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Thread: How to elicit critical information that other healthcare professionals really need

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    Exclamation How to elicit critical information that other healthcare professionals really need

    Critical information that defines the problem and elucidates the context of the question is not readily volunteered, but must be expertly elicited using effective questioning strategies, that is asking logical questions in a logical sequence, and other means.

    Good communication skills are essential for enabling the pharmacist to gather relevant information and understand the real question (often referred to as the ultimate request) and the genuine needs of the requestor.

    First, pharmacists should accept the responsibility for provide information to other healthcare professionals. The pharmacists' responsibility should extends beyond simply providing an answer to a question. Rather, it is to assist in resolving therapeutic dilemmas or managing patients' medication regimens. And pharmacists should eliminating barriers. That is to say, for pharmacists to provide meaningful responses and effective recommendations to drug information questions, real or perceived impediments must first be overcome.

    With the accepting of responsibility and eliminating the barriers, then we can start to discuss how to make a effective responses and recommendations.

    Step 1 Identifying the Genuine Need

    The question made by the requester itself might now be the true question since the question itself commonly contain few or even no any information about the clinical circumstances, the specific patient, and so on. Even questions that are not related to patient care must be viewed in their proper context.

    A documentation form may be useful to guide the process of data collection and ensure that all relevant information is considered. Meanwhile, pharmacists should remember that ultimately success will depend largely on maintaining the flow of information with minimal distractions and unnecessary or ill-timed questions. Requestors of information are typically vague in verbalizing their needs and will generally provide adequate information only when specifically asked or thoughtfully prompted.

    Questions to consider before formulating a response include:

    Is there the requestor's name, profession, and affiliation known?

    Does the question pertain to a specific patient?

    Is there a clear understanding of the question or problem?

    Is the correct question being asked?

    Why is the question being asked? Why now?

    Are the requestor's expectations understood?

    Has pertinent patient history and background information been obtained?

    What are the =unique circumstances that generated the query?

    What information is actually needed?

    When is the information needed and in what format (e.g., verbal, written)?

    How will the information provided be used or applied?

    How has the problem or situation been managed to date?

    Are there alternative explanations or management options that should be explored?

    Some important questions which might not be posed by requestor, for example like:

    Initial query posed by requestor: Can ranitidine cause thrombocytopenia?

    and below are questions not posed by requestor,

    What is the incidence of ranitidine-induced thrombocytopenia?

    Are there any known predisposing factors?

    Is the pathogenesis of this adverse effect understood?

    How does the thrombocytopenia typically present?

    Are there any characteristic subjective or objective findings?

    Does thrombocytopenia due to ranitidine differ from that caused by other H2-receptor anagonists, other medications, or other etiologies?

    Is the thrombocytopenia dose related?

    How severe can it become?

    How soon after discontinuing the drug does it reverse?

    How is it usually managed?

    What is the likelihood of cross-reactivity with H2-receptor antagonists?

    How risky is rechallenge with ranitidine?

    Are there treatments available that can be used in place of ranitidine?

    Are there alternative explanations for the thrombocytopenia in this patient (including other medications, medication combinations, or underlying medical conditions)?

    What complications, if any, be expected?

    (more coming...)
    Last edited by CheneyHsiung; Wed 24th September '14 at 11:20pm.
    Clinical Pharmacy Specialist - Hematology

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