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BASIC PRINCIPLES AND PRACTICE  OF DIAGNOSING  AND SELLING  IN A PATIENT-CENTERED  COMMUNITY PHARMACY

ASHIRAF LUBEGA B.PHARMACY, MUK ( fresh graduate, 2021)

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Definition of terms 1  diagnosis  =  is the process of identifying a disease, condition or injury based on the signs and symptoms a patient is having and the patients health history and physical exam. This further involves testing such as blood tests, imaging tests, etc and may be done after a clinical diagnosis is made. 2  selling  =  is any transaction in which money is exchanged for a good or service. 3  patient-centered care  =  providing care that is respectful of and responsive to individual patient preference, needs and values and ensuring that the patient takes part in all clinical decisions. 4  community pharmacy / retail pharmacy  =  any place under the supervision of a pharmacist where prescription orders are compounded and or dispensed directly to the individuals who are mainly people in that local area.

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The discussion topic has two subtopics  ie : 1  principles and practices of diagnosing in a patient-centered community pharmacy 2  principles and practices of selling in a patient-centered community pharmacy

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principles and practices of diagnosing in a patient-centered community pharmacy In a community pharmacy setting, simple diagnosis by the pharmacist/ dispenser is very much possible. However this means that the pharmacist, dispenser has to correlate clinical knowledge into proper diagnosis of the patient. Diagnosis in community pharmacy settings mainly involves a direct interaction between the pharmacist/ dispenser and the patient. Diagnosis can be in form of: 1 patients history taking, helps at arriving at the right diagnosis. 2  Simple physical examination 3 simple diagnostic tests incase a pharmacist consultation room is available

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It is vital, therefore , that the pharmacist possess excellent communication skills to ensure the correct information is obtained from the patient. This can be drawn from a combination of good questioning technique, listening actively to the patient and picking up on non-verbal cues. Clinical reasoning of pharmacists/ dispensers after a one on one interaction with the patient, this helps to arrive at a differential diagnosis that then leads to a proper diagnosis. In addition, clinical experience also plays a part in the process. Certain conditions have very characteristic presentations and once encountered with, its straight forward to diagnose.

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The keys steps in the diagnosis process in a community pharmacy are: 1  Formulating a diagnosis based on the patient and the initial presenting complaint 2  Asking  question to  mainly to let the patient give detailed information. 3  Confirming facts Therefore , diagnosis involves integration of  patho -physiology, microbiology, pharmacology and therapeutics  knowledge among  others.

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Some mnemonics which can be used in patient diagnosis at the community pharmacy are: W  Who is the patient and what are the symptoms?  H  How long have the symptoms been present?  A  Action taken?  M  Medication being taken?   A  Age/appearance  S  Self or someone else  M  Medication  E  Extra medicines   T  Time persisting   H  History  O  Other symptoms  D  Danger symptoms

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principles and practices of selling in a patient-centered community pharmacy Proper diagnosis leads to choice of a product of best fit for the patient, a process of selling. As like any other business, pharmacy business is also aimed at profit maximization through delivering a service to the patients which leads to their improvement in medical conditions and or cure as well as improving the quality of life. The strategies of selling in a community pharmacy include: 1 stock 2 proper inventory management system

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3  good customer service 4  good dispensing practice 5  proper marketing skills and strategies 6  CPD’s 7  extra services i.e. Clients data-base Patient monitoring B.P , DM, TEMPERATURE measuring  8 privacy in the  pharmacy 9 payment mode  ie  cash, visa machine,  momo  pay And  many others

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PHARMACY SCENARIOS TO APPLY THE TWO CONCEPTS A 22yr old makerere university male students flops into MM pharmacy requesting for diazepam. He complains that he wants to have some sleep at least over the weekend since he has not been sleeping for the past 2 weeks due to tests. How do you as a pharmacist/ dispenser  handle this case.

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2  A 40 years old lady staying at  Kazo  came to the pharmacy complaining of fluctuating fevers for about 5 days, fatigue, headache, shivering, general body weakness, vomiting and anorexia. She used some Paracetamol tablets but no improvement seen. The patient furthermore complained of joint pains and episodes of coldness in the evening. She is not pregnant neither is she breastfeeding. The malaria test tested positive and was given coartem which she took for 3-days. however, she is still complaining of the same symptoms and less improvement with the coartem treatment. How can she be handled at the pharmacy? Any  extra advise for this lady?

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3 A Young lady  was advised by a friend to come in the pharmacy to get ciprofloxacin to manage the Itching of private parts, with a whitish discharge like spoilt milk. Upon interaction, there was No fishy smell, No urgency to urinate, No polyuria for the past 2 days. Upon interaction with her, she narrates that she last had protected sex like 6 months back and that they share the toilet at the work place. What is the diagnosis for this lady? Treatment options and advice?