13 lectures, 8 tutorials and 27 hours of practical work (an additional 6 hours of practical work is taught in conjunction with `Medicinal chemistry II)
This subject follows on from `Pharmacy practice I' but concentrates more on the patients and their environment with particular attention spent on communications skill between pharmacist and patient. It also introduces the concept of problem solving from the point of view of pharmacist/patient/provider interactions and the role of the pharmacist in intervening in the therapeutic situation. Accordingly, the major aims of this subject are to provide students with a knowledge and understanding of the principles of counselling, illness behaviour, compliance and problem solving situations in the therapeutic environment.
General objectives
In this teaching program students are expected to develop:
understanding of the methods of effective communication with patients and providers; the problems of medication non-compliance and means of overcoming them; patient education in the broad sense of the pharmacist being a health provider; illness behaviour, normal and abnormal; the placebo effect and how it fits into pharmacy practice; the concepts of self role and the sick role;
abilities in the areas of written and oral communication; counselling; problem-solving in clinically oriented situations; the recording of prescriptions and the use of patient profiles through the use of pharmacy computers;
an appreciation of the relationships existing between drugs, medicines, patients and society; problem-solving in clinically oriented situations and an awareness of the pharmacist's role in therapeutic intervention.
Syllabus
Counselling and communications. Communication skills, professional/patient communication, professional/professional communication. Listening skills, barriers to communication, rapport, empathy, interviewing skills. Advanced counselling skills.
Patient compliance. The problem of noncompliance to health oriented regimens. Statistics and reasons for non-compliance to therapeutic regimens. The patient, the health provider, the social milieu, the therapeutic regimen, the health belief system. Methods of improving compliance.
Patient education. Definition of health education, methods of health education, improving compliance. Practical recommendations to improve comprehension, recall and compliance. The principles of brevity, organisation, primacy, readability, repetition and specificity.
Social pharmacy. The influence of others on behaviour. Categorisation and its dangers in the patient-provider situation. Groups and behaviour, obedience and behaviour. Person perception, behaviour and the patient.
Illness behaviour. What is illness behaviour? Parson's concept of role; the sick role; the well role. Social class and the sick role. Mechanic's Help Seeking Process. Suchman's five stages of the illness experience.
The placebo. Historical perspective, definitions, incidence, mechanisms, practitioner behaviour and placebo effect, patient characteristics and placebo effect, patient-practitioner communication and placebo effect, situational determinants of placebo effects, social norms and the placebo effect, generalisability and the placebo effect, the placebo as a methodological tool, alternative therapies and the placebo effect.
Practical
Practical classes are designed to provide experience in dispensing, communication and counselling, oral presentations (following on from `Pharmacy practice I'), prescription-solving situations and computers in pharmacy. In addition, sessions on aspects of pharmaceutical chemistry related to the practice of pharmacy and a pharmaceutical industrial visit will be organised.
Textbooks
Recommended texts
Human behaviour text prescribed for `Pharmacy practice I'.
Pharmaceutical Society of Australia Australian pharmaceutical formulary 15th edn, PSA, 1992
Pharmacy Board of Victoria Office consolidation 2nd edn, PBV, 1987
Quintrell N Communication skills. A manual for pharmacists Pharmaceutical Society of Australia, 1982
Victorian College of Pharmacy Pharmaceutics II/Pharmacy practice II laboratory manual VCP, 1995
Warden-Flood J Handbook for patient medication counselling 6th edn, Pharmaceutical Society of Australia, 1993
Wertheimer A I and Smith M C Pharmacy practice: Social and behavioral aspects 3rd edn, Williams and Wilkins, 1989
Reference books
Australian Pharmaceutical Publishing Australian prescription products guide APP, 1995
Fitzpatrick R and others The experience of illness Tavistock, 1984
Journal references
Australian Journal of Hospital Pharmacy
Australian Journal of Pharmacy
Australian Pharmacist
Australian Prescriber
Assessment
Subject assessment will reflect the learning objectives outlined above. Methods of assessment will include:
Practical work and counselling assignment: 10%
Open book practical examination (October) (3 hours): 90%
The theoretical aspects of the lectures on social pharmacy and illness behaviour will be examined in the `Pharmacy practice III' annual examination
Dispensing: Students are required to reach a satisfactory level of competence in dispensing by the end of the course