Presentasi berjudul: "Konseling MK Farmasi Komunitas Bag Farmasi Klinik dan Komunitas, Univ Jember."— Transcript presentasi:
Konseling MK Farmasi Komunitas Bag Farmasi Klinik dan Komunitas, Univ Jember
Definisi Konseling KBBI kon·se·ling n 1 pemberian bimbingan oleh yg ahli kpd seseorang dng menggunakan metode psikologis dsb; pengarahan; 2 pemberian bantuan oleh konselor kpd konseli sedemikian rupa sehingga pemahaman thd kemampuan diri sendiri meningkat dl memecahkan berbagai masalah; penyuluhan
Definisi Konseling Kepmenkes Nomor 1027/MENKES/SK/IX/2004 tentang STANDAR PELAYANAN KEFARMASIAN Dl APOTEK “Konseling adalah suatu proses komunikasi dua arah yang sistematik antara apoteker dan pasien untuk mengidentifikasi dan memecahkan masalah yang berkaitan dengan obat dan pengobatan.”
Konseling oleh Apoteker di AS an: kode etik kefarmasian menyarankan apoteker untuk menghindari diskusi ttg obat dengan pasien Alasan?
Konseling Kepmenkes Nomor 1027/MENKES/SK/IX/2004 tentang STANDAR PELAYANAN KEFARMASIAN Dl APOTEK Apotek harus memiliki: – “Ruangan tertutup untuk konseling bagi pasien yang dilengkapi dengan meja dan kursi serta lemari untuk menyimpan catatan medikasi pasien.”
Counselling Well-informed patients are more likely to use their medications correctly. The intervention of the pharmacist in the provision of advice on medicines improves medicine safety.
Counselling in the community pharmacy setting This should be an integral part during dispensing of medicines. – Kepmenkes 1027/MENKES/SK/IX/2004 – “Sebelum obat diserahkan pada pasien harus dilakukan pemeriksaan akhir terhadap kesesuaian antara obat dengan resep. Penyerahan obat dilakukan oleh apoteker disertai pemberian informasi obat dan konseling kepada pasien.”
Counselling in the community pharmacy setting Kepmenkes 1027/MENKES/SK/IX/2004 “Apoteker harus memberikan konseling, mengenai sediaan farmasi, pengobatan dan perbekalan kesehatan lainnya, sehingga dapat memperbaiki kualitas hidup pasien atau yang bersangkutan terhindar dari bahaya penyalahgunaan ataupenggunaan obat yang salah.“ “Untuk penderita penyakit tertentu seperti kardiovaskular, diabetes, TBC,asma dan penyakit kronis lainnya, apoteker harus memberikan konseling secara berkelanjutan.”
Counselling in the community pharmacy setting Pharmacists should be visible and accessible for patients to request advice. – Kepmenkes 1027/MENKES/SK/IX/2004 – “Masyarakat harus diberi akses secara langsung dan mudah oleh apoteker untuk memperoleh informasi dan konseling.”
Counselling in the hospital setting On admission During hospitalisation: needs assessment On discharge At outpatient clinics In rehabilitation settings.
Objectives of patient counselling by pharmacists To ensure that patients are adequately informed about their medication To predict any problems which might cause loss of efficacy of the drug or be detrimental to health of patient To identify any drug-related or health-related problems.
Counselling process during dispensing of medicines How and when to take or use a medicine How much to take or use How long to continue treatment What to do if a dose is missed How to recognise side-effects and minimise their occurrence Lifestyle and dietary changes Drug–drug and drug–nutrient interactions.
