Evaluation and Improvement of Communication with the Patient in the Community Pharmacy

Cezara M. Maxim1 , Eugenia Bratu2

1 B.Pharmacist, Researcher in Social and Medical Services and Public Health Management

2 Lecturer, Carol Davila University of Medicine and Pharmacy,

Bucharest-Romania-Europe

ABSTRACT: This research work aimed to assess the communication relationship between the pharmacist and the patients who are addressing in the community pharmacy. The hypothesis from which we started the research was the identification of those reasons that determine efficient communication within a community pharmacy, both from patients perspective and from specialized pharmacy staff (pharmacists and pharmacy assistants views being analyzed only qualitatively, not quantitatively). The instrument used for the study was a questionnaire with a total of 26 questions.

The first objective of the research was to identify the level of trust in the pharmacist's advice.

There was a high level of confidence towards pharmacists and pharmacy assistant shown by the subjects enrolled in the trial, which demonstrated the importance of effective communication between specialists in pharmacy and patient/client – this beeing the first reason stated by respondents for having confidence in pharmaceutical counceling. Also, this could be used as a marketing strategy in patients/clients loyalty.

The second objective of the study was to identify which are the optimal means for increasing patient’s loyalty in the pharmacy.

Analyzing the loyalty’s impact after introducing a customer loyalty card and the percentage of requests for introducing such card, it was found to be a very good patients / clients loyalty method. It can also be a way of monitoring certain drugs and pharmaceutical products consumption that address the population in pharmacy according to certain criteria (age, gender, monthly income, education level, disease etc).

The third objective was to identify patients’ views on how communication is done between the pharmacy specialized staff and patient/client.

It proved that a close connection between the drive time and the information provided in plain language to explain is needed due to the fact that each patient/client needs a certain time

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according to their personal needs at the time. A significant part of the subjects from pharmacy does not purchase products for personal use, beeing only caretakers.

Also, the expectations someone has from the pharmacy staff are as follows, in order of importance as were analyzed in the study: patient/client to first understand first what is being explained to him/ her and to be listened and understood by the specialist. At the same time, communication must be done on an appropriate tone, hence, the patient/client will feel respected and appropriatley treated, and ultimately leave the pharmaceutical unit with a good feeling.

Another objective was to identify the views of pharmacists and pharmacy assistants regarding the communication with the patient/client. In this study we pointed how specialists had the wrongful idea of the possibilities that would motivate customers to return to the pharmacy and the willingness to become loyal to the pharmaceutical unit through a loyalty card.

The following objectives for a future effective communication between pharmacy staff is to follow a course in effective communication with the patient/client; to introduce a loyalty card; to create a database of the most commonly purchased products, according to a specific disease, and to develop informative articles, booklets that are provided to patients/clients.

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Table of contents

INTRODUCTION….............................................................................................................................5

Chapter 1. The relationship between the pharmacist, the population addressing the pharmacy and the type of pharmaceutical unit………………………………………………………………………7

1.1. The pharmacist……………………………………………………………………….7 1.2. The pharmacy………………………………………………………………………...91.3. The population addressing to the pharmacist………………………………………101.4. The relationship between the pharmacist and the population addressing to the

pharmacist……………………………………………………………………………..10

Chapter 2. The types of pharmacist and patient/customer in terms of the way the communication is established…………………………………………………………………………………………… 12

2.1. The concept of efficient pharmacist……………………………………………………….. 12

2.2. The population addressing to the pharmacist……………………………………………...12

2.2.1. The patient/customer according to dominance and sociability criteria………………...13

2.2.2. The patient/customer with a rigid relational pattern, without communication skills…..13

2.2.3. The patient with educational demands and special needs……………………………...15

Chapter 3. Ethics and deontology of communicating with the population addressing the pharmacist ……………………………………………………………………………………………………….. 16

3.1. The pharmacist’s deontological code and its application with the population addressing the pharmacy…………………………………………………………………………………………… 16

3.2. Rules of good pharmaceutical practice (GMP) and communication with the population addressing the pharmacy……………………………………………………………………………. 18

Chapter 4. Communicating with the population addressing the pharmacy……………………...20

4.1. Communication techniques in the pharmacy……………………………………………...20

4.1.1. Opening the discussion…………………………………………………………………20

4.1.2. Investigating the patient……………………………………………………………......20

4.1.3. Conveying information………………………………………………………………...21

4.1.4. Ending the discussion………………………………………………………………….22

4.2. Nonverbal communication…………………………………………………………………23

4.3. Barriers to communication in the pharmacy……………………………………………..23

4.3.1. Barriers related to the environment…………………………………………………..23

4.3.2. Barriers related to the patient…………………………………………………………24

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4.3.3. Barriers related to the pharmacist…………………………………………………….24

4.3.4. Other communication barriers………………………………………………………..25

4.4. Other ways of communicating with the patient………………………………………….25

4.4.1.Communicating on the phone ………………………………………………………..25

4.4.2. Communicating over the internet……………………………………………………26

Chapter 5. Goals and objectives of the paper………………………………………………........27

Chapter 6. The Research Methodology..…………………………………………………………28

6.1. The type of study and the method used in research…………………………………….28

6.2. Target population…………………………………………………………………………28

6.3. The Instrument……………………………………………………………………………29

6.4. The research calendar…………………………………………………………………….30

6.5. Gathering and processing the data……………………………………………………….30

Chapter 7. The research results……………………………………………………………………31

Conclusions and suggestions on improving communication between the specialized personnel in the pharmacy and the population addressing a community pharmacy……………………………..50

Bibliography…………………………………………………………………………………...…….54

Annex 1…………………………………………………………………………………………........56

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INTRODUCTION

The communication between the population addressing the pharmacy and the specialized

personnel offering health services in a pharmaceutical unit is a very debated subject in our time,

raising real problems in practical everyday situations.

Being a pharmacist, I have often encountered difficulties in efficiently communicating

with the population addressing the pharmacy. This is due, on one hand, to the type of

patient/customer that can adopt a rigid way of relating, making the communication difficult (the

dominant, obstructive, avoiding or addicted patient) or he can be emotional, sometimes

authoritarian or reflective. These tense situations can almost always be avoided if the pharmacist

can recognize the patient/customer typology and adapts the communication to the his needs and

personality.

The population addressing the pharmacy has individual and complex characteristics, the

patients coming in can have their own needs or they are caregivers of other patients. They have

different ages (they can be children, adults or elders), come from a certain social category, have

different trainings and education, with various types of activity, ethnicity, and sometimes they

are people with special needs.

The contemporary pharmacist is, by his professional formation, the recognized specialist

in the field of drugs, his entire activity being oriented towards the patient’s needs. Thus, besides

the classic and traditional attributions, the pharmacist is increasingly involved in patient health

care activities, being responsible of giving information about the product and making sure that

it’s used correctly; furthermore, the pharmacist has an important role in making the patient

accept and apply the treatment.

I chose this topic because in the last year I have attended several conferences and

professional meetings that approached the concept of pharmaceutical care, which in Romania is

still in an early stage of development. Pharmaceutical care is essentially the practice in which the

pharmacist assumes responsibility for the patient’s needs regarding a drug, in order to achieve

results that increase the quality of the patient’s life. It is easy to see that the instrument with

which the concept of pharmaceutical care can be achieved at an European standard starts from

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establishing an efficient communication between the transmitter and receiver, respectively the

pharmacist and the patient/customer.

Therefore, I decided to turn to account my knowledge from the field of pharmacy and to

assess the communication relationship between a pharmacist and the population addressing an

independent community pharmacy by analyzing the communication situation starting with the

pharmaceutical unit where I perform my activity, considering the fact that I can analyze the data

from multiple angles.

Nowadays, the community pharmacy has lost its appearance from past ages, always being

in step with technology, a great influence in this respect being the chains of community

pharmacies who have entered the market with a high standard, a well developed system of

marketing and management, and with ways of customer retention like loyalty cards. This is why

I wish to find out the patients’/customers’ opinion about the best ways of customer retention and

what can make them have more confidence in the advice given by the specialized personnel in

the pharmacy.

This research paper captures theoretical and practical aspects of the process of

establishing an efficient communication relationship between the specialized pharmacy

personnel and the population addressing the pharmaceutical unit, identifying the main strengths

and obstacles that may rise in implementing the proposed changes for this level.

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Chapter 1

The Relationship between the Pharmacist, the Population

Addressing the Pharmacy and the Type of Pharmaceutical Unit

1.1 The PharmacistThe pharmacist is a licensed health professional, providing specialized health services to the

patient and the general public. By the services provided to the whole community, the pharmacist

prescribes medication, prepares it and offers counseling.

The role of the pharmacist in pharmaceutical care involves developing a relationship with

the patient or with his caregiver, collecting the patient’s information and evaluating its relevance,

assessing the patient’s health, identifying the patient’s expectations regarding the therapeutic

result. The pharmacist also has pharmacotherapeutical knowledge necessary to identify current

and potential problems related to a drug.

The pharmacist’s responsabilities:

A) Establishing a relationship with the patient or his caregiver:

- establishes and maintains a relationship with the patient by using efficient

communication skills in order to initiate dialogue by: listening, verbal and written skills;

receptiveness to nonverbal communication; receptiveness to fluency issues of the spoken

language (Romanian, English, Hungarian etc.); receptiveness to population diversity

(various ethnic groups);

- shows care, empathy and professional conduct;

- identifies the patient’s needs, values and desired therapy results;

- assesses the impact factors and impediments for the health of each patient;

- discusses with the patient about the responsibilities of the parties (pharmacist-patient),

highlighting the benefits of accepting them and the consequences in case they are not.

