.
In patient-centered care, the patient participates in his/her own healthcare through shared decision making with healthcare providers. Shared decision making involves decision aids or a process to facilitate patient understanding when multiple treatment options could be used.5 Shared decision making increases knowledge and improves patient understanding of the risks of their care and makes patients more likely to receive care that is consistent with their values and beliefs.6
Consequently, the patient–clinician interaction must involve more than simply collecting information during a medication history interview or conveying verbal or written information about a prescription. Active listening skills must be employed to understand the patient’s concerns about medication therapy, engage the patient in his/her care, and develop the trust required for a positive longstanding relationship. Establishing a trusting relationship is necessary for effective communication, but trust does not come quickly or easily. In the community pharmacy, it may result from a caring pharmacist always taking the time to ask how a patient’s medications are working. In an ambulatory clinic, it could come from a nurse practitioner or pharmacist teaching about diabetes care and improving A1C levels. Pathways to a trusting relationship may vary, but the ultimate goal is for patients to feel that they can confide in and rely on their healthcare providers about medication-related needs.
Patient interactions vary depending on the practice setting, clinician training, the purpose of the interaction, and other factors. In 2015, the Joint Commission of Pharmacy Practitioners (JCPP) published the Pharmacist’s Patient Care Process, which is similar to the patient care process used daily by other healthcare providers and is intended to standardize the ...