This document discusses effective communication skills related to pharmacology and therapeutics. It begins by outlining the objectives of developing communication skills for medical students. It emphasizes that communication skills are a core competency in medical practice and effective communication can lead to improved patient outcomes. The document then discusses various aspects of doctor-patient communication including establishing rapport, questioning techniques, overcoming communication barriers and providing medication instructions. It provides a case study example of communicating treatment for type 2 diabetes and outlines the key points that should be covered when explaining medication to a patient.
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Communication skills dr c m kamaal
1. Dr C M Kamaal MD DCH
Pediatrician and Clinical Pharmacologist
COMPETENCY No PH 3.8 (PRACTICAL PHARMACOLOGY FOR MBBS)
Associate Professor
Department of Pharmacology and Therapeutics
SMMH Govt Medical College Saharanpur
Communicate effectively on proper use of prescribed medication
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2. OBJECTIVES OF PRACTICAL CLASS
At the end of the session shall be able to:
• An overview of communication skills in medical practice
• Realizing the importance of effective communication in achieving optimal drug use.
• Identify that effective communication is directly related to patient compliance.
• Comprehend the dynamics of effective communication during a consultation.
• Learning the communication skills related to use of medication in clinical practice
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3. Communication skills in Pharmacology & therapeutics
Effective doctor-patient communication is in the core of building a
therapeutic doctor-patient relationship, as well as therapeutic
outcome.
Communication skills related to pharmacology and therapeutics by Dr C M Kamaal
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4. Clinical skills viewed as worthless without communication skills
Communication skills in Pharmacology & therapeutics
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Communication skills related to pharmacology and therapeutics by Dr C M Kamaal
5. Developing communication skills are now a part of newer medical
curriculum in as per Competency based medical curriculum.
Communication skills in Pharmacology & therapeutics
Communicate effectively with a patient on the
proper use of prescribed medication
COMPETENCY No PH3.8 PRACTICAL PHARMACOLOGY FOR MBBS
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Communication skills related to pharmacology and therapeutics by Dr C M Kamaal
6. Purposes of Doctor - Patient Communication
1. Creating a good inter-personal relationship - must
show .empathy, respect, genuineness, unconditional
acceptance and warmth.
2. Exchanging information - Consists of information-
giving (patient) and information seeking (doctor)
3. Making treatment - related decisions. - Consists of
information-giving (patient) and information seeking
(doctor). Doctor also gives information regarding
drugs, disease, life-style changes.
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Paternalistic approach' where the doctor directs care and makes decisions about
treatment has been replaced by the ideal of `shared decision making'.
7. Good communication between doctors and patients decreases the chance of
dissatisfaction with professional services, even with failed therapy, and the
likelihood of litigation.
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Communication skills related to pharmacology and therapeutics by Dr C M Kamaal
8. Communication skills
• Communication skills need to be taught and learned
• Can be both learned and retained; it is not just a personality trait
• Experience alone can be a poor teacher
• Needs to be taught with the same rigour as other core skills, such
as the physical examination
• Shifts in medical practice to amplify the need for even
experienced doctors to continually enhance communication skills
Highlights
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Communication skills related to pharmacology and therapeutics by Dr C M Kamaal
9. Advantage of effective communication
• Greater symptom improvement
• Increased Patient Doctor satisfaction
• Better adherence to treatment
• Fewer medication errors
• Better compliance to drug administration
• Reduction of diagnostic testing and referrals
• Improved compliance to drugs
• Better follow up
• Lesser complains against doctors
• Decreased litigation cases
9Communication skills related to pharmacology and therapeutics by Dr C M Kamaal
10. The communication and interpersonal skills are of
measurable and modifiable behaviours that can
evolve.
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Four factors in communication
Communication skills related to pharmacology and therapeutics by Dr C M Kamaal
12. Four factors in communication
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pharmacology and therapeutics by Dr C M
Kamaal
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1. Doctor
2. Patient
3. Atmosphere
4. Message
15. Purposes of Doctor - Patient Communication
• Creating a good inter-personal relationship - must show empathy,
respect, genuineness, unconditional acceptance and warmth.