B) Collects and evaluates the relevance of patient information:

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- develops professional relationships with other health professionals involved in the

patient’s health

- identifies the patient’s needs, the desired level of healthcare and results;

- actively listens and interprets the given information.

C) Assesses the patient’s health status:

- uses techniques and specific procedures to assess the patient’s health status and concerns;

- uses basic knowledge in order to understand the scope and the extent of the patient’s

health problems;

- identifies the factors that impact the therapeutic result.

D) Identifies the patient’s expectations regarding the therapeutic result:

- integrates knowledge about the patient’s health status with pharmacotherapeutic

knowledge and non-drug treatment options;

- allows the patient to choose from several therapeutic options.

E) Possesses a level of pharmacotherapeutic knowledge required to identify current and

potential medication issues:

- determines if the patient requires drug therapy, if drug therapy is required but not

received, or if it’s received in a wrong way;

- determines if the medication dose is correct and if it’s properly administered;

- recognizes the drug interaction;

- recognizes side effects, toxic effects of medication;

- explains indications, contraindications and issues that can appear during the treatment.

F) Assesses, selects and recommends appropriate treatment options, non medicinal, OTC

drugs (without prescription), drugs with prescription (doctor’s advice):

- prioritizes emergencies;

- assesses alternative strategies of therapy;

- selects the best therapeutic option for the patient, agreeing with the patient and with other

healthcare professionals;

- explains the patient the motivation for the proposed treatment.

G) Refers patients to other specialists when necessary:

- determines if a specialist’s opinion is necessary;

- identifies the most appropriate specialist (or team of specialists) for patient guidance.

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H) Develops and implements plans to monitor the patient’s progress and to evaluate the

therapeutic result:

- recognizes the important clinical indicators (signs and symptoms of the patient);

- identifies the most appropriate ways of monitoring;

- establishes effective plans that include onset, frequency and duration of monitoring;

- encourages the patient’s involvement in implementing and developing the therapeutic

plan;

- discusses with the patient or caregivers about the responsibilities of the pharmacist,

patient and other professionals involved in the treatment plan.1

1.2 The PharmacyThe pharmacy is the health unit that prepares and releases medication to the population and

medical units in order to prevent and cure diseases, which makes a vital contribution in

maintaining and improving the health of the population.

Pharmacies are institutions that are part of the health care system in which pharmacists

operate, in which specialized activities are carried out by highly skilled indiviaduals.

Under the current legislation, the community pharmacy provides pharmaceutical care to the

population by:

- releasing medication given on prescription at a retail price;

- releasing, in accordance with the legal provisions, medication without prescription at a

retail price;

- preparing magistral and officinal drugs or other healthcare products;

- controlling and assuring the quality of drugs prepared in the pharmacy;

- chemical quality control of pharmaceutical substances that enter the pharmacy, except

toxic substances and stupefacients;

- sale of cosmetics, parapharmaceutical products, medical devices for individual use and

supplies for them, food supplements, anodyne plants and products based on anodyne

plants, products for infant care, items for personal hygiene, equipment, materials or

products for protecting or improving health, products for protection against sexually 1 ***Professional Competencies for Canadian Pharmacists at Entry to Practice, 1997

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transmitted diseases or with contraception action, homeopathic products, products for

aromatherapy and other products intended for use in several pathologies;

- informing and advising patients regarding the proper and rational use of medication and

maintaining the health status;

- testing biological parameters with equipment destined for individual use, as well as the

administration of vaccines, under the conditions set by the Minister of Public Health.2

1.3 The Population Addressing the Pharmacy

According to the Law of the Patient’s Rights, Law no.46 from 21st January 2003, published

in Monitorul Oficial no.51 from 29th January 2003, the patient is a healthy or diseased person

using health services.3

The population that addresses the pharmaceutical unit is assisted by the specialized

personnel under the same conditions, without any discrimination of age, race, financial status etc.

The patients have the right to health care of the highest quality that the society has,

according to human, financial and material resources.

1.4 The Relationship between the Pharmacist and the Population Addressing

the Pharmacy

Patient orientation, the focus being on the patient at the expense of the medication, was

made possible by the emergence of the pharmaceutical care concept. This raises the need to build

a professional relationship with the patient, which requires maximum efficiency and

professionalism. Focusing the pharmacist’s activity on the patient was originally made in his

specialization as a clinical pharmacist.

2 ***Law No.266/2008 published in Monitorul Oficial, Part I, no.765 from 13.11.20083 ***Law No.46/2003, The Law of the Patient’s Rights

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The professional relationship between the pharmacist and the population addressing the

pharmacy pursues the following:

- the pharmacist must possess good communication skills with the patient/customer;

- the pharmacist is responsible for selecting the efficient medication (from the OTC

category), secure and appropriate in terms of benefit – cost, for customizing the patient’s

pharmacotherapy;

- advises patients regarding the medication released with medical prescription, advice

based on scientific analysis of the prescription, in the patient’s context;

- guides self-medication with OTC medicines, known and requested by the patient, based

on the interrogation aimed in the patient’s context;

- recommends OTC medication for 1-2 days, at the patient’s request, presenting symptoms

of acute illness, the recommendation being based on minimal consultation, in the area of

confidentiality of the pharmacy;

- the pharmacist recommends seeing a doctor in case of an emergency and can release

without medical prescription 1-2 doses of medication, the release being based on

observing a severe symptomatology, which can’t be solved with OTC medication.

- monitors the patient’s medication therapy;

- solves the problems of drug therapy (drugs therapy problems – DTP or PTM) of the

patient, based on creating the patient’s file with complete data (diagnosis, lab analysis,

prescribed pharmacotherapy and self-medication history);

- the pharmacist is responsible for reporting adverse reactions (pharmacovigilance) of the

patient suspected to drug-induced;

- advises the patient regarding proper diet correlated with diagnosis and medication;

informs the patient about foods and drinks he should not consume, in relation with the

medication;

- gives first aid in medical emergencies.4

Chapter 24 Cristea AN, Consilierea pacientului în farmacia de comunitate, Revista PharmaBusiness Nr.15, aprilie 2007 Cristea AN, Farmacie Clinică, Vol.1, Editura Medicală, București, 2006***Ordinul Nr.75/03.02.2010 pentru aprobarea RBPF, publicat în MO Nr.91/ 10.02.2010

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The Types of Pharmacist and Patient/Customer in Terms of the Way the Communication Is Established

2.1 The Concept of Efficient Pharmacist

Communication with the patient/customer plays an important role in a pharmacist’s professional life as it’s the fundament of this type of medical act.

Effectiveness is the ability of producing the desired results or defined before the action.

Efficiency is the ability to perform an activity with minimal resources, without affecting the quality of the results.

Sometimes pharmacists can be effective, but not efficient in their relationship with the patient, and this should be taken as an objective of improving professional skills as an efficient pharmacist can be recognized by the patient through:

- physical appearance: pleasant smile, proper attire;- the pharmacist’s personality characterized by: sociability, enthusiasm, honesty, ambition,

confidence, motivation for work.- the pharmacist’s preparation should be based on: expertise in the medication field and in

the relationship with the patient, credibility, positive attitude, listening skills, ability to communicate with the patient, adaptability to different typologies of patients.

- the communication skills consist of: integrating the information for the patient, positioning the messages in the communication, presenting conclusions for the therapeutic result, stimulating the active participation of the patient in the communication, conveying emotional messages.5

2.2 The Population Addressing to the Pharmacist

The population addressing the pharmacy has individual and complex characteristics. The patients can have personal needs or they can be the caregivers of other patients. They are different in age (they can be children, adults or elders), they come from a certain social category, with different trainings and education, with various types of activity, ethnicity, and sometimes they can be people with special needs.

To achieve good communication with those who address the pharmacy, it is essential for the pharmacist to know the typology of patients/customers.

2.2.1 The Patient/Customer according to Dominance and Sociability Criteria

5 Rusu A, Pașca MD, Hancu G, Ghidul farmacistului în comunicarea cu pacientul, Editura University Press Târgu Mureș, 2014

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According to the criterion of dominance and sociability, there are four types of patients/customers: the emotional type, the authoritarian type, the reflective type and the obliging type.

The emotional type – the dominance and sociability are strong, he talks fast and gesticulates a lot, prefers informal relations, he is empathetic and persuasive.

The authoritarian type – the dominance is strong, but the sociability is low, he displays a serious attitude, preoccupied, expresses clear opinions in a decisive manner, he is difficult to approach, communicates with some effort, has a rough behavior, imposing, raises many claims.

The reflective type – weak dominance, low sociability, has a powerful emotional control, carefully formulates his statements, seems to be preoccupied with something else, he is slow, he likes to review the details, doesn’t make decisions quickly, he’s not a good conversation partner, prefers intimate communication.

The obliging type – weak dominance, high sociability, patient, sensitive, doesn’t take to play an important role in decision making, listens carefully, avoids using power and strengths, when he makes decisions he expresses them in a serious manner, somewhat impersonal.6

2.2.2. The Patient/Customer with a Rigid Relational Pattern, without Communication Skills

This category includes: the domineering patient/client, the paranoid, the obstructive, the avoidant, and the addict.

The domineering – these patients are labeled as self-confident, competitive, authoritarian. They lack empathy, they are characterized by their self-confident and coercive way of interacting with others, being independent, energetic and attractive to a certain extent. In order to motivate these patients for the therapeutic result, the pharmacist should treat them in a courteous way, with a lot of respect. Often in communicating with them, there are difficulties in assuming their role of patients. This is why the pharmacist must listen to them with great interest (active listening), to advise without exaggerating and to respect the way they fared until the current moment. The pharmacist should always give the possibility to this type of patient to choose.

