Patient Management: When “Fine” Is Not Fine
A specialty pharmacist’s typical conversation with a patient goes a little something like this – the specialty pharmacist or patient care advocate asks the patient how they are doing. The most common response is “I’m fine.”
However, seasoned specialty pharmacists and staff know that when they ask more questions – or ask questions the right way – they quickly realize that fine is often not, in fact, fine.
As specialty pharmacists, it is our job to help patients achieve the best results. Here are three ways specialty pharmacy team can support patients as they work towards their optimal therapy goals.
Set Appropriate Expectations
When it comes to treating chronic illnesses, it is important for patients to understand what to expect and what goals to set.
Depending on the condition, some goals of therapy are resolution of symptoms or complete remission. If that is the case, a patient feeling “a little bit better” should not be considered reaching their goal of therapy.
Jeffrey Bornstein, MD, board-certified pediatric gastroenterologist and division chief of the Pediatric Center for Digestive Health and Nutrition at Arnold Palmer Hospital for Children, agrees. “Sometimes patients have low standards when they are diagnosed with a chronic condition, and it is important to make sure they know what their goals of therapy are,” he says.
It is important to educate patients on expectations because if they aren’t reaching goals, they may require adjustments to their medication regimen.
Ask the Right Questions
Questions like “How are you doing?” usually don’t help us understand what the patient is really going through.
Through AllianceRx Walgreens Pharmacy’s Connected Care program, we ask disease-specific questions about the patient’s symptoms, the severity of symptoms, and other indicators that may suggest they aren’t reaching their goals. Our hope is to provide valuable interventions for patients, such as counseling and prescriber notifications.
Asking open-ended questions is another helpful method that can encourage a patient to spill the beans. Open-ended questions are questions that can’t be answered with a simple ‘yes’ or ‘no’.
Creaky Joints, a patient advocacy group, polled patients on why they do not divulge information about their disease state to other people. Some patients reported these reasons:
People don’t seem to really understand what you are going through.
They don’t want anyone’s pity.
It’s just easier to not explain.
They don’t want to burden people with their problems.
You can read about it here. Asking the right questions in an empathetic way can help the patient feel heard and comfortable to speak up.
Close the Loop with the Patient’s Health Care Provider
The specialty pharmacy team is on the front line. We have pharmacists available 24/7 and talk to the patient every time they fill their medications.
When we discover through our Connected Care assessments or even during other conversations with the patient, that they are worsening or not meeting therapy goals as expected, it is our duty to close the loop and notify the patient’s healthcare provider.
Whether it is calling the provider, sending a message, or even explaining to the patient that they should advocate for better outcomes, the specialty pharmacist can help the patient not accept feeling “fine” and strive for living their best life.
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