Making the most of remote consultations
Below are some phrases that may be helpful to use in a remote DMS consultation using the ‘Five E’s’ structure. The outline has been modified to support DMS stage 3.
Five E phrases
Establish the timeframe
- “Thanks for taking the call, are you ok to talk for x minutes?”
Their agenda, then yours (pre-frame)
- “I understand you were recently discharged from hospital. How are you doing?” – this question allows for red flags to be identified.
- "I am calling you to discuss your medicines following your discharge from hospital. But, before I go through them, is there anything you would like to ask me about your medicines?”
- “What do you know about any new medicines or changes to your medicines that have happened in hospital?”
- “What do you want to know about your new medicines/changes?”
This is important to support the patient in getting the most from their medicines. The “ask – share – ask” approach can be useful here.
Ask: “Would it be helpful if I told you a few things about getting the best from your new medicine?”
Share: Give the information
Ask: “What questions have you got about what I’ve said?”
Consider what resources the patient might need for more information (how and when to take, store and dispose of these/old medicines) and whether they actually want more information or just time to think about things:
- “I’ve got some information about this – would you like me to share it with you?”
Give options about information sources and ask:
- “Is that helpful?”
When discussing the relative benefits of medicines and potential interactions/adverse effects to be aware of, always refer to absolute risk, and use positive and negative framing of your discussion.
Encourage the patient to share their thoughts with you about what you’ve discussed:
- “What do you think about what we’ve discussed in relation to your medicines?”
- “What would you like to do now in relation to your medicines?”
Support the patient to embed any new medicines into their everyday life.
- “What do you need to do to remember to take your medicine(s)?”
- “How will you adjust your medicines-taking to incorporate these changes?”
- “What help do you think you need with your medicines-taking, if any?”
You may wish to ask the following four trigger questions:
- Supply: “Do you need help in getting a regular supply of your medicines?”
- Compliance: “Do you take your medicines the way that the doctor (or other prescriber) thinks you do?”
- Functionality: “Can you swallow or use all of your medicines and get them out of their containers?”
- Clinical: “Do you think that some of your medicines could work better?” and “How will you know whether your new medicine(s) is/are working?”