Role Play A Hospital consultation warfarin therapy

Pharmacy professionals brief

A 55 year old patient has been admitted to your hospital diagnosed with a DVT in the left calf.
He/she has been initiated on warfarin and you have been asked to see them to talk through
the warfarin counselling but have been warned that the patient is reluctant to take it.
The focus is not to give a detailed warfarin counselling session.
Please share these instructions with patient and observer: For this consultation
assume the welcoming and introduction has been done. Focus on the central part of the
consultation using appropriate questioning (information gathering) to find out what the
patient knows about warfarin and their concerns/beliefs of treatment. Use explanation and
planning whilst considering building the relationship throughout.
Starter for ten if helpful.So, youve been prescribed warfarin for a DVT, tell me what you
know about warfarin

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Role Play A Hospital consultation warfarin therapy

Patient brief
You are a 55 year old patient who has been admitted to hospital with a DVT. You have been in
hospital for several days now and the consultant has prescribed warfarin.
Here are some answers to the questions you may be asked:

You have never taken warfarin but know it a little bit about it as your sister took it. You
know it thins the blood.
You dont want to take warfarin because you have no fixed abode at the moment and
from what you remember your sister had to have her blood monitored regularly. You
feel worried because you have no idea where the clinic is, you dont have any means of
transport and you feel as though you may get the tablets mixed up (you seem to
remember lots of different colours)

You can be open about not wanting to take the tablets from early on in the consultation.
The object of this scenario is for the pharmacy professional to be non-judgemental about your
concerns about warfarin and empathetic to your situation. They should offer some options for
you before agreeing a plan.

You
You
You
You

take no other medication

have no pets
move around staying with friends as you have lost your home
drink about ten bottles of wine a week

Role play B Hospital/community/primary care Asthma

Pharmacy professionals brief
You are asked to see a patient (on the ward to take a medication history/ in the community
pharmacy or GP practice for a medicines review/- please agree a location as a group) to
discuss their regular asthma medicines.
The patient was admitted to hospital with an asthma attack and has been prescribed a course
of oral prednisolone tablets.
The focus is not to check inhaler technique
Please share these instructions with patient and observer: For this consultation
assume the welcoming and introduction has been done. Focus on the central part of the
consultation using appropriate questioning to find out how the patient was using their asthma
medicines previously and what they understand about their medicines. Use explanation and
planning whilst considering building the relationship throughout.
Starter for ten if helpful.So, tell me which medicines you were taking for your asthma
before you went into hospital

Role play B Hospital/community/primary care Asthma

Patient brief
You are Jo(e), a 31 year old and have suffered with asthma since childhood. Lately you have
suffered a lot of stress at work and feel very anxious all the time. (Try to look anxious: maybe
clasp hands tightly; frown; speak quickly)
The pharmacy professional would like to know what medication you have been taking and
how you use it. This is the first time you have been in hospital with your asthma for 10 years.
Here is some information to help you answer questions but only offer this information if
asked:
You use a blue inhaler and take two puffs when you need to, to help you breathe. You
are currently using this 2-3 times a day
You also use a Qvar 100 inhaler (you call this the brown puffer) - you should take one
puff twice a day but stopped using it two months ago.
You stopped using your preventer as you dont want to keep filling your body full of
steroids. You are unaware that prednisolone is a steroid.
Asthma control you wake up coughing very early on about 4 mornings each week.

Alcohol you dont drink alcohol

You have never smoked
You dont have any pets
You dont take any other medicines

Role Play C Community/ Primary Care Type 2 diabetes

Pharmacy professionals brief
A patient has asked to speak with you about their medicines for Type 2 diabetes. The patient
was diagnosed a month ago and their medicines record states they have been taking
Metformin 500mg three times a day for three weeks.
Please share these instructions with patient and observer: Start at the beginning of
the consultation (welcome and introduction) and move on to establish the agenda for the
consultation. Use appropriate questioning to gather information from the patient. Use
explanation and planning whilst considering building the relationship throughout.

Role Play C Community/ Primary Care Type 2 diabetes

Patient brief
You are Sam, a 46 year old with type 2 diabetes. You have been referred to the pharmacy
professional because you have had some problems with your medication.
Here is some information to help answer questions but only offer this information if asked:

You were diagnosed with diabetes 1 month ago on receiving your results from a
general MOT from your GP (general blood pressure and blood test)
You are concerned about diabetes and dont know much about it. You dont understand
why you have it as no one in your family has diabetes. You dont understand what it
means.
You take your Metformin 500mg tablets regularly three times a day (one with
breakfast, one with lunch and one with evening meal as informed) and have had
terrible diarrhoea since. You feel embarrassed and want to stop taking them.
Alcohol you dont drink alcohol
Smoking you have never smoked
Exercise you dont do any regular exercise
Blood pressure and cholesterol The GP said both were a little bit high.

Role Play D Community OTC advice

Pharmacy professionals brief
It is a busy Thursday morning and you go out onto the medicines counter to help out. A
young woman appears and is a little anxious. She has a packet of cigarettes in her hand. She
requests a cough medicine for her child.

Please share these instructions with patient and observer: OTC consultations are
generally quite short so start at the beginning of the consultation (welcome and introduction)
before moving to appropriate questioning to gather information from the parent.

Role Play D Community OTC advice
Patient brief
You have come to the pharmacy for a bottle of cough medicine for your child. Youve had a
stressful morning and not much sleep the night before so you appear a bit anxious. Youve
just had a cigarette outside and still have your cigarettes in your hand.
This information may help you answer specific questions at points in the consultation. Only
provide this information if asked:

You would like a cough medicine for your son who is 3 years old
The cough started about 2 and a half weeks ago when he caught a cold it sounds very
dry and tickly, he is not bringing up any phlegm
The cough is much worse at night and last night neither of you got much sleep as he
coughed until he vomited
He is not wheezing
He is drinking normally but is not eating as much as usual
He doesnt have any fever
He has had all his vaccinations
You dont have any pets
Smoking: you try to smoke outside as much as possible but you must admit that
sometimes its too cold and when you are tired and stressed you just want a cigarette
to calm you down. You never smoke in the childrens bedrooms but sometimes in the
lounge.

Role Play E Community Smoking cessation advice

Pharmacy professionals brief

A customer has come into the pharmacy to buy paracetamol 500mg tablets. You notice that
they are also looking at the nicotine replacement therapy products and reading a leaflet.
Tips:
Consider how you will open up the conversation about smoking cessation advice
Please share these instructions with patient and observer: OTC consultations are
generally quite short so start at the beginning of the consultation (welcome and introduction)
before moving to appropriate questioning to gather information.

.
Role Play E Community Smoking cessation advice
Patient brief
You are 32 years old and have come to the pharmacy to buy paracetamol 500mg tablets but
while you are at the counter you see a leaflet about giving up smoking and a stand with
nicotine replacement products on. You know you should give up but not sure you want to.
Youve given up briefly before but with little success as your heart wasnt really in it. You
enjoy smoking and as you dont drink alcohol you see it as your one treat and stress reliever.
This information may help you answer specific questions in the consultation:

You smoke between 10 and 15 cigarettes each day, in the car on the way to work, in
your breaks at work and then in the evening once you have put your 5 year old son to
bed
You have a new partner who is very anti-smoking and he has been putting pressure on
you to quit
You know that it is not particularly good for your health but you dont smoke that many
and never around your son
You do not take any medication other than the combined oral contraceptive and the
odd painkiller for a headache
You do not drink alcohol
You walk your son to school and swim with him once a week