INTRODUCTION & PREFACE

Pharmacists as the experts of medication have a role to play in ensuring safe and effective use of medications. Supplementary to that, pharmacists also function as educators, advocates, managers, mentors, collaborators and scholars.1 Poor adherence to treatments by patients has serious implications on various areas such as poor clinical outcome, increased healthcare costs, and higher hospitalisation rates.2 Poor adherence is due to many voluntary and involuntary factors and pharmacists intervention such as patient counselling has been shown in studies and reviews to increase adherence and improve treatment outcomes.2 As an example, patients who are left with the lack of understanding on how the medication works may lead to self-made assumptions and actions which compromise therapeutic outcome. Pharmacists are able to bridge this gap through counselling. 

Kuala Lumpur Hospital (HKL) Pharmacy Counselling Working Committee 2018 (Jawatankuasa Kerja Kecil Kaunseling, JKKK) was formed under the purview of HKL Clinical Pharmacy Working Committee. This committee comprises of members from all the Pharmacy Departments and Satellites distributed around HKL. Previous committee Counseling Team in the Main Block that convened developed a few checklists that is now currently in use in HKL for counselling purposes.

During the maiden meet of this committee, several aspects that required attention to help standardize and streamline the counselling practices among pharmacists in HKL were identified. As a result of this meeting, the previous counselling checklists used in HKL, the counselling checklists provided by Pharmaceutical Services Division were to be reviewed and validated to be later compiled into a general counselling guide for use in HKL. Where there were no existing checklists, validated checklists were to be developed for medications that are commonly used.

Guide version:  2.0

Preparing Committee : HKL Counselling Working Committee

 Date Release:  OCT 2020 - JAN 2021

Next Review Date: 2023-2024

Objectives

The objectives of this Counselling Guide are as follows:

a)    To serve as a general primary quick reference standard for all HKL pharmacists’ counselling

b)    To enable standardization in implementation of all counselling activities in HKL

c)    To be used in peer review assessment sessions in HKL as needed  

d)    To provide guidance for counselling validation of contract pharmacists in HKL

e)    To modulate echo-training sessions pertaining to major updates as needed 

f)     To ease continuous updates, revision, and expansion by future committees 

References:

1.  Simpson S. The Roles We Have as Hospital Pharmacists [Internet]. PubMed Central (PMC). 2018 [cited 6 June 2018]. Available from:

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5358056/

2. Suzanne Albrecht I. The Pharmacist’s Role in Medication Adherence [Internet]. Uspharmacist.com. 2018 [cited 6 June 2018]. Available from: https://www.uspharmacist.com/article/the-pharmacists-role-in-medication-adherence 

Counselling is one of the core elements of pharmaceutical care provision by preparing and motivating patients to adhere to pharmacotherapeutic regimens and monitoring plans. Counselling aimed to improve patients understanding toward their prescribed medicines and devices apart from ensuring the maximum therapeutic benefit from the prescribed regimens. 

In Hospital Kuala Lumpur (HKL), patient counselling are conducted in all practice settings be it in-patient or out-patient care, ward pharmacy care, ambulatory care or home care. Pharmacists are responsible to counsel and educate all patients to the extent possible and eliminate potential barriers in providing an effective counselling at all time. It is of utmost importance for pharmacists to tailor counselling information as per individual patient’s condition, knowledge and understanding. Pharmacists are encouraged to collaborate with other health care professionals as a coordinated effort will enhance patient compliance to medication regimens and monitoring plans. 

Counselling checklists on insulin, inhalers and anti tuberculosis drugs were developed back in 2016 by Counselling Team, Ward Pharmacy Unit in the Main Block. In an effort to standardize and update references for counselling cut across all pharmacy units in HKL, general counselling checklists for all drugs and devices including insulin, inhalers, anticoagulants, dermatological products, immunosuppressants, bowel cleansing agents, anti-osteoporotic agents, anti-tuberculosis drugs, hepatitis drugs, strong opioids, eye, ear and nasal preparations, patches, suppositories, pessaries and enemas have been prepared by Counselling Working Committee 2018.   

This guide aimed to assist pharmacists in providing effective patient education and counselling without omitting the pertinent points in counselling any drugs or devices. These checklists may need to be adapted to meet the specific requirements for patients and their family members or caregivers. Pharmacists can contribute significantly to positive clinical outcome through ensuring safe, effective and appropriate use of medicines.    

It is hoped that this guide will serve as a useful reference to all pharmacists. However, we continuously strive to improve from time to time.

Let this guide be a prized possession for all of us! 

Puan Kamarunnesa bt Mokhtar Ahmad

Head of Department,

Pharmacy Department, HKL