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A comparison of the Indian Health Service counseling technique with traditional, lecture-style counseling
Objectives:
To compare the immediate postcounseling retention of important information using the traditional method with retention obtained using the Indian Health Service (IHS) interactive technique, and to compare the time required to counsel patients on new prescriptions using the traditional method with the time required using the IHS technique.
Design:
A prospective, nonrandomized, observational study at four different local community pharmacies in Oregon. Two sites that used the traditional counseling model served as the control sites, while two other sites used the IHS counseling model. Only new prescriptions were included in this study. The pharmacists did not alter their counseling styles for new prescriptions for the purposes of this study. The duration of counseling between the pharmacist and patient was recorded. Immediately upon completion of counseling, patients met with the primary investigator for postcounseling knowledge assessment on indication of therapy, directions on how to take their medication properly, and expected adverse effects.
Setting:
Four local community pharmacies in Oregon.
Participants:
Five hundred patients at four local community pharmacies in Oregon.
Intervention:
Use of the IHS counseling technique.
Main Outcome Measures:
Immediate recall of key counseling points and time per counseling session.
Results:
A total of 500 patients participated in the study. Seventy-one percent of patients counseled using the IHS technique answered all three questions correctly, compared with 33% of patients counseled using the traditional method (P <0.00). For patients who were counseled about adverse effects, 80% counseled using the IHS technique compared with 51.5% counseled using the traditional approach answered all three questions correctly. For indication of therapy, there was no evidence of a difference in the proportion of correct answers between counseling types on the reason for taking their medication (P = 0.06). Those who received IHS counseling had four times the odds of correctly answering when to take their medication and four times the odds of correctly answering all adverse effects questions. The duration of counseling methods differed by 53 seconds (128 s for IHS vs. 75 s for traditional).
Conclusion:
The interactive style of the IHS method of counseling provided significantly improved immediate memory recall compared with the traditional method. The IHS method also took longer than the traditional method.