Supported in part by Arkansas Blue Cross and Blue Shieldand the Office of the Arkansas Drug Director and in partnership with the Arkansas Academy of

Family Physicians (AAFP), the Arkansas Medical Society (AMS), the Arkansas State Medical Board (ASMB), the Arkansas Department of Health (ADH) and its Division of Substance Misuse and Injury

Prevention (Prescription Drug Monitoring ProgramPDMP)

Continuing Education Credit: TEXT: 501-406-0076Event ID: 24764-23985

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AR-IMPACT Team Members

Michael Cucciare, PhD

Johnathan Goree, MD

Corey Hayes, PharmD

Teresa Hudson, PharmD, PhD

Shona Ray-Griffith, MD

Leah Tobey, PT, DPT

Graduate Student: Andrea Melgar-Castillo

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Flow of the Case Conferences

General Information: 5 minutes

Topic Presentation: 20 minutes

Case Conference: 25 minutes

Feedback and Thoughts on Future Sessions: 5 minutes

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AR-IMPACT website: arimpact.uams.edu

AR-IMPACT email address: AR-IMPACT@uams.edu

Twitter: @ArkansasImpact

Joining the Conference:

Click to join: https:// join.uams.edu/invited.sf?secret=YtVKQkHsoWTgJaguonymZw&id=415081971

Or call in: 1-844-885-1319, then enter 415081971

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http://arimpact.uams.edu/mailto:AR-IMACT@uams.eduhttps://join.uams.edu/invited.sf?secret=YtVKQkHsoWTgJaguonymZw&id=415081971

Faculty Disclosure of Financial Relationships:The planners of this RSS, Corey Hayes, Michael Cucciare, Johnathan Goree, Leah Tobey, Teresa Hudson, Marti Morrison and Cathy Buzbee have no financial relationships with commercial interests to disclose.

A planner of this RSS, Shona Ray-Griffith, MD, has a financial relationship with a commercial interest to disclose: Neuronetics, Inc. Contracted Research.

The speaker of this RSS has no financial relationships with commercial interests to disclose. The accreditation compliance reviewers of this RSS, Karen Fleming and Courtney Bryant, have no financial relationships with commercial interests to disclose.

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Continuing Education

Accreditation: In support of improving patient care, University of Arkansas for Medical Sciences is jointly accredited by the Accreditation Council for Continuing Medical Education (ACCME), the Accreditation Council for Pharmacy Education (ACPE), and the American Nurses Credentialing Center (ANCC), to provide continuing education for the healthcare team.Credit Designation: The University of Arkansas for Medical Sciences designates this live activity for a maximum of 1 AMA PRA Category 1 Creditcredit commensurate with the extent of their participation in the activity. The University of Arkansas for Medical Sciences designates this live activity for a maximum of 1 ANCC contact hour. Nurses must attend the entire session in order to receive credit. This knowledge-based activity will provide pharmacists up to 1.0 contact hours or 0.1 CEU. ACPE# JA0000298-0000-18-040-L01-PAAFP Credit: Submit your AMA creditPharmacists: Please email us your NABP number and month and day of birth

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Other General Information

CISCO IPhone App CISCO Meeting Information

Please mute your microphone in CISCO

Able to ask questions through CISCO Chat

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How to Give Advice to Patients Ambivalent toward Change

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Michael A. Cucciare, PhD

University of Arkansas for Medical Sciences

1. Discuss general challenges to effectively communicating with patients

2. Discuss practical suggestions for improving communication

3. Present a strategy for sharing information/giving advice to patients who are unsure about next steps

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What do we mean by ambivalence?

Having mixed feelings about a course of action

What issues elicit ambivalence in your patients?

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General challenges to effectively communicating

Passivity

High emotion

Depression or distraction

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Practical suggestions for improving information exchange

Slow down, and progress will be quicker

Consider the broader priorities of the patient

Positive messages matter

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A brief, motivational strategy for giving advice

Remember: If a patients asks for information/advice, go ahead and give it

If ambivalent, consider starting by asking permission (i.e.,

Consider using Ask-Provide-Ask

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Ask-Provide-Ask

Understand what is most important for the patient to know from their perspective

What would you most like to know about________?

Create an opportunity to provide focused information/correct misconceptions

What do you already know about_________?

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Ask-Provide-Ask

Provide

Give advice/information in a manageable chunk

Ask permissionWould it be ok if I shared some information with you about

_______?

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Ask-Provide-Ask

Check-in to see if the patient is getting what you say

Some possibilities include:What are you thoughts/feelings about this?

What else would you like to know?

What questions do you have?

What do you think about this?

The focus is on not how much information you can get across but helping the patient make sense of the information and make good decisions about behavior

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What to take away

For ambivalent patients, advice/information giving is optimized when you:

ask permission (makes it more collaborative)

use manageable chunks (personalized and focused)

- to assess impact)

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Resources

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What questions do you have?

What do think about Ask-Provide-Ask?

How would this work in your practice?

What challenges do you anticipate?

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Thank you!

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