Laura Schackmann, Netherlands Institute for Health Services Research, Utrecht, The Netherlands
Ellen S. Koster, Division of Pharmacoepidemiology & Clinical Pharmacology, Utrecht Institute of Pharmaceutical Sciences, Utrecht University, Utrecht, The Netherlands
Liset van Dijk, Groningen Research Institute of Pharmacy, Unit of PharmacoTherapy, -Epidemiology & -Economics, University of Groningen, Groningen, The Netherlands
Marcia Vervloet, Netherlands Institute for Health Services Research, Utrecht, The Netherlands
Mette Heringa, SIR Institute for Pharmacy Practice and Policy, Leiden, The Netherlands
ABSTRACT
Background
Pharmacy staff members have important tasks related to patient education and counseling about medicines. However, especially challenging situations that increase stress or negative emotions tend to disrupt effective communication. For example, encounters about non-medical medication switches. In these encounters, the pharmacy team delivers a message to patients that may lead to negative emotions, and are often experienced as difficult conversations between pharmacy staff and patients. To support pharmacy staff in how to best deliver the message and how to address patients’ emotions, a communication training has been developed. In this training, pharmacy staff members were taught how to apply two communication strategies, ‘positive message framing’ (emphasizing positive elements of the message) and the ‘breaking bad news model’ (break the news immediately, give room for and address emotions) for use in pharmacy encounters.
Aim
To understand to which extent the communication strategies learned during the training were applied in practice and how pharmacy staff members’ experienced the use of the strategies in medication switch encounters.
Methods
The training was tested with staff from 15 Dutch pharmacies. The effects of the training (level three and four of the Kirkpatrick Model) were assessed. In order to assess which strategies pharmacy staff applied in practice (level three) and how the training effects patients’ and pharmacy staff satisfaction of the conversation after use of the strategies (level four), conversations were registered. Pharmacy staff filled in a questionnaire per conversation post-training. Questionnaire topics included: respondent background and conversation characteristics, applied strategies, and (overall) experience(s) (message delivery, reaction to patient’s emotions/concerns).
Results
In total 68 conversations were registered post-training by 22 pharmacy staff members (half were pharmacy technicians, about one-third were pharmacists). The applied strategies were divided, the most commonly used was breaking the bad news model (29.9%), followed by a combination of both strategies (22.4%) and positive message framing (17.9%). 14.9% staff members indicated to have used neither. About two-thirds (65.2%) of the pharmacy staff members indicated that they told the patient that they have to switch medication(s) directly at the beginning of the conversation (65.2%). The majority indicated that they brought the message by explaining why the switch took place (93.9%) and what the similarities were between the new and old medicine (73.8%). Moreover, about three-fourths (74.2%) indicated that they could deal with the patient’s emotions well. Particularly, pharmacy staff gave the patient the space to express their concerns (86.4%), patients were reassured that the new medicine was a good alternative (80.3%), and pharmacy staff showed understanding for the patients’ concern(s) (75.8%). Overall, pharmacy staff and patients were quite satisfied with the conversations about medication switches, as according to the pharmacy staff, 62% of the patients experienced the conversation as (very) positive and 78% of the pharmacy staff members themselves experienced the conversation as (very) positive.
Conclusion
This training seems to be beneficial in providing pharmacy staff members with tools on how to have conversations about non-medical medication switches. Incorporating these tools in these encounters can lead to improved patient-centered communication.