Pharmacy Practice, Pharmaceutical Care, and Patient Counseling
Pharmaceutical care is examined as behaviour, not slogans: can you gather the right information, decide whether self-treatment is safe, and confirm the patient understood?
The consultation sequence
- Assess: who, symptoms, duration, red flags, comorbidities, pregnancy or lactation, current medicines, allergies.
- Decide: OTC self-care, referral, or prescription; check duplication and interactions.
- Advise: indication, dose, timing, duration, storage, missed-dose action.
- Confirm: teach-back ("show me how you would use this inhaler"), with written or pictorial support where literacy is limited.
Counseling specifics
Mongolian winters mean insulin and many biologicals must not freeze - "refrigerate, do not freeze" is a real instruction, not a formality. TB patients on DOTS need adherence support and hepatic warning signs. Warfarin patients need consistent vitamin K intake and INR monitoring.
Worked example
A 68-year-old on warfarin for atrial fibrillation asks for an OTC NSAID for knee pain. Reasoning: NSAIDs add antiplatelet effect, displace warfarin from albumin and cause GI bleeding - clinically significant. Alternatives: paracetamol at the correct dose, topical NSAID, physiotherapy, or referral. Advice given: avoid oral NSAIDs, check INR if any new medicine is started, watch for black stools. Document the intervention.
Traps
Counseling by telling rather than checking comprehension; missing pregnancy or breastfeeding; not asking about herbal and traditional products already in use; dispensing a prescription-only medicine on request; recording advice so vaguely that nothing can be audited.