Case commentary

What happened Marie anticipated having no problems at all in fulfilling the earlier agreement and dispensing the medication as expediently as possible. She assumed that any questions and concerns that mrs. Prout might have would have come up intheir earlier conversation. Why was marie wrong in assuming there would be no conflict? How did unspoken thoughts and assumptions affect the interaction? Because marie assumed the agreement was explicit, she was caught off guard by mrs prouts objections. It is very human trait to get very quiet when we are stunned by something and we are trying to figure out how to respond. Marie is already a few steps ahead in wondering if she can return the special order for credit. When the conflict at hand hasnt yet been fully discussed. Marie also obviously assumed that money was not as important to mrs.prout as brand loyalty. In the end marie is kicking herself and is ready to submit her name for wimp of the year.

How did the communication strategis affect the outcome? Marie must have felt that mrs. Prout didnt listen to her in their first conversation and that she wasnt listening to her again. But if marie puts all the blame on mrs prouts poor skills, she is missing out on an opportunity to improve her own. Looking back on maries statements, it easy to infer that she has a problem with being specific and direct. When she says, dont you recall our discussion that the brand was no longer on contract and would be higher? mare doesnt say that she told mrs. Prout exactly how much more the cost would be.. the word higher is to abstract in this case and mrs.prout may have thought that higher meant a few cents more. Did marie fail to be specific with her because she was uncomfortable talking about money with this retiree? Was she hoping mrs.prout would say, forget it, I guess I can take another brand to save money? when she didnt say this, marie went ahead with the extra effort of the special order hoping everything would turn out okay. How could this have been handled differently? obviously in the first conversation marie needed to state the exact price difference per inhaler refill. Given that this didnt happen, she needed to take ownership for her lack of specificity. She needed to say something like, mrs.prout, I can tell from your shock about the price that I wasnt clear enough about the cost difference the last time we talked and Im sory for that.still, this presents a bit of problem. Although it may be possible to return this presents a bit of problem. Although it may be possible to return this special order for credit, if it doesnt present too much of a financial hardship, I am wondering if we can come to some agreement about your purchase of the order we placed for you and then discuss exactly what we should do in the future. by telling mrs.prout more of what is going

through her mind, marie increases the chances that they can work effectively together toward a compromise

Medication record The patients medication record functions as that section of the pharmacists workup of drug therapy where the indication for drug therapy, and all of the drugs a patient is actually taking, are organized in a meaningful context. Here is the format most frequently used for gathering this information : this includes prescription medications, nonprescription products, professional samples, medications obtained from friends or family members, home remedies, natural and homeophatic remedies, and drugs of abuse. Indeed, it includes all things considered drugs! Establishing the appropriate indication or connection between each an every drug the patient uses and the medical condition, disease, or illness is an absolute necessity in the provision of pharmaceutical care. For many patients, this will be the first time that any practitioner has put forth the effort to collect and document all indications and associated drug therapies. These data are invaluable, not only to the pharmaceutical care practitioner but also to medical, nursing, emergency, and dental practitioners, as well as other care providers. In addition to the list of indications and drug therapies, the current problem list section is uused to document the assessment of whether or not the patient has any indications that are presently not being adequately treated with drug therapy, or it any of the patients present condition might be the results of medication taken. The problem section is also used to asses if any of the patients conditions might adversely influence the manner, or extent, to which drugs are absorbed, distributed, metabolized, eliminated. In order to provide pharmaceutical care it is essential to establish and document the indication for evert medication the patient is taking. Indication is a critically reflexive category. The concept of indication for drug therapy is intended to encompass all of the possible reasons for drug therapy might be required by a patient. Therefore, indicvation reaches well beyond disease or medical diagnosis and in general includes curative, preventive, palliative, and diagnostic purposes. An indication for drug therapy is designed to : Cure a disease or illness Prevent a disease or illness Provide comfort and temporary relief from signs and symptoms of a disorder\ Assist in the diagnostic procces Correct abnormal laboratory values

It is vital during the assessment that the intended indication for each medication the patient is taking described, associated with the appropriate medication and documented.

All of the drug products that a patient is taking (or is expected to take) are documented on the medication record. Whether the medication is prescription filled at some other pharmacy, a mail-order item, a nonprescription product purchased at a grocery store, gas station, or from some other source, it must be included in the medication record in order to make a comprehensive assessment of the patients unique drug related needs. The practioner must be able to asses the appropriateness of the entire dosage regimen, including the dosage form, the dose the patient is expected to take, the intended route of administration, and , and the frequency of actual drug administration. When the patient began the particular drug regimen and, if applicable, when itt was discontinued, is also important to consider and document. Lastly, this portion of the pharmacist workup drug therapy also consider goals of therapy.