4. Ending the consultation
Ending the consultation
Every consultation is different but the following questions may provide a useful framework for closing the discussion:
- “Is there anything you’d like me to go over again?”
The information that a patient receives when starting a new medicine can feel overwhelming. Asking this question gives embarrassment-free permission to ask for some key information to be repeated, which could make all the difference in terms of their confidence in – and hence compliance with – their new medicine.
- “Is there anything else you want to know about your medicine?”
The patient may not have any questions at this point, but suggest they make a note of any that occur in the future and pop back in to ask them, rather than abruptly stopping the medicine.
- “Have you heard of the UK Gout Society?”
Signposting to this and other relevant resources can be a useful source of knowledge and support as a patient moves forward with their treatment. The UK Gout Society can be accessed on the website or by emailing info@ukgoutsociety.org. NHS information is also available.
A reflective account on gout – an example
Conversations with patients starting on gout medication could be used as part of a reflective account for your revalidation submission. An example follows:
“There is good evidence of the positive impact on adherence resulting from early input from a community pharmacist when any treatment is first started. This is particularly important following Covid when patients may not have had as much contact with certain health professionals (not pharmacists!) as would normally be the case.
Having read a CPD module in Pharmacy Magazine about conversations with patients suffering from gout who have been prescribed a new medicine, I reflected on my current practice and identified ways in which I could be more proactive in exploring with patients their understanding of their condition and any newly prescribed medicines.
Gout is relatively common and so this situation is something I could expect to encounter at least every week. I briefed my dispensing team to be on the look-out for new or changed prescriptions for relevant patients/medicines. When this happens, I use the structure and tips from the module to guide my interaction with patients. Feedback has been positive. Patients say they feel more confident as a result of their increased understanding of the condition and medication, and more motivated to remember to take their gout treatment as prescribed.
In terms of the GPhC Standards, I have demonstrated person-centred care (Standard 1) in my conversations with patients, partnership with others (Standard 2) by working with my pharmacy team on identifying patients for whom this intervention may be relevant, and professional judgement (Standard 5) by identifying that this was a clinical growth area for me.”
Learning scenario 2
CORRECT. Helping him to establish a daily routine to remember to take his medication is a good idea.
INCORRECT. Samran needs regular blood tests to establish his serum urate levels and guide dosage increases.
INCORRECT. While starting ULT can precipitate a gout attack, a NSAID or colchicine is recommended first-line, but never aspirin.
CORRECT. Allopurinol can cause neurological effects such as somnolence and dizziness, so Samran should make sure he is not experiencing any of these before embarking on skilled tasks such as driving.