• Exchanging information Consists of information-giving (patient)
and information seeking (doctor)
• Making treatment - related decisions. - Consists of information-
giving (patient) and information seeking (doctor). Doctor also gives
information regarding drugs, disease, life-style change
Communication skills related to pharmacology and therapeutics by Dr C M Kamaal 15
16. Good communication habits
• Environment
• Initial greeting (friendly & helpful way)
• Seating - conducive.
• Body posture/body language
• Maintain eye contact
• Good listening/warmth
• Effective questioning
• Interruption & facilitation where needed
• End of interview
16Communication skills related to pharmacology and therapeutics by Dr C M Kamaal
18. Nonverbal communication/Body language
More human communication can takes place by use of gesture,
postures, position and distances
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19. Empathy in communication skills
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20. PHASES OF CONSULTATION/COOMUNICATION
1 Establishment of rapport
2 Diagnostic phase
(Establishment of diagnosis)
• the history
• the physical and mental examination
• investigations
explanation and education
3 Management phase
(Medications/procedure/follow up)
• explanation and education
• prescribing medication
• procedural—therapeutic or extended diagnostic
• referral
• follow-up
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21. Rapport establishing techniques
• Greet the patient with a friendly interested manner.
• Treat the patient with respect and courtesy.
• Greet the patient by his or her preferred name.
• Make the patient feel comfortable.
• Be ‘unhurried’ and relaxed.
• Be well briefed about prior consultations.
• Focus firmly on the patient.
• Listen carefully and appropriately.
• Make appropriate reassuring gestures.
• Start with: ‘What would you like to tell me?’ or ‘How
can I help you?’
21Communication skills related to pharmacology and therapeutics by Dr C M Kamaal
22. Questioning effectively
• Use a tone of voice that shows interest, concern and friendliness.
• Don’t ask too many questions that can be answered with a “yes” or
“no”.
• Ask questions that encourage patients to say more e.g., "How can I
help you?" "What have you heard about...?“
• Ask the same question in different ways if you think the patient
has not understood.
• Ask only one question at a time and wait for an answer.
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Communication skills related to pharmacology and therapeutics by Dr C M Kamaal
26. Barriers in communications
Waiting room
Poor physical layout
Too much waiting time for consultation
Time pressure
‘Traffic level’
Busy OPD
Noisy atmosphere in and around consultation room
Sense of urgency
Physical factors
Large size table/desk -barrier
Physician attire
Inappropriate layout
Poor record system
Substandard examination couch
Privacy
Dressing/undressing
Presence of opposite sex physician/assistant (eg. Gynae Obs)
Sound interruptions -telephone
Communication skills related to pharmacology and therapeutics by Dr C M Kamaal
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27. Tips to improve communication in therapeutics
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Use of diagram/video to explain Asthma
28. Checking empty blister package on follow up
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Tips to improve communication in therapeutics
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Demonstrating the of use of device (eg. metered dose inhaler)
Tips to improve communication in therapeutics
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Tips to improve communication in therapeutics
Communication skills related to pharmacology and therapeutics by Dr C M Kamaal
31. Drug effect in support of compliance to treatment
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32. Advice related to life style modification
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33. 1. Brief explanation of disease/condition
2. Name of drug (Brand, generic)
3. Therapeutic effects of drug on disease /condition
4. Medications details (dosage/freq hrly basis/route)
5. How to take (water/milk/juice/curd) chew/do not chew
6. Side effects/food or drug interactions/contraindications
7. What to do if a dose is missed
8. When to stop
9. Food related advice/nondrug advice
10.Follow up instructions/therapeutic adharence
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Communication relevant to therapeutics/pharmacotherapeutics
34. Advice related to dietary modification
Communication skills related to
pharmacology and therapeutics by Dr C M
Kamaal
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EXCERCISE
A 60 year male patient weighing 56 kg working in tea garden has been diagnosed with
Type -2 Diabetes mellitus and has been put on oral hypoglycemic Metformin (Glycomet
500 SR).
CASE FILE
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EXCERCISE
CASE FILE
Description
Glycomet 500 SR is a oral hypoglycemic medications used for the treatment of type 2
diabetes mellitus..
