What are the challenges to new prescription conversations?
While the importance of supporting patients to understand and make the most of a new medicine may be clear in theory, the practicality of incorporating these conversations into daily pharmacy practice can be challenging.
Balancing your multiple responsibilities as a community pharmacist may de-prioritise these conversations by practical necessity. When you work in a busy environment, it can be hard to focus on these conversations – and constant interruptions only exacerbate the issue.
It can be helpful to plan a support strategy for your team that takes account of potentially unpredictable workflows and interruptions – so when a patient is willing to have a conversation about a new medicine, you are more likely to be able to find the time. When more information is required or you want to pass information onto the patient’s GP, this can be particularly time consuming if you haven’t allowed for it. Some GPs give community pharmacists ‘bypass’ phone numbers or specific emails for these communications.
Similarly, communication with hospital pharmacy teams is often complicated by lack of direct telephone or email access to the appropriate pharmacist. It is worth developing links with your local hospital pharmacy so that you can agree a method of communication – both to ensure that their calls about medicines reconciliation happen at a time convenient for you and so you can contact the right person about new prescriptions as part of the discharge medicines service.
Communicating with patients as part of the new medicine service
Open question: How much of your new medicine have you felt able to take so far, if any?
Open question: What concerns have you had about your new medicine, if any?
Open question: How well do you think the medicine is working?
Open question: What unexpected effects or changes have you noticed recently/since starting this medicine?
Open question: How many doses of your medicine have you missed in the past week?
Open question: What else would you like to discuss or revisit about your medicine?
Reflection exercise
Think about a recent patient for whom you undertook a NMS intervention or you counselled about a newly prescribed medicine. How could the alternative, ‘open’ NMS questions (see panel above) have been helpful in exploring issues for that patient?