Request for tips for counseling patients with HIV/AIDS

[agape720]

Hi everyone,
My name is Lisa, and I am a pharmacy student.  In January I will be on rotation at an HIV/AIDS pharmacy.  I will be counseling patients on their ARVs, checking on adherence to the drug therapy, etc, and I would like tips from all of you about how to counsel patients in the most effective way.  Of course I know I should be nonjudgemental and empathetic, but I would like specific tips.  IE: are there things that other health professionals do when counseling you that you like and don't like?  Please let me know- I want to provide the best possible care to my patients!

[hotpuppy]

Lisa,
  Congratulations on getting to where you work in a Pharmacy.  It's fantastic that you are taking the time to research. 

Here's my feedback:
1. I'm there for the cure not the guilt.  Save the guilt for church.  I *HATE* when healthcare workers preach to me or try to make me feel guilty.
2. Don't make a scene.  I want to come in, get my meds, and get out.  I'm not there for a show and it's not anyone else's business what I take or for what.
3. Talk in as low of a voice as is suitable.  i.e. don't shout... see #2
4. Be prepared for stressed out patients.  It can be extremely stressful when you are told your meds aren't covered, aren't covered like you expected, etc.  If you read the forums you will people stressing on here about it.

Be cheery, upbeat, and fun.  My favorite healthcare workers are the ones that are genuinely fun to be around.

[ga1964]

Lisa,

Congratulations and thank you so much for caring enough to do a little researching.

I agree with hotpuppy.

As I am at my 2nd anniversary with HIV, I am very sensitive right now and appreciate when my pharmacist takes time to ask if I have any questions about my meds.  I try to be courteous when I go in, even when it seems like everything that can go wrong, is.

I take Atripla, which I am doing well on.  When I started meds the pharmacy did not always have the Atripla in stock.  But, after the second time, she has always made sure it was in stock when I was getting close to needing my refills.  She always has a smile and is very courteous and goes out of her way to find a pharmacy that has what I need if she happens to be out. 

The only thing that bugs me is when I call in my prescriptions, I am asked for a phone number to contact me, but they never call if there is a problem with filling my prescriptions. 

One time it happend to be on a Friday and due to a screw up with my insurance company, they said my policy had been cancelled and I would have to pay cash.  (My Atripla is almost $1700.00/mo)  Needless to say, I did not have that much on hand.  If they would have used the number that they ask for when I called in my refills, I could have had the situation cleared up before going to the pharmacy. 

Of course, it was after 5pm. when I made it to the pharmacy, and my insurance company had already closed, so I had to go for the weekend without my meds, which can have adverse affects to my health, so PLEASE call your customers if there is a problem that they will have to correct so they can get their meds on time.

Your customers are going to be lucky to have you as their pharmacist, because you sound like a very caring person to ask us what makes it easier for us.

Come to Ga.

[072508]

I agree with hotpuppyas well. I go to a pharmacy inside my ID dr's office, which $.94 of every dollar goes toward HIV research. I too am on Atripla, the pharmacisit ALWAYS has a smile on her face and asks me about my day or recently what kind of fun I had over the holiday. They fedex me my meds free of charge 2 days before I am out and she always includes candy in there. "How nice" I always say to myself when opening my package.

Good Luck and a big THUMBS UP to ya!

[SoSadTooBad]

I still remember my first trip to CVS to get my meds back in 2006.  The pharmacy did not have Mepron, and they moved heaven and earth to get it for me on a Friday afternoon because they were concerned about my need for it (PCP prophylaxis.)  They did not even know me, and they called around, found a CVS that had enough for the weekend, got that for me, and ordered the rest for me to arrive Monday.

A group of total strangers at CVS that really cared about getting everything taken care of.  I was amazed.

So, in short:

1)  There are no small issues when dealing with HIV meds -  you know that already, but I'm just sayin'...
2)  At the same time, as others said, speak quietly, the whole HIV thing has a HUGE stigma - even in a big city like New York, I am deathly concerned about people finding out.
3)  Be sensitive to getting prescriptions called in - don't lose them, or make that process difficult for the doctor or patient.  Sometimes we need things witout a doctor visit, and being able to get them easily is of paramount importance.

The gang at the CVS on Lexington Ave and 53rd St in Manhattan really gets it - if you are ever in the neighborhood, give them a shout.