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The Role of the Community Pharmacist in Patient Education

Self-care Counseling by Pharmacists — QuEST/SCHOLAR

  • QuEST/SCHOLAR process is a comprehensive self-care counseling process
  • Guides the clinician to ask a series of questions with subsequent analysis in order to:
    • Assess the patient's problems
    • Establish that patient is a self-care candidate
    • Select the most appropriate nonprescription product along with general care measures
    • Counsel the patient on 5 aspects of their nonprescription medication

Buring SM et al. AJPE 2007; 71(1) Article 08.

Self-care Counseling by Pharmacists — QuEST/SCHOLAR

Quickly and accurately assess the patient: Ask about the current problem (SCHOLAR) Symptoms
What are the main and associated symptoms?
The "E.S.T" Portion of QuEST: Establish, Select, and Talk Characteristics
What is the situation like? Is it changing?
Establish that the patient is an appropriate self-care candidate:
  • Any severe symptoms?
  • Any symptoms that persist or return repeatedly?
  • Is the patient self-treating to avoid medical care?
What has been done so far?
Suggest appropriate self-care strategies Onset
When did it start?
Talk with patient about:
  • Medication action, administration, adverse effects
  • What to expect from treatment
  • Appropriate follow-up
Where is the problem?
  Aggravating factors?
What makes it worse?
  Remitting Factors
What makes it better?

*American Pharmaceutical Association

Exclusions to self-treatment of headache

  • Severe head pain
  • Headaches that persist for 10 days with or without treatment
  • Last trimester of pregnancy
  • Less than 8 years of age
  • High fever or signs of serious infection
  • History of liver disease or consumption of ≥ 3 alcoholic drinks per day
  • Headache associated with underlying pathology (secondary headache)
  • Symptoms consistent with migraine, but no formal diagnosis of migraine headache

Krinsky DL, Ferreri SP, Hemstreet B, et al, editors. Handbook of Non-Prescription Drugs, 18th edition. Washington DC: American Pharmaceutical Association; 2015. Chapter 5, Headache; p.63-81.

Use the information from the counseling session video to fill in the table below.

Morgan's Case: Initial Pharmacist Interaction

Information to Obtain From Mrs. Smith About Morgan What Mrs. Smith Tells You About Morgan
Quickly and accurately assess the patient: Ask about the current problem (SCHOLAR)
Aggravating Factors
Remitting Factors
Establish that the patient is an appropriate self-care candidate: Your assessment, recommendation, and counseling
Suggest appropriate self-care strategies
Talk with the patient

(Click Me to Reveal Answers)

Pharmacy Visit Question #1

Which of the following are associated with migraine headache?

  1. Uncomfortable, but not debilitating pain
  2. Pain is unilateral (occurs on one side of the head)
  3. Is associated with moderate to severe pain
  4. Patient may experience photo- or phono-phobia

(Click me for answer.)

Pharmacy Visit Question #2

Select all that apply. Medication overuse headache occurs with acute therapies used to treat migraine such as __________.

  1. Beta-blockers
  2. Triptans
  3. Simple analgesics (NSAIDs, Tylenol)
  4. Anti-depressants

(Click me for answer.)

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