title: Investigating strategies used by hospital pharmacists to effectively communicate with patients during medication counselling.
abstract: Medication counselling opportunities are key times for pharmacists and patients to discuss medications and patients' concerns about their therapy. Communication Accommodation Theory (CAT) describes behavioural, motivational and emotional processes underlying communication exchanges. Five CAT strategies (approximation, interpretability, discourse management, emotional expression and interpersonal control) permit identification of effective communication.
  
  
  
  To invoke CAT to investigate communication strategies used by hospital pharmacists during patient medication counselling.
  
  
  
  This was a theory-based, qualitative study using transcribed audiorecordings of patients and hospital pharmacists engaged in medication counselling.
  
  
  
  Recruited pharmacists practised in inpatient or outpatient settings. Eligible patients within participating pharmacists' practice sites were prescribed at least three medications to manage chronic disease(s).
  
  
  
  The extent to which pharmacists accommodate, or not, to patients' conversational needs based on accommodative behaviour described within CAT strategies.
  
  
  
  Twelve pharmacists engaged four patients (48 total interactions). Exemplars provided robust examples of pharmacists effectively accommodating or meeting patients' conversational needs. Non-accommodation mainly occurred when pharmacists spoke too quickly, used terms not understood by patients and did not include patients in the agenda-setting phase. Multiple strategy use resulted in communication patterns such as "information-reassurance-rationale" sandwiches.
  
  
  
  Most pharmacists effectively employed all five CAT strategies to engage patients in discussions. Pharmacists' communication could be improved at the initial agenda-setting phase by asking open-ended questions to invite patients' input and allow patients to identify any medication-related concerns or issues.
authors.affiliation: School of Pharmacy, The University of Queensland, Brisbane, QLD, Australia.
authors.forename: Bernadette A M
authors.identifier: 0000-0003-2809-1170
authors.initials: BAM
authors.lastname: Chevalier
authors.affiliation: Department of English, The Hong Kong Polytechnic University, Hung Hom, Kowloon, Hong Kong.
authors.forename: Bernadette M
authors.initials: BM
authors.lastname: Watson
authors.affiliation: School of Pharmacy, The University of Queensland, Brisbane, QLD, Australia.|Pharmacy Department, Princess Alexandra Hospital, Brisbane, QLD, Australia.
authors.forename: Michael A
authors.initials: MA
authors.lastname: Barras
authors.affiliation: School of Pharmacy, The University of Queensland, Brisbane, QLD, Australia.
authors.forename: William Neil
authors.initials: WN
authors.lastname: Cottrell
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001519:Behavior; D003142:Communication; D004644:