Patient counseling - A focus on maintenance therapy

Richard K. Lewis*, Nancy L. Lasack, Bruce L. Lambert, Sharon E. Connor

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

49 Scopus citations


Pharmacist counseling of patients receiving long-term medications for chronic diseases is discussed. Patient counseling should be viewed as one component of the overall drag-use process. Pharmacists counseling patients prescribed long-term medications need to understand the lifestyle effects of chronic illness, particularly the different types of 'work' the chronically ill patient must undertake. Pharmacists need to go beyond traditional sender- message-receiver communication models in counseling patients and to adopt a problem-solving approach through which each patient's needs and level of understanding are taken into account. Patients should be actively involved in their therapy decisions. Patients will be at varying stages in terms of making any behavioral changes needed to maximize therapeutic outcomes, and counseling must be adapted to fit the stage of change. The Indian Health Service (IHS) model of counseling uses open-ended questions to determine patients' knowledge of their disease and medications; this enables the pharmacist to fill in any gaps and review specific points. The health communication model provides strategies for enhancing patient compliance and recall and complements the IHS model. In practice, the techniques used will depend on whether the patient is a new-proscription patient or an established patient. The models can be adapted to counseling care-givers and can be complemented by compliance aids. The demand for pharmacist counseling of patients with chronic illnesses is likely to increase, and, to effectively counsel patients about long-term medication use, pharmacists need to appreciate the personal impact of chronic illness beyond the direct effects of the biomedical disease itself and must understand modern communication models.

Original languageEnglish (US)
Pages (from-to)2084-2098
Number of pages15
JournalAmerican Journal of Health-System Pharmacy
Issue number18
StatePublished - Sep 15 1997


  • Communication
  • Dosage schedules
  • Models
  • Patient information
  • Pharmacists
  • Pharmacy

ASJC Scopus subject areas

  • Pharmacology
  • Health Policy


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