Quantification of communication processes, is it possible?

The PAS system (Problem-Analysis-Solution-system) is developed to quantify oral communication processes during counselling in pharmacy practice. The pharmacist translates the patient's drug-related questions into a P-code, the analysis of the question into an A-code and finally the given solution upon the question into a S-code. The PAS system has been developed for two goals. First, for the registation of drug-related questions from patients which gives the pharmacist insight in the most common issues addressed by patients. Second, it might help the pharmacist to structure the communication with the patient during the consultation. Forty-one pharmacists participated in the evaluation of the PAS system. The validation of the PAS system consisted of two phases: the external validation and the internal validation. Kappa values were calculated as a measure of agreement in the coding by the pharmacists. The kappa-value of the external validation for the P-, A- and S-codes for the total set of questions indicate a moderate to poor agreement. This means that pharmacists categorize drug-related questions from patients in a different way. Therefore we conclude that the PAS system is less reliable for research purpose. The kappa-value of the internal validation for the P-code varies from 0.42 to 0.91. For the A-code it varies from 0.07 to 0.35 and for the S-code from zero to 0.68. Internal reproducibility is good for P-code but not for the A-code and S-code. This implies that the pharmacist can use the P-codes for registration of patients' questions in his own pharmacy. Moreover, the usage of the PAS system during counselling in pharmacy practice can structure the consultation.