The paranoid – these patients are cold, serious, critical, reserved and defensive, with paranoid and antisocial personality traits. For them, the world seems to be threatening and hostile. They are suspicious (e.g. of doctors and pharmacists) because they are always afraid that the information related to their illness will be used against them. These patients question sincerity, loyalty and fidelity. Therefore, these patients must be trained in communication with great care. A pharmacist who doesn’t prove a good self-control, can undermine the confidence of

6 Rusu A, Pașca MD, Hancu G, Ghidul farmacistului în comunicarea cu pacientul, Editura University Press Târgu Mureș, 2014

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this type of patient. The pharmacist should be courteous, careful in choosing his words, very clear in offering information, but tolerant at the same time, without adopting a submissive behavior or, conversely, too authoritarian. Moralizing the patient or expressing personal views (of the pharmacist) should be avoided as much as possible. The fear of this type of patient of losing his independence or the power to dominate the events, requires the pharmacist’s skills in communicating and building a professional relationship.

The obstructive – these patients are hostile and uninvolved, rebellious, skeptical, they have some traits of the following personality disorders: passive-aggressive, antisocial and schizotypal. Most often they have serious problems in compliance with social standards, fulfilling professional tasks or within the family. They are unpredictable and often create distance from others, feeling a lack of appreciation on their part. These patients have low self-esteem, display a cynical attitude, express opposition openly or through continuous postponements of tasks to accomplish in the treatment. This type of patient needs plenty of patience from the pharmacist. If the pharmacist is criticized by his patient, it is preferable to seriously address this issue, expressing regret, instead of adopting a defensive behaviour. Addressing these patients should not be coercive; it is preferable to be given the opportunity to express their opinions on the issue of health or treatment to follow.

The avoidant – these patients are labeled as inhibited, insecure and have the traits of avoidant personality and obsessive-compulsive disorders. They are rigid, passive and selfish, they consider they have important issues. In general, they are not willing to build a working relationship with their doctor or pharmacist. Their social behaviour is non-assertive. Decision-making is avoided, delayed of fear of making mistakes. They are extremely perfectionists and tend to blame themselves. Pharmacists can become discouraged and irritated due to the pessimism of these patients. The pharmacist should show patience, understanding, empathy and friendliness.

The addict – these patients, labeled as submissive and passive, have the traits of dependent personality disorder. They seek emotional support, showing an excessive dependence on others (doctor, pharmacist). Generally, they are not enthusiastic and tend to overestimate the qualities of others. They show a critical and repulsive attitude, but at the same time, they are gripped by fear of being abandoned. Through their behaviour they stimulate protection from the people they come into contact. Therefore, the pharmacist should always point the positive aspects, but also the circumstances that led to the patient’s failures.

The communication strategies mentioned above with the source from the patient’s interpersonal style, must be chosen by the pharmacist at the earliest stage of establishing the professional relationship with the patient, in order to be placed in the benefit of the treatment.

A pharmacist with good communication skills and truly professional must adapt his style of interaction and communication with patients according to their type of personality and needs.7

2.2.3. The Patient with Educational Demands and Special Needs7 Gîrlașu-Dimitriu O, Tehnici psihoterapeutice, București, Editura Victor, 2004 Stanton N, Comunicarea, Editura Societatea Știință și Tehnică, București, 1995

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This type of patient has the same rights as any other person who addresses the pharmacy. Yet, in the sequence of communication with this type of patient, the pharmacist must take into account certain factors such as: inspire confidence, explain the medication so that the patient can fully understand, to accept that the patient has special education demands, to try not to create conflicts and to explain the medication to the patient’s companions, when needed.

The pharmacist must observe in his communication with the patient the bodily reactions (nonverbal language, body language), to speak up, to determine a positive intake of the patient towards the medication. Also, the pharmacist must develop nonverbal communication elements to the patient’s understanding.

If the pharmacy space allows it and the staff levels are adequate, some discussions about the drug therapy should be held in the confidential space of arranged in the pharmacy, giving the patient the opportunity to be heard, understood and protected.

Chapter 3

Ethics and Deontology of Communicating with the Population Addressing the Pharmacist

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3.1 The Pharmacist’s Deontological Code and its Application with the Population Addressing the Pharmacy

The Pharmacist’s Code of Deontology in force was adopted by Decision no.2 of 15/06/2009 concerning the approval of the Statute of the Romanian College of Pharmacists, published in Monitorul Oficial no.490 from 15/07/2009 and it’s divided into seven chapters. The professional relationship between the pharmacist and the patient is shown in the following paragraphs of the Code:

Chapter I – General principles:

Art.1. (1) The Pharmacist’s Code of Deontology comprises a set of principles and rules that represent the core values on which the pharmacist is practicing in Romania.

Art.2. – The Pharmacist’s Code of Deontology has as main goal: a) protecting the patients’ rights; b) compliance with professional obligations by the pharmacists; c) defending the dignity and prestige of the profession of pharmacy.

Art.3 (1) In the exercise of his profession, the pharmacist provides specialized health services to the patient and general public without any discrimination.

(2) The relationships between the pharmacist and the beneficiaries of the provided services must be based on the trust in the pharmacist’s competence and professional experience.

(3) This confidence requires that the pharmacist, throughout his career, ensure and maintain the highest performance, professional and personal conduct, to constantly update his professional knowledge in the sphere of his activity.

Art.4 – The fundamental principles on which the pharmacist is practicing are:

(a) the profession is exercised exclusively with respect for life and the human person;(b) in any situation, the interests of the patient and public health prevail;(c) compliance in any situation of patient rights;(d) working together, whenever needed, with all the factors involved in ensuring the health

of the patient;(e) taking an active role regarding the information and health education for the public as well

as combating drug addiction, polypragmasy, doping, self-medication and other scourges;(f) the provision of pharmaceutical services is done at the highest possible quality standards

based on a high level of competence, practical skills and professional performance;

Chapter II – Deontological standards

Art.8 – (1) No matter his activities, the pharmacist must focus his attention on the well-being of the patient and the public in general.

(2) The pharmacist is responsible for all professional decisions, regardless the assumed responsibilities in practicing his profession.

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Art. 9 – to fulfill the provisions of art. 8, the pharmacist, while carrying out the professional act, is obliged to follow these rules:

a) refrain from criticizing or condemning the personal or religious beliefs of the patient appealing to him;

b) provide services in an equal manner to all patients without discrimination, in order of their requests, except the emergencies;

c) ensure that his services were correctly perceived and understood by the patient, encouraging him to actively participate in the success of the treatment;

Art. 10 – The pharmacist can refuse offering his services to a patient when the refusal is justified by the well-being of the patient’s health.

Art. 16 – The pharmacist must respect and protect the confidentiality of the information concerning the patients, obtained during professional activities.

Art. 17 – The information may be disclosed in the following cases:

a) when the patient consents in writing;b) when the patient’s guardian consents in writing, if the patient’s age or health condition

does not allow it;c) when it’s necessary to prevent major disease or endangering the patient’s health, a third

party or the public in general;d) if proven guilty of offenses at the request of the court;e) in other cases provided by law.8

The pharmacist must know and respect the rules of Good Pharmaceutical Practice and the

Code of Ethics and professional deontology. Throughout his entire professional activity, the

pharmacist must focus on the patient’s well-being.

In the pharmacist-patient communication, the pharmacist is obliged to respect the right

of everyone to assistance with medication, without discrimination, and his patients’ moral,

cultural and ethnic values.

Confidentiality of information is one of the pharmacists’ obligations. The Deontological

Code lays down the pharmacist’s obligation to protect professional information regarding

patients and the unit where he performs his activity.

The pharmacist is obliged to correctly inform the patient on all aspects regarding the

medication, way of administration, dosage, side effects and price. He also has the obligation to

inform patients about their rights, dispensing medication with or without personal contribution.

8 Codul deontologic al farmacistului adoptat cu Decizia nr. 2 din 15/06/2009 privind aprobarea Statutului Colegiului Farmaciştilor din România şi a Codului deontologic al farmacistului, publicat în Monitorul Oficial Nr. 490 din 15/07/2009

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Acting with honesty and integrity, the pharmacist, through his attitude in communicating

with the patient, must not exploit any potential vulnerability or lack of knowledge from the

patient’s side. He must offer information in a precise and impartial manner.

The pharmacist addresses the patient at his level of understanding, using simple terms;

he verifies if the patient understood the information provided, requesting him to ask questions in

case he has concerns.

The pharmacist must respect the patient’s autonomy, encourage his involvement in

taking decisions that directly concern his health.

By promoting products or pharmaceutical services, the pharmacist must not limit the

patient’s decision concerning his choice or the service provider.

3.2. Rules of Good Pharmaceutical Practice (GMP) and Communication with the Population Addressing the Pharmacy

GMP is comprised of recommendations applicable in pharmaceutical units, designed to ensure that the services provided by the pharmaceutical personnel are suitable, efficient patient-oriented.

In Romania, since 10th February 2010, by Order of the Minister of Health no. 75/2010, published in M.O., Part I no.91, the Rules of Good Pharmaceutical Practice (GMP) were approved.

GMP addresses the following areas: informing the patient, space – pharmacy facilities, pharmacy personnel, dispensing medication (on prescription, OTC drugs and other health products), rational use of medication, preparation of medication in the pharmacy.9

The GMP general principles on informing the patient aim at:

Art. 4.1: the importance of correctly informing the patient in taking an efficient decision regarding the treatment; respecting the patient’s rights regarding his consent; the pharmacist’s role in advising the patient about correctly managing the medication and treatment.

The general principles of GMP concerning the issue of prescription medication aim at:

Art.4.4: receiving the medical prescription and verifying its authenticity; evaluating the prescription by a pharmacist; preparing and dispensing the prescribed medication; counseling the patient or his representative.

