Dialogue and Health Literacy: Bridging Gaps for Patient Understanding in Community Pharmacy

A pharmacist hands a prescription to a patient in a community pharmacy.

Break downs in patient engagement accounted for about 15 percent of reported harm incidents in Manitoba community pharmacies. These incidents often happened because of missed patient counselling, or a lack of confirmation of patient understanding. A focus on communication and health literacy can reduce the chances of a medication incident in your pharmacy.

Health literacy is an important factor in a person’s ability to find, understand, and adhere to health advice. Health literacy is also a person’s ability to make appropriate health decisions on their own. Sixty per cent of Canadian adults have low health literacy.

People with low health literacy are less likely to:

  • Be able to identify their own medications
  • Understand how to take their medications
  • Understand the potential side effects

It’s important to engage with patients during counselling in a way that is easily understood and confirms their understanding. Patient dialogue is needed to prevent medication incidents that arise because of drug shortages, complex regimens, or other complicating factors.

Incident Example from a Manitoba Community Pharmacy

Incident example: Since a limited supply of hydrochlorothiazide 12.5 mg tablets was available from the manufacturer, a patient was dispensed 25 mg tablets with label instructions to take ½ tablet daily. The patient took 1 tablet per day and, upon request for an early refill, the error was recognized. At the next refill, the patient was verbally reminded of the correct dose and the tablets were cut in half.

5 Approaches to Effective Patient Dialogue

  1. Identify and document discussion points during the prescription verification process. For example, you could indicate the discussion points on a hardcopy of the prescription. Attach your documentation to the filled prescription to alert the pharmacist to engage in patient dialogue.
    • This can include highlighting key information directly on the vial label or compliance package label
  2. Consider using technology to support virtual communication with patients when they can’t visit the pharmacy themselves.
  3. Use the teach-back method to confirm patient or caregiver understanding.
  4. Encourage patients to ask questions. Use resources such as 5 Questions to Ask About Your Medications and 5 Questions to Ask About My Medications for Kids to encourage engagement and promote health literacy.
  5. Learn more about health literacy and effective communication:

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