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Understanding Patients’ Needs,

Wishes, and Preferences

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Objectives
1. Help to explain people's behaviors in relation to
medication use.
2. describe patients' potential emotional reactions
to illness and how they may affect their
behavior.
3. describe how people feel about medication use
and information about it.
4. discuss strategies pharmacists can use to
improve patients' quality of life (QOL).
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Understanding Patients’ Needs, Wishes, and
Preferences
• Case#1: Mrs. Um Ali is receiving a prescription for high
blood pressure and says to the pharmacist, "I know Dr.
Raed told me I need this, but I feel fine. My mother and
father both lived into their 90s and never needed pills.
Maybe I don't really need them."
• Case#2: Mr. Abu Zaid, receives a prescription for the
same medication as Mrs. Um Ali. He comments to the
pharmacist, "I know my blood pressure is pretty high, and
I should be taking these pills regularly, but I have a busy
schedule and I find it difficult remembering to take them."

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Understanding Patients’ Needs, Wishes, and
Preferences
• These two patients have different counseling
needs:
1. Mrs. Um Ali needs help in understanding her
illness and the necessity to take medication
daily
2. Mr. Abu Zaid needs help in remembering
and scheduling his medication.

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PATIENTS' FEELINGS ABOUT ILLNESS
1. Fear and Anxiety:
Patients: may fear :the
1. The physical outcome of their disease;
2. The worsening of symptoms;
3. The adverse effects of treatments
4. The social consequences of the illness.
Pharmacist: can help:
1. making Pt accepts these feelings and by encouraging him to
discuss them.
2. help alleviate certain fears by explaining symptoms and their
possible outcomes, and by putting such fears into proper
perspective.

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PATIENTS' FEELINGS ABOUT ILLNESS

2. Feeling of Damage:
Patients: may perceive themselves to be impaired
or "different“ because:
1. their bodies are no longer functioning in their normal
capacities,
2. or because they need to take medication.
Pharmacist: may be able to help the patient
recover from the feeling and, to find ways of
resolving it.

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PATIENTS' FEELINGS ABOUT ILLNESS

3. Anger, Dependency, and Guilt:


Patients: Emotions such as anger,
dependence, and guilt are expressed during
illness due to the comparison with previous
life experiences.
Pharmacist: pharmacist will need to discover
the patient's feelings, and let the patient
know that he recognizes, accepts, and
understands such feelings.
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PATIENTS' FEELINGS ABOUT ILLNESS

4. Depression and Loss of Self-esteem:


– Patients: Depression is recognizable by withdrawal
and unwillingness to talk, eat, or engage in activity
as well as difficulty sleeping and loss of enjoyment
of previously enjoyable activities.
– Pharmacist: should deal with depression by being
aware of it and by directing the patient to
professional psychological help

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PATIENTS' FEELINGS ABOUT ILLNESS

5. Feelings Connected with Death and


Dying:
– Patients: 5 stages: denial, anger,
bargaining, depression, and acceptance.
– Pharmacists: listen, understand, allow
privacy, recognize the feelings and show
empathy.

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PATIENTS' FEELINGS ABOUT MEDICATION
AND COUNSELING
1. Reasons for Taking Medication:
1. medication use as a fact of life (eg. seizures)
2. Psychological—to reduce worry
3. the desire to ensure "normality,“
4. patients' decision-making processes are not
always logical
Pharmacists: need to understand this decision-
making process and be nonjudgmental to
patient
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PATIENTS' FEELINGS ABOUT MEDICATION
AND COUNSELING
2. Beliefs about Counseling and Information:
1. Patients want basic information about the
medical condition being treated
2. Specific information about side effects
3. Duration of treatment
4. Range of available treatment options
5. Not all patients ask questions
6. patients need to be empowered to
participate
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PATIENTS' FEELINGS ABOUT MEDICATION
AND COUNSELING
3. Feelings About Risk:
Patients generally want information about
side effects, but how risk is presented and
understood makes this a challenge
Patients expect pharmacists to provide
information on how to manage and avoid
risk

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Pharmacist's Contribution to Patients'
Quality of Life
1. Discuss the therapy in relation with lifestyle interference.
2. Explain to the patient what he can expect from therapy
3. Offer suggestions on how to minimize the impact of
therapy –Vs effect on the patient's QOL
4. Be prepared for medication-induced patient complaints
5. suggest an alternatives for medication-related QOL
complaints
6. Include lifestyle characteristics such as hobbies and
occupation on the patient's profile

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