9 ***Ordinul Ministrului Sănătății Nr.75/2010 pentru aprobarea RBPF, publicat în M.O., Nr.91 din 10.02.2010

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The purpose of this procedure is to ensure the quality of pharmaceutical assistance as a component of public health care, which promotes the protection of the population’s health.

Informing the patients has a great importance in the appropriate use of medication.

A correct information will allow the patient to make a just decision regarding the treatment, facilitating an effective communication between patient and pharmacist, or other health professionals.

An inaccurate information or misunderstanding some aspects can lead to treatment failure, and therefore, to an increase of health costs.

This is why it is necessary that:

-informing the patients must comply with their free decision, to lead to the improvement of their health and optimizing the result of the applied treatment;

-the patient must have access to other useful information for his personal needs related to his health

-the information must formulated and presented in accordance with the level of understanding of each patient;

-the information should be simple and easy to understand;

-the benefits and risks of medication should be presented in a balanced and objective manner;

-the pharmacist must convince the patients how important it is to read the medicine information and to encourage them to ask questions about it;

-the pharmacist should advise patients to create and maintain a comprehensive list of all the medicines they use (prescription or self-medication) and to be able to give it to their physician or pharmacist.10

The pharmacist transmits all the necessary information for a safe, proper and effective usage of the medication, in a form suited for the needs of each patient.

The pharmacist must ensure that the patient or his caregiver is entirely enlightened regarding: the medication action, the way of administration (how, when and how much), the treatment duration, possible side effects, interactions and precautions to take.

Chapter 4

Communicating with the Population Addressing the Pharmacy

10 Rusu A, Pașca MD, Hancu G, Ghidul farmacistului în comunicarea cu pacientul, Editura University Press Târgu Mureș, 2014

19

4.1 Communication Techniques in the Pharmacy

The communication with the population addressing the pharmacy can be defined as the total means through which information passes from the pharmacist to the patient/customer, and a good communication means, firstly, that the message sent by the pharmacist is the same message received by the patient/customer.

Communicating is not just talking, and to communicate efficiently, this is not enough. Therefore, in interacting with the patient, in the community pharmacy, the pharmacist follows some steps: opening the discussion, investigating the patient, conveying information until the closure of the discussion.

4.1.1. Opening the Discussion

Opening the discussion represents the stage in which the pharmacist enters into contact with the patient/customer in the pharmacy. This stage has the following components:

- visual contact with the person addressing the pharmacy;- smile – as soon as the visual contact is established, before greeting, the pharmacist should

smile to express confidence and the message “I’m here to help you”;- greeting – this is also the moment in which the pharmacist opens the discussion with the

patient.

4.1.2 Patient Investigation

The second stage in communicating with the patient/customer is investigating the patient. During this stage, the pharmacist learns details on the patient’s name, age, symptoms, what causes the health problems and their duration, previous medication, other medicines currently used etc. Only after that the pharmacist proceeds to explain the purpose of the next questions to be addressed to the patient.

The pharmacist must also find out if the patient enters for the first time in contact with the pharmacy/pharmacist (patient with a new prescription, patient requesting OTC medication etc.) or if it’s a patient who came back (continuing the treatment chronic patient).

In asking questions as well as in listening to answers, the pharmacist must show interest, empathy towards the patient, encouraging him to provide the necessary information for the treatment prescription.

The pharmacist will lead the dialogue with the patient through a well established set of questions. There are several ways of asking questions and several types of questions that will lead to answers from the patient.

Types of useful questions in the stage of investigation:

20

a) closed questions of election/selection – with these questions the patient is forced to choose an alternative, from two or more of them. Examples: Is the prescription for you or someone else? Do you prefer tablets or capsules?

- closed questions with yes/no – these are questions to which the patient has only two possible answers – yes or no respectively. Example: Have you had pains before?

- closed identification questions – these questions provide identifying information about the patient or factual information about the patient’s health. Examples: How old are you? What temperature do you have?

b) open questions – give the patient the opportunity to give full answers to the pharmacist, but, in the same time, give great freedom in how the answers are formulated. These questions are used when more information about the patient is needed. They have the role of encouraging the answers. Example: What? How? Where? When? What symptoms do you have?

c) control questions – these questions always have attached an expectation, they indicate the patient the answer the pharmacist wishes to hear. The pharmacist confirms or denies the mental anticipation of the patient’s answers and makes a report of the patient’s current health. Example: You used the medicine like I advised you to, right?

d) research questions – these questions are used to build up the information from an initial answer. These questions clarify the information previously received. Example: What kind of pain do you have? How does it ache?

e) auxiliary questions – these questions are useful when the patient gives a wrong or vague answer to the initial question. They can be necessary if the original question was not clear enough for the patient. Example: How often do you take the tablets? Answer: Quite often. How many tablets do you take per day? Answer: Four.

4.1.3 Conveying Information

When the pharmacist recommends OTC symptomatic medication, it is important to explain any decision to the patient; the patient must be included in this decision, he has to be able to choose from several therapeutic alternatives. Sometimes the pharmacist’s explanations are much more important than using OTC medication.

The pharmacist has the responsibility of ensuring he gave the appropriate product to the patient, and it is also important to make sure the patient knows how to correctly administer the medication. It is necessary that he helps the patient overcome any confusion and to meet the treatment regimen.

The pharmacist must convey the following information to the patient, using a clear and appropriate language:

- drug name and concentration;- the purpose of treatment and the medication effects;- administration- when the medication should be administered reported to main meals and circadian

biorhythm;- the maximum dosage that must not be exceeded;- the interval between administrations

21

- precautions and contraindications;- predictable side effects;- adequate nutrition during the treatment;- proper storage of the medication and compliance of validity;- minimum hygiene rules to be observed during administration and storage of medication.

4.1.4. Ending the Discussion

For the ending stage to be efficient some important aspects are necessary:

- summarizing and reminding the patient the most important aspects discussed previously;- getting feedback through which the pharmacist can make sure the patient understood

what was explained to him;- creating the opportunity for future meetings, in order to strengthen the professional

relationship;- motivating and encouraging the patient about the real benefits of the treatment;- referring the patient to a doctor;- use signals that indicate the conversation coming to an end (posture, phrases like: “I think

we’ve talked about all that was necessary…”, “I think we covered all the necessary information…”).

In the closing stage visual contact and smiling are equally important.11

4.2. Nonverbal Communication

Nonverbal communication, often named nonverbal behaviour or body language, is a way of

conveying information through facial expressions, gestures, touch, movement, posture, personal

accessories (clothes, jewelry, hair style, tattoos etc.), voice tone, timbre and voice volume. In

general, nonverbal behaviours represent approximately 60-65% of all interpersonal

communication.

Nonverbal communication plays an important role in the pharmacist-patient interaction.

The important elements in nonverbal communication are: tone of voice, facial expression,

posture, eye contact, smile, proximity and the use of gestures.

Mastering the elements of nonverbal communication is useful for the pharmacist in

establishing an efficient communication with the patient.12

11 Rusu A, Pașca MD, Hancu G, Ghidul farmacistului în comunicarea cu pacientul, Editura University Press Târgu Mureș, 2014

12 Navarro J, Marvis Karlins M, Secretele comunicării non-verbale, Editura Meteor Press, București, 2008

22

4.3. Barriers to Communication in the Pharmacy

Communicating with the patient in the pharmacy can present a series of disturbing factors

which may interfere in a negative way. These factors are, essentially, communication barriers.

4.3.1. Barriers Related to the Environment

The pharmacy environment can generate communication barriers for the people addressing

the pharmacy:

- inadequate furniture (shelves too high, the office requires a certain distance);

- a very crowded and noisy office;

- the phone always ringing and nobody answering it, the entire personnel being busy;

- the presence of another person between the pharmacist and patient;

- lack of privacy in the pharmacy.

4.3.2. Barriers Related to the Patient

Even the person addressing the pharmacy can generate communication barriers like:

- distrusting the pharmacist (unpleasant previous experiences, the pharmacist lacks

experience or has an inappropriate attire etc.);

- the patient’s anxiety due to his illness;

- patient typology (timid, irritable, nervous, silent);

- the patient’s age (infant, child, elder person);

- disabilities (speech, cognitive etc.);

- prejudices of the patient;

- unpleasant previous experiences;

- fatigue, personal issues;

- the patient doesn’t know how to listen or is not ready to listen;

- lack of communication skills;

- different cultural model;

23

- lack of mutual respect.

4.3.3. Barriers Related to the Pharmacist

The pharmacist can generate communication barriers when relating with the population

addressing the pharmacy:

- shyness;

- lack of experience in communicating with the patient, lack of communication skills;

- the choice of inappropriate messages ( the message is ambiguous because of

inappropriate words, using a specialized language);

- lack of confidence in interpersonal communication;

- fear of not facing the patients’ questions;

- not paying attention to the patient (multiple tasks simultaneously);

- prejudices, false perceptions;

4.3.4. Other Communication Barriers

Besides the barriers listed above, other types may occur such as:

- the multitude of activities performed in the pharmacy;

- lack of time for communication (a line of patients waiting);

- insufficient personnel for the pharmacy activities;

- language barriers.13 14

4.4. Other Ways of Communicating with the Patient

Besides the face to face communication, the pharmacist can use other ways of

communicating with the population addressing the pharmacy.

4.4.1.Communicating on the Phone

13 Silvaș A, Comunicare educațională, Universitatea Petru Maior Târgu Mureș, 200814 Rusu A, Pașca MD, Hancu G, Ghidul farmacistului în comunicarea cu pacientul, Editura University Press Târgu Mureș, 2014

24

Most often the patient also uses the phone as a way of communicating with the pharmacist,

especially when the patient has locomotion difficulties or is an elder patient who gets tired fast or

when he simply needs information or advice urgently.

