Listing the whys and listening to the why nots

Abstract

It's been recommended for decades that patient education encounters contain specific information, including drug onset of action, administration route, adverse effects, storage, and many more. These requirements, along with components of a drug utilization review and written documentation, are detailed in the Omnibus Budget Reconciliation Act of 1990 (OBRA ‘90) and have been widely adopted in pharmacies nationwide. Explaining this required information to patients is absolutely vital. However, if we focus on that alone, we risk minimizing an essential piece of the patient counseling puzzle: the process of education. Descriptions of the patient education process paint a more interactive picture with broader strokes that include establishing a caring relationship; assessing patients’ attitudes toward their health problems; and exploring cultural identity and how it impacts patient care. I would argue that by dropping these crucial components from many of our patient interactions, we risk missing out on a much bigger picture. In this month's cover story (p. 26) on structural racism, Anne Lin, PharmD, of the Notre Dame of Maryland School of Pharmacy describes a counseling encounter with a vaccine-hesitant coworker that was ultimately successful. She recalls explaining the reasons the vaccine was important and did not dismiss her patient's concerns. In other words, she listed the whys and listened to the why nots. When we neglect exploring deeper issues such as culture, barriers to care, and bias with our patients and within ourselves, we contribute to structural racism. In this issue, you'll get details on recent drug approvals (p. 14), intermittent use of intranasal corticosteroids for allergic rhinitis (p. 21), and strategies to address unmet mental health needs in your patients (p. 19). Catch up on your CPE and prepare for the upcoming influenza season with our comprehensive 2021 immunization update (p. 52). As human beings, each of us is susceptible to overlooking a patient's or colleague's perspective, their cultural identity, and barriers to care. As pharmacists, we have a responsibility to acknowledge and recognize these perspectives, our own internal biases, and implicit biases that patients face in the health care system. As a profession, we can strive to be better listeners to what our patients say and what they don’t say, and address our own internal preconceptions about culture, socioeconomic status, and race to affect change to structural racism. It starts with me, it starts with you, but ultimately it will take all of us working together.