Exploring patient expectations for pharmacist-provided literacy-sensitive communication

Limited health literacy is common and associated with adverse health care outcomes. Although pharmacies and pharmacists are accessible to most patients, research has indicated that they do not routinely report efforts to target interventions for patients with suboptimal health literacy. Moreover, little is known about the use and expectation of literacy-based communication techniques in pharmacies from the patient perspective.

The intent of this pilot study was to describe the use of health literacy-based communication techniques, expectations for their use, and satisfaction with communication as reported by patients at high risk for medication misadventures who receive care at a clinic-based community pharmacy.

A cross-sectional telephonic interview of a purposive sample of patients aged 65 years or older who were prescribed at least 8 unique medications was conducted. Patients were recruited from 1 clinic-based pharmacy that serves a predominantly urban low-income population. A telephonic interview guide was derived from previous literature and included 52 questions related to respondent characteristics, perceptions of experiences regarding verbal communications with the pharmacist, expectations for communication with the pharmacist, and satisfaction with current pharmacy communication techniques. Responses were summarized and described.

Nineteen patients completed the telephonic interviews. Patients commonly reported that the pharmacist provided the following counseling for new prescriptions: how to take their medication (88.9%), side effects (84.2%), and indication (47.4%). In contrast, only 44.4%, 55.6%, and 33.3% of patients expected the pharmacist to engage in these same counseling behaviors. A minority of patients reported the use of various recommended clear health communication techniques by the pharmacist, and an even smaller percentage expressed expectations for their use. Despite the limited use of literacy-based communication techniques, 73.7% of patients reported being very satisfied with pharmacy counseling, and 94.7% reported good to excellent understanding of their medications.

Patient-pharmacist interactions consistently met or exceeded patient expectations. However, pharmacists use of literacy-based communication techniques was low as were patient expectations. Future research and training efforts should focus on not only increasing pharmacists' use of literacy-based communication techniques but also raising patients' expectations for performing these activities.