Also, the pharmacist communicates with the patient over the phone when he wishes to

verify a prescription or to inform the patient about the delivery of a medication by the supplier.

Communication over the phone requires the steps of face to face communication with the

patient: the opening, investigating the patient, conveying information and closing. These steps

are important because the nonverbal communication (body language) is missing both for the

patient and the pharmacist.

4.4.2. Communicating over the Internet

The internet is one of the most important media, facilitating interpersonal communication

at distance. It’s a handy means of communication to both patients and pharmacists.

The population that wishes to purchase online OTC medication, without a prescription,

has the advantage of not having to go to the pharmaceutical unit, but will not receive counseling

from the specialized personnel in the pharmacy. This is a disadvantage and the efficient

communication between the pharmacist and the beneficiary of health services is no longer

established.

Modern pharmacies have their own website and e-mail address, meeting their patients’

need of communication.

25

Chapter 5

Goals and Objectives of the Paper

The present research contains the results of a study conducted in an independent

community pharmacy on the way communication is established between the specialized

personnel from the pharmacy and the population addressing the pharmaceutical unit. The aim of

the study is to assess the communication relationship between the pharmacist and the population

addressing an independent community pharmacy.

26

The study is a blueprint of the current state. The aspects that could determine an

efficient communication which would increase the confidence of patients/customers in the

counseling received from the specialized personnel in the pharmacy will be more thoroughly

investigated.

The framework from which the research started was to identify the reasons that

determine an efficient communication within a community pharmacy, both in terms of the

population addressing the pharmacy and the specialized personnel in order to increase the

confidence in the offered counseling, thus managing to improve the customer retention.

The study objectives were:

1. Identifying the best means of improving the customer retention;

2. Identifying the degree of trust in the pharmacist’s counseling;

3. Identifying the patients’ views on how the communication is established between the

specialized personnel and the patient/customer.

4. Identifying the pharmacists’ and pharmacy assistants’ views on how the communication

is established between the specialized personnel and the patient/customer.

To create an overview regarding the communication with the patient/customer in the

pharmacy, both the emitter’s as well as the receptor’s opinions, respectively pharmacist or

pharmacy assistant and the person addressing the pharmacy, were considered.

Chapter 6

The Research Methodology

6.1. The Type of Study and the Method Used in Research

The present research is a quantitative and descriptive study, with the area of interest in the

health services management.

The used method in the research is the opinion survey.

27

6.2. Target Population

The target population consists of patients/customers addressing a community pharmacy,

but also the specialized personnel working in the pharmaceutical unit.

The survey was carried on with the help of patients/customers that were in the pharmacy

between 5th – 11th May 2014. The participation in the study went on a voluntary basis and there

was a response rate of 43.7%. 209 patients had valid surveys, out of the 226 patients who wished

to answer the questions in the questionnaire. 17 surveys were canceled because they were

incomplete or multiple answers were specified. The rate of people who wanted to take the

survey, namely 226, however, is quite low in relation to 521 patients/customers who refused to

complete the questionnaire for various reasons, the most often one being the lack of time.

Also, the survey was taken by the specialized personnel in the pharmacy, 3 pharmacists

and 2 pharmacy assistants. They were asked to write down what they think, in their personal

opinion, the patients/customers addressing the pharmacy they work at would answer, why they

address that respective pharmacy and not another one, what makes them come back etc.

6.3. The Instrument

The used instrument consisted of a questionnaire filled in by the population addressing

an independent community pharmacy between 5th – 11th May 2014. This questionnaire was also

filled in by the pharmacists and pharmacy assistants from the respective pharmaceutical unit.

Before giving the questionnaire to a larger group of respondents, I wanted to test it in

order to see if this type of instrument is suitable and effective for the population addressing a

pharmaceutical unit. Therefore, I tested the questionnaire with 6 customers.

The questionnaire is attached in Annex 1.

28

The survey had three sections: a section of personal characteristics of the respondents,

one that follows general behaviour and one that investigates the communication characteristics.

The survey had a total of 26 questions.

Section A, containing personal characteristics of the respondents, has 7 questions,

with pre-formulated answers as well as open answers.

Section B, about the general behaviour, includes a series of 6 questions, aiming to

retain the customer and to find out what causes him to choose the current pharmacy etc. The

questions in this section have pre-formulated answers. Only the fourth question has an open

answer leaving the respondent the possibility of saying what led him to choose, in the day of

completing the survey, the respective pharmaceutical unit.

Section C is comprised of 13 questions about communication features, most of which

have pre-formulated answers. Question no.3 has the possibility of an open answer, and questions

no.12 and 13 include the date and time of completing the survey.

I chose to add pre-formulated answers to most of the questions because the time

allotted by the person who comes in the pharmacy for this activity is generally low.

6.4. The Research Calendar

The research was conducted between 24th February – 6th June 2014 and was based on taking

the survey.

The period of survey application was 5th – 11th May 2014, during a week, the period of time

being 07:30 – 22:30. This interval was chosen in order to include both the population who

usually acquire the treatment at the beginning of the month, respectively in the first week of the

month; the population who usually acquires the treatment during the week or those who prefer to

29

do it at the end of the week, as well as the patients who don’t have an exact period in which they

come to the pharmacy, but come whenever it’s necessary, without a specific criterion.

The review of press articles for the chosen topic, other studies and works already

published was conducted in February 2014.

The design of the survey and the analysis of the goals and objectives of the research was

conducted in March and April 2014.

Creating the survey and the data entry in a standardized format was conducted in April

and May 2014.

The initial research and centralizing the data in a database was conducted in May 2014.

Developing the final report and communicating the results was done in May and June

2014.

6.5. Gathering and Processing the Data

The respondents were asked to fill in the questionnaires, with the appropriate instructions

from the investigator, who assured them of keeping the confidentiality anonymity. The absolute

and relative frequencies of the studied characteristics were calculated.

Data processing was done using Microsoft Excel, graphic representations being used to

present the results.

Chapter 7

The Research Results

The pharmacy where the study was conducted is an independent community pharmacy,

singular, founded in 1996, conducting its activity in the same premises for 18 years. The main

activity is retail trade of pharmaceutical products and preparation of pharmaceutical form, the

30

pharmacy being well equipped. Also, the pharmaceutical unit has no longer a contract with the

National Health Insurance House since 2010.

The pharmacy opening hours are Monday to Sunday from 07:30 to 22:30; this

timetable remaining unchanged during the 18 years since the pharmaceutical unit has been

operating.

The specialized personnel is made up of 5 specialists: 3 pharmacists (a primary

pharmacist, a specialist and a pharmacist with one year worth of professional experience) and 2

major pharmacy assistants. They participated in the study and answered the questionnaire from

the specialist’s point of view. The 5 respondents are all females.

The surveys were completed by 209 patients with the average age of 47.85 years, of

which 86 (41%) respondents were males and 123 (59%) female respondents.

The chart below is the structure of the studied group in terms of gender.

Chart No.7.1.

0.00%

20.00%

40.00%

60.00%

80.00%

100.00%

120.00%

59.00%

41.00%

The structure of the studied group in terms of gender

MenWomen

The respondents had to choose from the survey the occupation they had at the time the

study was taken. Thus, 6 (3%) respondents are pupils/students, 107 (51%) respondents are

employed, 26 (12%) responded that they are employers, 29 (14%) respondents take care of the

household, 41 (20%) respondents are retired.

We can summarize the active population and see that 63% of the respondents fall into

this section.

The chart below presents the lot structure in terms of the occupation the respondents

31

have.

Chart No.7.2.

Employed Retired Householder Owners Pupils/Students0%

10%

20%

30%

40%

50%

60%

51%

20%

14% 12%

3%

The lot structure in terms of the respondents occupation

Also, in the study analyzing the communication between the specialized personnel from

the community pharmacy and the population addressing this pharmacy, I considered it is

important to have an overview of the respondents’ level of education.

Thus, no respondent had the level of education between 1-4 grades and 5-8 grades.

Only 3 (2%) respondents have the level of education of 9-10 grades. 103 (49%)

patients/customers graduated high school, 97 (46%) have university degrees, and 6 (3%) even

have post university degrees.

Chart No.7.3.

32

High School University Degrees

Post University Degrees

9 - 10 Grades 5 - 8 Grades 1 -4 Grades0%

10%

20%

30%

40%

50%

60%

49% 46%

3% 2% 0% 0%

The lot structure in terms of the respondents education level

The respondents were asked to fill in the survey the field in which they perform their

activity. Thus, most persons who completed the questionnaire of this research paper work in the

field of trade, namely 84 respondents – a percentage of 40.2%. 47 (22.5%) respondents perform

in the economic field, 34 (16.3%) work in constructions, 18 (8.6%) in light industry, 16 (7.6%) in

the medical field, 9 (4.3%) in IT, only respondent (0.5%) in tourism and no respondent performs

his activity in the heavy industry field.

33

Chart No.7.4.

Commerce

Economic

Constructions

Light In

dustry

Medical IT

Turism

Heavy In

dustry

0.0%

5.0%

10.0%

15.0%

20.0%

25.0%

30.0%

35.0%

40.0%

45.0%

40.2%

22.5%16.3%

8.6% 7.6% 4.3%0.5% 0.0%

The lot structure in terms of the respondents field activity

From these results and as you can see from the previous chart, the

patients/customers forming this study group have jobs in the trade, economic and constructions

field.

In the survey taken by the population addressing this pharmacy on 5th-11th May 2014,

the respondents’ monthly income was also taken into consideration. Those who have a monthly

income of between 1500-1999 lei prevail in the lot selected for the study - 88 (42%) of them.