Elements of Counselling (US NABP, 1990) Name and description of the drug Dosage form, dose, route of administration, and duration of drug therapy Intended use of the drug and expected action Special directions and precautions for preparation, administration, and use by the patient Common severe side effects or adverse effects or interactions and therapeutic contraindications that may be encountered, including their avoidance, and the action required if they occur
Elements of Counselling (US NABP, 1990)... continued Techniques for self-monitoring drug therapy Proper storage Prescription refill information Action to be taken in the event of a missed dose Pharmacist comments relevant to the individual’s drug therapy, including any other information peculiar to the specific patient or drug
Counselling Records—Patient Information (US NABP, 1990) Name, address, telephone number Date of birth (age), gender Medical history – Disease state(s) – Allergies/drug reactions – Current list of medications and devices Pharmacist comments
Pharmacist counselling process Recognising the need for counselling: – extent of counselling required varies from one individual to another. Assessing and prioritising the needs: – what points need to be emphasised? Checking assessment methods: – to identify outcomes and follow-up counselling process.
Pharmacist counselling process Environment in pharmacy: – must be conducive to privacy and to induce patients to ask for professional advice from the pharmacist. Professional appearance of pharmacist: – to project a professional appearance that enables individuals, including those who feel that they have a very sensitive issue to discuss, to address the pharmacist with confidence.
Recognising the need for counselling Is it a repeat medication? – Patients who have already taken the medication also require counselling to ensure proper use of medicines. If the patient is taking medication for the first time more information is required. Polytherapy: – patients who are taking more than one medicine need more support to manage the drug-handling process.
Recognising the need for counselling Complex instructions: – with medicines that have a complex drug regimen or require an unusual drug-taking pattern (e.g. bisphosphonates) the pharmacist needs to provide counselling and must ensure that the patient has understood the drug regimen. Narrow therapeutic index drugs: – the risk associated with these medications (e.g. Warfarin) is higher if patient is not aware of how to take medication, which side-effects should be reported and the necessity of relevant routine checks.
Recognising the need for counselling Patient characteristics: – the pharmacist needs to adapt the counselling session according to patient characteristics and to individualise the session (e.g. elderly, frail, psychiatric conditions).
Assessing and prioritising needs Patient needs vary according to a number of factors. The counselling process has to be developed according to each individual patient’s needs. Patient priorities in life (e.g. lifestyle) should be taken into consideration during the counselling session if maximum patient benefit is expected.
Assessing and prioritising needs Information about patients that will help to prioritise the needs includes: – educational background – available support – sight or hearing problems – pregnancy and breast-feeding.
Follow-up counselling sessions During follow-up counselling sessions, which may take place during dispensing of a repeat medication, identification of the following factors should be considered: – patient problems with medication (side-effects, complex drug regimen, drug therapy interfering with lifestyle) – deterioration in health status requiring pharmacotherapy review – medication errors – medication mismanagement.
Written information Patient-specific written information Patient information leaflets Warning cards (e.g. used for lithium, anticoagulant therapy, steroids, benzodiazepines) Leaflets on drug administration (e.g. pessaries, inhalers, nebulisers).
Pharmacist counselling programmes Lifestyle measures: – counselling on exercise and diet – monitoring of body weight, lipid profile, glucose levels and blood pressure
Pharmacist counselling programmes Diabetes: – giving information on condition, advising on proper techniques for insulin storage and administration – identifying and providing guidance on actions to monitor and compensate for aberrations in glucose levels, dietary and exercise management, and foot care
Pharmacist counselling programmes Asthma: – providing information on condition, medicines and pharmaceutical dosage forms – identifying and providing guidance on actions to compensate for aberrations in peak flow meter readings and exercise management
Pharmacist counselling programmes Hypertension: – providing counselling on significance of monitoring blood pressure – carrying out drug therapy review – advising patients on lifestyle measures
Pharmacist counselling programmes Anticoagulant therapy: – giving information on identification of symptoms indicating haemorrhage – providing education on anticoagulant–food interactions and drug–drug interactions – explaining significance of monitoring of prothrombin time
Pharmacist counselling programmes Hormone replacement therapy: – providing counselling on impacts of drug therapy, lifestyle measures and requirement for continuous monitoring.