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EXCERCISE
CASE FILE
Describe and demonstrate communication skills important in the
case
39. 1. Brief explanation of disease/condition
2. Name of drug (Brand, generic)
3. Therapeutic effects of drug on disease /condition
4. Medications details (dosage/freq hrly basis/route)
5. How to take (water/milk/juice/curd) chew/do not chew
6. Side effects/food or drug interactions/contraindications
7. What to do if a dose is missed
8. When to stop
9. Food related advice/nondrug advice
10.Follow up instructions/therapeutic adharence
Communication skills related to pharmacology and therapeutics by Dr C M Kamaal 39
Communication relevant to therapeutics/pharmacotherapeutics
40. Communication skills related to pharmacology and therapeutics by Dr C M Kamaal 40
EXCERCISE
1) Brief explanation of disease/condition
People with type 2 diabetes are not able to make enough insulin or respond normally to the insulin made
by their bodies. When this happens, the concentration of sugar/glucose increases in the blood.
Glycomet 500 MG Tablet is an effective first choice medicine used to control high blood glucose levels in
patients with type II diabetes.
Glycomet 1gm Tablet SR is an anti-diabetic medication (biguanide). It works by lowering glucose production
in the liver, delaying the absorption of sugar (glucose) from the intestines and increasing the body's
sensitivity to insulin. It also helps body to respond better to the insulin it makes naturally.
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EXCERCISE
CASE FILE
2) Name of drug
(Brand name and generic name)
Brand name : Glycomet 500 SR
Each film coated tablet contains Metformin 500 mg
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EXCERCISE
CASE FILE
3) Therapeutic effect
• Controlling high blood sugar levels in people with type 2 diabetes mellitus.
• Preventing serious complications of diabetes such as kidney damage and blindness and may
reduce chance of having a heart attack or stroke.
• Helps in controlling weight gain.
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EXCERCISE
CASE FILE
4) Medications details dosage form/route
Once daily oral route
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EXCERCISE
CASE FILE
5) How to take (water)
Swallow it as a whole. Do not chew, crush or break it swallow it with a glass of water.
Prefer taking it in the morning with breakfast
The peak effect of this medicine can be observed within 1-3 hours of administration
can be taken with or after meal Taking Glycomet with meals will reduce its digestive
problems like indigestion, nausea, vomiting, diarrhea, stomach ache and loss of
appetite..
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EXCERCISE
CASE FILE
6) Side effects/food drug interactions
/contraindications
• In addition Lo general restrictions for use of oral hypoglycaemics, Metformin is
contraindicated in renal insufficiency, because risk of lactic acidosis increases. It should
also not be given in hypotensive states, heart failure, severe respiratory/hepatic
disease, as well as in alcoholics.
• Drugs like cimetidine, furosemide may compete with metformin excretion and enhance
its toxicity
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EXCERCISE
CASE FILE
7) If a dose is missed
If a dose of Glycomet is missed it can be taken take it as soon as possible.
However, if it is almost time for next dose, skip the missed dose and going back
to regular schedule is advisable. Doubling the dose to make up for the missed
one is not recommended
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EXCERCISE
CASE FILE
8) When to stop
Medication may continue for life long
This medication should be taken regularly, at the same time each day, to get the most
benefit and should not stopped unless recommends by doctor
The dose is likely to change over time based on therapeutic response and clinical
condition. Regular monitoring of blood sugar levels is recommended during treatment
with this medicine. Do not change the dose or duration of use without consulting the
doctor.
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EXCERCISE
9) Food related advice/nondrug advice
It is important to stay on strict diet and exercise program while taking this medicine. Lifestyle plays a big part in
controlling diabetes.
Physical exercise helps lower your blood sugar level. Physical activities and excercises like fast walking climbing
stairs doing more strenuous housework or gardening are advisable
For overweight patient finding a way to lose weight is important as it really improves diabetes management. This
is because it can help to lower blood glucose and reduce risk of other complications.
Foods to eat for a type 2 diabetic diet meal plan include complex carbohydrates such as brown rice, whole wheat,
oatmeal, fruits, vegetables, beans, and lentils. Foods to avoid include simple carbohydrates, which are processed,
such as sugar, pasta, white bread, flour, and cookies, pastries.
Meal plan/weight reduction/Exercise/change in life style/reduce stress
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EXCERCISE
CASE FILE
10) Follow instructions/
therapeutic adharance