Those who have a monthly income of 1000-1499 lei are 65 (31%), 27 (13%) of them have an

income of 500-999 lei, 12 (6%) of the respondents 100-499 lei and 12 as well (6%) earn between

2000-2499 lei. Only 5 (2%) respondents have monthly earnings that exceed 2500 lei.

We can see from these results, as shown in chart no.7.5, that the population

addressing this pharmacy and who participated to this study, has an average of 1000-1999 lei

monthly income.

34

Charter No.7.5.

100 - 499 RON 500 - 999 RON 1000 - 1499 RON

1500 - 1999 RON

2000 - 2499 RON

Peste 2500 RON0%

5%

10%

15%

20%

25%

30%

35%

40%

45%

6%13%

31%

42%

6%2%

The lot structure in terms of the respondents monthly income

For this study to be more comprehensive and efficient for the objectives of this research

paper, the questionnaire had a line the respondent was supposed to fill in if he suffers from a

certain disease and what type it is, acute or chronic.

Thus, 139 (67%) respondents were suffering from an acute illness when filling in the

questionnaire, 46 (22%) suffered from a chronic condition, and 24 (11%) had no disease when

presenting at the pharmacy and taking the survey. This data can be seen in chart 7.6.

Chart No.7.6.

67%

22%

11%

The lot structure in terms of the respondents disease

Acute illnessChronic illnessNo

35

All results previously presented targeted personal characteristics of the respondents.

Hereinafter, I will present the research results about the general behaviour of respondents with

regard to their relationship with the pharmaceutical unit and specialized personnel, what made

them address this pharmacy and what may determine them to return.

The first question from the second part of the survey refers to the type of product

purchased. Thus, 122 (58%) respondents purchased at the time of taking the survey allopathic

medication, 46 (22%) respondents bought homeopathic medication, 39 (19%) came for

parapharmaceutical products and only 2 (1%) respondents bought medical equipment.

From these data we can see that a high percentage of respondents turn to specialized

services in a community pharmacy to purchase allopathic and homeopathic medication. This

involves establishing an efficient communication between the patient/customer and the

specialist, in which information about using the products, the administered dosage, possible side

effects etc. is provided. Therefore, the communication between the pharmacist and the

population addressing the pharmacy must involve efficient verbal and nonverbal communication

techniques, through which the message conveyed by the pharmacist to the patient/customer

should be clear, easy to understand, and at the end of the conversation the pharmacist should

receive a positive feedback from the patient/customer.

The previously presented information can be analyzed in chart no.7.7.

Chart No.7.7.

58%22%

19%

1%

The lot structure in terms of the respondents kind of product

Allopathic MedicationHomeopathic MedicationParapharmaceutical ProductsMedical equipment

36

Also, the details about the person who will use the purchased products are important,

and in the pharmacist-population communication the question “Who will use the purchased

products?” is essential.

Therefore, in the survey taken by the participants to the study, this question was

present and 148 (71%) respondents purchased products for their own use, while 61 (29%)

respondents purchased the products for someone else to use. This information is present in chart

no.7.8.

Chart No.7.8.

71%

29%

The lot structure in terms of the person who is using the achieved products

For myselfFor other person

In the present study, I also considered the frequency with which the respondents address this

pharmacy when they need health services specific to a pharmaceutical unit.

After centralizing the data from the 209 questionnaires, it was found that 89 (43%)

respondents come often to this pharmacy, 71 (34%) said they always come to this pharmacy, 27

(13%) only sometimes come to this pharmacy, 19 (9%) rarely come to the pharmacy and only 3

(1%) respondents came for the first time to this pharmaceutical unit.

37

Chart No.7.9.

Often Always Sometimes Rarely It is the first time0%

5%

10%

15%

20%

25%

30%

35%

40%

45%

50%

43%

34%

13%9%

1%

How often do you come in this pharmacy?

In this research paper I also gave the questionnaire to the specialized pharmacy

personnel, the 3 pharmacists and 2 pharmacy assistants. The purpose was to investigate their

opinion on what would the patients/customers coming to the pharmacy where they work would

answer. The objective was to identify the differences between what the clients expect to receive

when they request services from the community pharmacy and what the personnel offers as a

response to their own image created regarding the patients’/customers’ needs.

The 5 respondents were asked to tick the questions in the survey based on what

they thought the population would answer. Their responses were analyzed qualitatively.

Thus, for the question in which I wish to know the reasons why the

patients/customers came to this pharmacy and not to another one on the day of the survey, the

following results were centralized: 86 (41%) respondents chose the pharmacy because it is close

by; and among the pharmacy personnel only 2 persons out of 5 considered this would be a reason

for which the population would address this pharmaceutical unit. 49 (24%) respondents choose

to come to this pharmacy because they consider it has good prices for their personal budget; also

2 out of 5 persons from the pharmacy staff believe that this is the reason the patients/customers

choose this pharmacy. 44 (21%) respondents chose this pharmacy because they believe the

38

pharmacy staff is polite; and one pharmacy employee has the same opinion. 23 (11%)

respondents chose it because they consider they always find what they need, and 6 (3%) of them

choose the pharmacy for the promotions it offers. Only one respondent said he chose this

pharmacy for the working program.

The results for this question are shown in chart no.7.10.

Chart No.7.10.

It is clo

sed by

It has g

ood prices

The pharm

acy sta

ff is polite

I always

find what I need

For the p

romotions in offers Other

0%5%

10%15%20%25%30%35%40%45% 41%

24%21%

11%

3%0%

Respondenți

What are the reasons you chose this pharmacy now?

Another question was the one trying to identify the respondents’ opinion regarding

customer retention by introducing fidelity cards and if it’s important for a pharmaceutical unit to

offer them. There was a large share for the affirmative response, 175 (84%) respondents were

excited about this option. 27 (13%) claim they don’t choose the pharmacy for the loyalty card,

but for the services offered, and 7 (3%) respondents are not interested in the fidelity card. The

results can be analyzed in chart no.7.11.

To this question, 2 persons out of 5 from the personnel considered that the patients

are not interested in a pharmacy using fidelity cards for customer retention, and the other 3 are

39

inclined to think that the patients/customers don’t choose the pharmacy for the fidelity card, but

for the services it offers.

The centralized responses to this question were important for one of the objectives

of this research paper – identifying the best means of customer retention. This way we could find

out the difference between what the patients/customers want and the pharmaceutical personnel’s

opinion regarding fidelity cards.

Thus, a future objective was set for the pharmaceutical unit – introducing fidelity

cards for the population addressing this pharmacy.

Chart No.7.11.

Yes They don’t choose the pharmacy for the loyalty

card

No0%

10%

20%

30%

40%

50%

60%

70%

80%

90% 84%

13%

3%

Does it matter to you if a pharmacy runs a customer retention campaign by offering loyalty cards?

Respondents

The next question also concerns the importance of a loyalty card in the pharmacy

and it was customized for introducing the loyalty card in the pharmaceutical unit where the

survey was taken.

A total of 193 (92%) respondents said they would come more often to this

pharmacy if fidelity cards were introduced, 16 (8%) think it’s possible to come more often due to

this change and none of the respondents remained indifferent to this change.

40

From the pharmacy staff, one person believes that the patients/customers would

come back if the fidelity card was introduced, 2 of them think it would be a possibility, and the

other 2 think this is not a sufficient reason to determine patients/customers to come more often to

the pharmacy.

The difference of opinion between the population addressing the pharmacy and

what they want and the pharmacists and pharmacy assistants with reference to the

patients’/customers’ expectations is visible. The representation of the population’s option is

shown in chart 7.12.

Chart No.7.12.

Yes Maybe No0%

10%

20%

30%

40%

50%

60%

70%

80%

90%

100%92%

8%0%

If this pharmacy offered loyalty cards, would you come more often?

Respondents

The third part of the survey was designed to identify the communication

characteristics between the pharmacy personnel and the people addressing the pharmacy where

the study was conducted.

One of the objectives of this research paper was to identify the degree of trust in the

pharmacist’s advice and this is why the survey included a question that sought the respondents’

opinion regarding the choice of pharmacy based on the offered counseling.

Thus, 151 (72%) respondents reported that they go to this pharmacy for the advice

and counseling they receive, and 58 (28%) don’t go to this unit for this reason.

41

The 3 pharmacists and 2 pharmacy assistants were of the opinion that the

patients/customers come to this pharmaceutical unit for the counseling they receive.

Chart No.7.13.

Yes No0%

10%

20%

30%

40%

50%

60%

70%

80%72%

28%

Do you come to this pharmacy for the advice and indications that you receive?

Respondents

A large portion of the respondents, 188 (90%), consider that the pharmacist’s

indications help them choose the OTC medication, that can be released without a prescription,

and 21 (10%) respondents don’t usually buy medication that can be released without prescription

at the pharmacist’s indications.

The pharmacy personnel unanimously consider that the indications received by

patients/customers help them choose the OTC medication they need.

Chart No.7.14.

Yes No0%

10%

20%

30%

40%

50%

60%

70%

80%

90%

100%90%

10%

Do you usually buy medication released without prescription based on the pharmacist’s indications?

Respondents

42

This study also wants to find out if the patient/customer, before purchasing a product

from the pharmacy, previously looks for information from other sources or only trusts in what

the pharmacist recommends. This is why at the question presented in chart no.7.15, 92 (44%)

respondents said they use to get their information only from the doctor, 46 (22%) seek

information from acquaintances, friends, 38 (18%) consult the newspapers or the information

given on TV, 25 (12%) surf the internet, and only 8 (4%) respondents don’t use to search for

information from other sources before purchasing a product from the pharmacy.

