Adherence counseling during patient contacts in swiss community pharmacies

Figures & data

Table 1 Definitions and numbers of observed counseling events by counseling themes and topics of explicit adherence counseling

Counseling theme	Definition	Numbers of observed counseling
		Prescription	OTC
Administration	Counseling on basic administration issues (eg, with respect to meals)	435	317
Dose	Counseling on dosage, dosing times, intervals, and duration of medication therapy	418	226
Effect	Counseling about the effects of the medication	53	221
Adherence	Explicit adherence counseling according to the list of topics	73	57
Topics of explicit adherence counseling
Morisky question	Asking the explicit question: “Do you ever forget to take your medication?”	0	0
Adherence	Directly addressing adherence; assessing the patient’s attitude towards adherence; and mentioning the importance of adherence	8	2
Positive reinforcement	Acknowledging and encouraging the patients on efforts for adherent behavior	2	0
Motivation	Assessing motivation of patient to be adherent and, if necessary, providing support	2	2
Organization	Offering facilitation of medication management through stick-on labels, diaries, timers, dose-dispensing aids, phone reminders, organization of social support, etc	9	2
Appointment keeping	Reminding the patient of appointments (with physician, refill, monitoring)	1	1
Psychological barriers	Among others: forgetfulness; fear of side effects	3	0
Physical barriers	Among others: impaired vision and dexterity; difficulties with swallowing	4	0
instruction of product	Providing comprehensive verbal information on use of the medication in the context of adherence	31	18
Written information	Providing written information on the medication	2	5
Knowledge about disease/therapy	Explaining the relation between medication therapy and disease/necessity of therapeutic intervention	10	26
(Self-) monitoring	Instructing the patient about how to perform (self-) monitoring, including instruction on interpretation of monitored parameters	1	1

Abbreviation: OTC, over the counter.

Figure 1 Patient numbers and allocations by category and themes.

Abbreviation: OTC, over the counter.

Figure 2 Numbers of observed counseling events about administration, dose, effect, and adherence in total and according to dispensing category (prescription/OTC)

Note: n=1,800.
Abbreviation: OTC, over the counter.

Figure 3 Triggers to start adherence counseling named by 31 pharmacists.

Figure 4 Topics of adherence counseling named by 33 pharmacists.

Notes: The topics marked with asterisks correspond to the predefined topics of explicit adherence counseling in Table 1.