Laura Schackmann, Netherlands Institute for Health Services Research, Utrecht, The Netherlands
Minke Copinga, 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
Stijn Crutzen, Groningen Research Institute of Pharmacy, Unit of PharmacoTherapy, -Epidemiology & -Economics, University of Groningen, Groningen, The Netherlands
Ellen van Loon, Groningen Research Institute of Pharmacy, Unit of PharmacoTherapy, -Epidemiology & -Economics, University of Groningen, Groningen, The Netherlands
Paula Sterkenburg, Vrije Universiteit Amsterdam & Bartiméus Doorn, Amsterdam, The Netherlands
Katja Taxis, Groningen Research Institute of Pharmacy, Unit of PharmacoTherapy, -Epidemiology & -Economics, University of Groningen, Groningen, The Netherlands
ABSTRACT
Background
Pharmacy staff members have important tasks related to patient education and counseling about medicines. For example, pharmacy staff have a central role in providing support and advice to patients regarding potential drug related problems they may have that hinder proper use. These may include patients’ misunderstanding of essential medication use information (practical barriers) or the hesitancy patients may have to take their medication due to certain needs and concerns (perceptual barriers). The detection of perceptual barriers is made difficult by stress or negative emotions, as these can disrupt effective communication. The pharmacy team can be trained on how to deal with both pharmacy staff member’s own emotions and those of the patient. A communication training based on the mentalizing concept, the ability to reflect on the behavior of oneself and others in terms of mental states, was developed to improve patient-oriented communication in community pharmacies.
Aim
The aim of this study was to investigate whether a mentalization-based communication training for Dutch pharmacy staff members impacts their ability to provoke and recognize patients’ implicit and explicit medication related needs and concerns.
Methods
In this single-arm intervention study, conversations at the pharmacy counter between pharmacists or pharmacy technicians and patients were video-recorded before and after the mentalization training. The data from the video-recordings were observed and coded using a developed protocol for analysing perceptual barriers. The protocol combined the Beliefs in Medicine Questionnaire (BMQ) and the Verona Coding Definitions of Emotional Sequences (VR-CoDES). Outcome measures included: recognition of patients’ implicit and explicit medication related needs and concerns and implicit and explicit provocation of these needs and concerns. Descriptive statistics, such as frequencies on provocation and recognition of needs and concerns, were used to describe the effect of the training on mentalization. Also, differences between job function and the outcome measures were investigated.
Results
In total, 22 pharmacy staff members participated. 84 video-recordings were analyzed, of which 50 videos before and 34 after the training. Patients seemed to explicitly express more concerns during counter-conversations post-training compared to implicitly expressing concerns (shift 40.0% to 55.6% (N=10 and 5). Pharmacy staff members seemed to provoke and recognize needs and concerns explicitly more often (shift 60.0% to 100.0% (N=6 and 4) and 70.8% to 86.7% (N=17 and 13)). Specifically, pharmacy technicians showed an increase in explicit provocations (n=1 to 4) and recognitions (n=4 to 11) after the training.
Conclusion
This training appears to increase pharmacy staff members’ explicit recognition of patients’ medication related needs and concerns. The training seems to be valuable to improve patient-oriented communication in the pharmacy. Larger studies should further confirm this result.