The specialized personnel, from the daily experience with people addressing the

pharmacy, claims that the patients/customers get their information from the doctor (2 of them),

from acquaintances and friends (2 of them) and from the internet (one of them).

This criterion helps us conduct the study because it provides information on how

respondents relate to pharmaceutical products and it also offers an overview over a part of the

pharmaceutical counseling – the communication between the pharmacist and patient/customer.

Chart No.7.15.

Only fro

m the d

octor

From ac

quaintan

ces/fr

iends

Newsp

apers

/TV

On the i

nternet

I don’t u

suall

y get

informed

Other so

urces

0%5%

10%15%20%25%30%35%40%45%50% 44%

22%18%

12%

4%0%

Before buying a product from the pharmacy, where do you get informed about it from?

Respondents

Another question aiming the population’s information refers to the frequency with

which patients/customers seek information before purchasing a product from the pharmacy.

43

Thus, 161 (77%) respondents said that they seek information only sometimes before

buying a product, 11 (5%) always inform themselves and 37 (18%) said they never seek

information before purchasing a product. Chart no.7.16 indicates these results.

The pharmacists and the pharmacy assistants from the pharmaceutical unit where the

study was conducted unanimously declare that the population sometimes seeks information

regarding the products they wish to purchase, and depending on what sources of information

they use, they want or not additional information from the personnel in the pharmacy.

Chart No.7.16.

Sometimes Never Always0%

10%

20%

30%

40%

50%

60%

70%

80%

90%

77%

18%

5%

How often do you consult various sources of information before purchasing a product from the pharmacy?

Respondents

The survey also had a question that was meant to identify the regularity with which the

respondents purchase products on the pharmacist’s recommendation. Thus, 181 (87%) replied

that it happens very often, even in most cases to choose the products recommended by the

pharmacist. 26 (12%) respondents said that it happens only sometimes, and 2 (1%) said that it

happens only rarely to purchase a product recommended by the pharmacist. No respondent

claimed that he has never purchased products recommended by the pharmacist.

Chart no.7.17 illustrates the obtained results for this question.

44

Chart No.7.17.

Very often, in most cases

Sometimes Rarely Never0%

10%20%30%40%50%60%70%80%90%

100%87%

12%

1% 0%

How often do you buy products recommended/indicated by the pharmacist?

Respondents

Also, another question aiming this paper’s objective of identifying the degree of trust in

the pharmacist’s advice, is that in which the respondents were asked if they trust the counseling

received from the pharmacist. They responded affirmatively in a large extent, 196 (94%), and 11

(5%) responded that they have more confidence in the pharmacists’ indications than in other

sources. 2 (1%) of the respondents don’t trust the pharmacists’ advice. Chart no.7.18 indicates

these results.

The result for this question is gratifying for the pharmaceutical personnel, as well as for

the pharmacist profession in general. The trust that patients/customers have in the counseling and

indications offered in the pharmaceutical unit determines the pharmacy specialists to deal more

interestedly the part where they advise the patient.

45

Chart No.7.18.

Yes,

I put a

lot o

f tru

st in th

e phar

macy s

pecial

ists

Yes,

I put m

ore tr

ust in th

e phar

macy s

pecial

ists t

han in

other

source

s

No0%

20%40%60%80%

100% 94%

5% 1%

Would you say you trust the pharmacist’s indications?

Respondents

We found that the population addressing the pharmacy has a large percentage of trust in

the pharmacist’s advice (94%). The next question seeks to identify the main reasons that

triggered this score.

With the highest percentage, (66%) (corresponding to 131 respondents), how the

patient/customer receives the information weighs the most in the respondents’ opinion.

The professional experience of the specialist in the pharmacy, in case the

patient/customer previously knows the specialist, led 43 (19%) respondents to trust the

pharmacist for this reason.

The pharmacist’s attitude, the confidence he proves while communicating the

information, the data he has about the results in other patients, is reason enough for 27 (12%)

respondents.

The remaining 3% (corresponding to 7 respondents) consider it is better to consult other

sources as well because they don’t trust the advice of specialists,and a respondent never trusts the

specialist in the pharmacy.

The results for this question can be analyzed in chart no.7.19.

46

To this question, the 5 specialists in the pharmaceutical field, who work directly with

patients/customers, considered that what determines the population to trust their advice is:

professional experience (3 out of 5 were of this opinion), the specialist’s attitude (1 out of 5) and

only one specialist believes that the way the information is conveyed is the reason why the

patient/customer trusts his advice.

Following the results of this question we can set up another future goal for the

personnel in this community pharmacy. More than 50% of the respondents believe that the type

of established communication is a factor of trust in pharmaceutical counseling, as well as the

way information is transmitted and its clarity, while the pharmacists and pharmacy assistants

consider that professional experience is the most important.

Analyzing the two percentages, we can identify the concept of efficient communication

the population expects, the message sent by the pharmacist to be understood by the

patient/customer.

Chart No.7.19.

The way

information is c

onveyed to me

Professio

nal experie

nce (if I

know the specia

li...

The pharm

acist’s

attitude (s

eems su

re of w

hat he sa

ys, h...

I don’t always

trust t

he pharm

acist an

d that’s why I

s...

I never tr

ust the p

harmacis

t

0%10%20%30%40%50%60%70% 66%

19%12%

3% 0%

Respondents

What makes you trust the indications received from the phar-macist?

47

In chart no. 7.20 we can see the results from the respondents on their expectations

when addressing a community pharmacy, in terms of interaction with the pharmacist.

Thus, 208 (99%) respondents want to understand what is being transmitted. Due to

specialized medical terms and the pharmacist’s fast way of explaining, it’s possible that many

patients don’t understand easily what the specialist wishes to transmit, and that’s why, when

entering a pharmacy, they wish to understand the message. This percentage that includes almost

all of the respondents’ same wish confirms once again the importance of efficient

communication in the pharmacy.

A percentage of 94% (corresponding to 196 respondents) wish to be listened to and

understood. It is also an item that refers to the type of communication, both verbal and nonverbal

and the concept of efficient pharmacist.

A total of 121 (58%) respondents expect when addressing a community pharmacy to

be treated politely. This, however, is indispensable in a pharmacist’s conduct, being part of the

deontology of the profession – being respectful and polite to all people equally.

Also, 98 (47%) want to leave the pharmacy with a good feeling, maybe of optimism,

if we can relate to patients with a poor psychological condition due to their condition.

At the same time, the need to feel respected when they enter a pharmacy is identified

in 73 (35%) respondents, and 42 (20%) of them want to be served quickly, while 7 (3%) of them

have no expectations.

To this question, the entire pharmacy personnel believes that all options should be on

patients’/customers’ expectations list. Only at the option where the patient wishes to leave the

pharmacy with a good feeling, only 2 out of 5 specialists considered it would be an expectation

from patients/customers. But considering the fact that approximately half of the respondents

wish this attitude, good feeling when leaving the pharmacy, it’s clear that this item will be

another future goal to be discussed and improved.

48

Chart No.7.20.

To understan

d what the p

harmaci.

..

To be listen

ed to and unders

...

To be treat

ed politely

To leave t

he pharm

acy with a g

o...

To feel re

spected

To be serve

d promptly

I have no exp

ectation

0%20%40%60%80%

100%120%

What expectations do you have when you enter a pharmacy, in terms of interaction with the pharmacist? – You can choose more than one

option.

Another important parameter in the communication process between the specialized

personnel in a community pharmacy and the population addressing the respective pharmaceutical

unit is the time allotted to each person in order to have an efficient communication.

Thus, based on the time allotted by the pharmacy personnel for each respondent,

they said in a proportion of 95% (corresponding to 199 respondents) that they are satisfied with

the allotted time, considering it was sufficient to establish an efficient communication.

Another 10 (5%) respondents think they would have needed more time to clarify

their issues, more information from the pharmacist. However, no respondent considered it

necessary to go to another pharmacy for additional information.

49

The pharmacy personnel consider that all patients/customers are given sufficient

time, necessary to clarify all issues and misunderstandings, that they do their best to offer an

efficient and complete counseling, focused on the patient and his needs.

Analyzing the survey results for this question, from both the transmitter and the

receiver, I noticed that the time allotted by the pharmacy personnel is so distributed that each

patient/customer is satisfied, regardless of the number of people waiting in line; each of them has

the right to adequate time for his needs.

Chart No.7.21.

It was e

nough. I’m plea

sed.

The pharm

acist didn’t c

ommunicate e

nough. I need

ed more inform

ation, more c

ounseling ti

me.

I didn’t unders

tand an

ything. I

’m going to

another

pharmacy

for ad

ditional inform

ation

0%20%40%60%80%

100%

Was the time allotted for communication by the pharmacist enough for you to understand all the indications?

In chart no.7.22 only the positive answers are presented for the tenth question, third part

of the survey, for the communication with the specialized personnel on the day of filling in the

questionnaire.

50

Chart No.7.22.

D G A E B F C0%

20%

40%

60%

80%

100%

120%

100.0%90.5%

80.0%70.0%

32.5%

3.0% 1.0%

The respondents answers that describe the communication between them and the pharmacist for the interview day

Respondents

A. The pharmacist established visual contact as soon as my turn came. Yes/No

B. The pharmacist smiled to me and this pleased me. Yes/No

C. The pharmacist smiled to me and it irritated me. I don’t need a forced smile.

Yes/No

D. I was greeted by the pharmacist. Yes/No

E. I was asked many questions and this pleased me. I felt I was given the necessary

attention. Yes/No

F. I was asked many questions and I felt uncomfortable. Yes/No

G. The information was clearly conveyed and I could understand it. Yes/No

Thus, 163 (80%) respondents noted that the pharmacist established visual contact as

soon as his turn came, this actually being the first step to an efficient communication.

The next step, after eye contact, but before greeting, is the smile. At item B, only

68 (32.5%) respondents said that the personnel greeted them with a smile.

51

At item C, 2 (1%) respondents felt uncomfortable and disturbed by the

pharmacist’s smile.

As can be seen from chart 7.22, there was a 100 percentage for item D, in which

each respondent was greeted by the personnel on the day of taking the survey.

An important part of the communication between the pharmacist and the population

is addressing questions and receiving answers. But this, however, is not sufficient for

establishing an efficient communication. The way questions are asked, the tone, the timing for

additional questions, the whole situation, all these can deteriorate the message that needs to be

transmitted and a negative feedback will be received from the patients/customers. Therefore, at

item E, 148 (70%) respondents were happy with the additional questions asked by the

pharmacist, but there were 7 (3%) respondents who were bothered by those questions.

Item G can conclude the communication process that each respondent had with the

pharmacist on the day of taking the survey. Thus, 189 (90.5%) respondents consider that the

information was clearly conveyed.

The last question refers to the nature of this research paper, assessing the

communication between the specialized personnel and the population addressing an independent

community pharmacy and the respondents’ satisfaction rate.

The results can be analyzed in chart 7.23.

Chart No.7.23.

99%

1%

Are you satisfied with how you communicated today with the pharmacist?

YesNo

52

Thus, 207 (99%) respondents were satisfied with how the communication was done

with the pharmacist, while 2 (1%) of them were not satisfied.

The pharmacy personnel believes that they are trying to establish an efficient

communication, both through verbal and nonverbal communication, but due to lack of time,

personal issues, illness effects and treatment of patients/customers, but first of all due to their

personality typology, obstacles arise in the communication process, and their dissatisfaction

comes as feedback.

The result, as can be seen in chart no.7.23, observes the patients’/customers’

satisfaction for the way the communication developed and so emerges the idea that the

pharmacists from this unit master the art of communication with the patient and succeed into

offering proper counseling.

53

Conclusions and Suggestions on Improving Communication

Between the Specialized Personnel in the Pharmacy and the

Population Addressing a Community Pharmacy

The conclusions that resulted after analyzing the responses of the subjects that

participated to this study indicate positive results for the objectives of this research paper.

1. The best means of customer retention were identified. After analyzing the impact of the

presence of a loyalty card for the pharmacy’s customers and the high percentage of

requests for introducing this type of card, it was found that this method can also be a way

of monitoring the consumption of certain medicines and pharmaceutical products by the

population addressing the pharmacy according to a certain criteria (age, gender, monthly

income, education level, disease etc.).

2. Regarding the degree of trust in the pharmacist’s advice, a high degree of confidence was

identified from the subjects participating in the study. I also demonstrated the importance

of establishing an efficient communication between the pharmacy specialists and the

patient/customer, this being the first reason stated by respondents for having confidence

in the pharmaceutical counseling.

Given that the results indicate a high percentage of confidence from customers in the

professional experience of specialists proven by establishing an efficient communication,

this could be a strategy of customer retention.

3. After this study, I identified the respondents’ view on how communication between the

pharmacist and the patient is established. Analyzing the allotted time for specialist-

respondent communication, it was proven that a close link between the temporal unity

and the informational one is needed. The information must be provided in a clear, explicit

manner because each patient/customer needs a certain time according to his personal

needs at that moment, especially that an important part of the subjects don’t purchase

products for personal use but are merely caretakers.

54

Also, the main expectations a person has from the specialist are the following, in order of

importance as they were analyzed in the study: the patient/customer has to understand

first of all what he is being transmitted and to be heard and understood by the specialist.

At the same time, the communication must be made in an appropriate tone so that the

patient/customer can feel respected and politely treated, and finally to leave the

pharmaceutical unit with a good feeling.

4. Pharmacists and pharmacy assistants working in the unit where the study was conducted

had in some respects different opinions regarding the expectations and wishes of

patients/customers. They failed to notice in their daily practice in the pharmacy the

customers’ wish of receiving additional information, conveyed in a clear manner and

with relevance to their health.

Also, the specialists had a mistaken idea about the possibilities that would motivate

customers to return to the pharmacy and their wish regarding a loyalty card.

Now, after the presentation of this study data, the situation regarding the communication

with the patients and the personnel’s skills is known and in the future it will be improved.

Based on these findings I propose the following future objectives:

1. The pharmacy personnel must take a course in efficient communication with

patient/customer.

2. The pharmacy should introduce a storing software and a system of loyalty cards for

the population requesting services from it.

3. The pharmacy should create a database for the most commonly purchased products,

according to a specific disease, and to develop articles, brochures (with information

about the respective illness, how it manifests, about the medication and how it acts,

side effects, the proper diet for the treatment etc.) that the pharmacists can offer to the

patient/customer who purchased that product. This will help both the pharmacist in

case he forgets to mention something, as well as the patient if he doesn’t remember

the information received in the pharmacy.

Even if modern information sources are varied, much of the information found on the

internet for example, is not from specialists and this proposal mainly helps in

achieving the pharmaceutical care concept more efficiently and helps increasing the

degree of trust in the pharmacist’s advice.

55

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57

Annex 1

Survey

I kindly ask you to answer the questions in the following survey. This will help me develop a

research paper. Your answers are confidential and anonymous and they will be processed

statistically.

A. Personal characteristics of respondents

1. Age

2. Sex: Male/Female

3. Occupation:

A. Pupil/Student

B. Employee

C. Employer

D. Home-keeping

E. Retired

4. Education level:

A. 1-4 grades

B. 5-8 grades

C. 9-10 grades

D. High school

E. University

F. Post university

5. Field of work:

A. Economics

58

B. Medical

C. Light industry (garment industry, skin dressing, food industry)

D. Trade

E. Constructions

F. Tourism

G. Heavy industry

H. IT

I. None of the above:____________________

6. Monthly income:

A. 100-499 lei

B. 500-999 lei

C. 1000-1499 lei

D. 1500-1999 lei

E. 2000-2499 lei

F. Above 2500 lei

7. Do you suffer from a condition?

A. Yes, an acute disease

B. Yes, a chronic condition

C. No

B. General behaviour

1. What kind of products made you come in the pharmacy today?

A. Allopathic

B. Homeopathic

C. Parapharmaceutical

D. Medical equipment

59

2. Who are you buying the products for?

A. For myself

B. For someone else

3. Do you come often to this pharmacy?

A. Yes, I always come here.

B. Yes, often.

C. Only occasionally

D. No, rarely.

E. No, it’s the first time I come here.

4. What are the reasons you chose this pharmacy now?

A. It’s convenient, close by.

B. It has good prices.

C. I always find what I need.

D. I like that the pharmacists are nice to me.

E. Because they have promotions.

F. Other: ____________________________

5. Does it matter to you if a pharmacy runs a customer retention campaign by offering

loyalty cards?

A. Yes

B. No

C. I don’t choose the pharmacy for the loyalty card, but for the services it offers.

6. If this pharmacy offered loyalty cards, would you come more often?

A. Yes

B. No

C. Maybe

60

D. Communication characteristics

1. Do you come to this pharmacy for the advice and indications that you receive?

A. Yes

B. No

2. Do you usually buy medication released without prescription based on the pharmacist’s

indications?

A. Yes

B. No

3. Before buying a product from the pharmacy, where do you get informed about it from?

A. Only from the doctor.

B. On the internet

C. From acquaintances/friends

D. Newspapers/TV

E. Other sources: _____________________

F. I don’t usually get informed.

4. How often do you consult various sources of information before purchasing a product

from the pharmacy?

A. Always

B. Sometimes

C. Never

5. How often do you buy products recommended/indicated by the pharmacist?

A. Very often, in most cases

B. Sometimes

61

C. Rarely

D. Never

6. Would you say you trust the pharmacist’s indications?

A. Yes, I put a lot of trust in the pharmacy specialists.

B. Yes, I put more trust in the pharmacy specialists than in other sources.

C. No

7. What makes you trust the indications received from the pharmacist?

A. Professional experience (if I know the specialist for a longer time)

B. The way information is conveyed to me

C. The pharmacist’s attitude (seems sure of what he says, has information about other

patients’ results)

D. I don’t always trust the pharmacist and that’s why I search other information sources

as well

E. I never trust the pharmacist.

8. What expectations do you have when you enter a pharmacy, in terms of interaction with

the pharmacist? – You can choose more than one option.

A. To feel respected.

B. To be treated politely.

C. To be listened to and understood.

D. To understand what the pharmacist transmits.

E. To leave the pharmacy with a good feeling.

F. To be served promptly.

G. I have no expectation.

9. Was the time allotted for communication by the pharmacist enough for you to understand

all the indications?

A. It was enough. I’m pleased.

62

B. The pharmacist didn’t communicate enough. I needed more information, more

counseling time.

C. I didn’t understand anything. I’m going to another pharmacy for additional

information.

10. Please choose the options that best describe the communication between you and the

pharmacist today.

A. The pharmacist established visual contact as soon as my turn came. Yes/No

B. The pharmacist smiled to me and I liked it. Yes/No

C. The pharmacist smiled to me and it irritated me. I don’t need a forced smile. Yes/No

D. I was greeted by the pharmacist. Yes/No

E. I was asked many questions and I liked that. I felt I was given the necessary attention.

Yes/No

F. I was asked many questions and I felt embarrassed and uncomfortable. Yes/No

G. The information was clear and I could understand it. Yes/No

11. Are you satisfied with how you communicated today with the pharmacist?

A. Yes

B. No

12. Date of survey: ________________

13. Time of survey: ________________

Thank you!

63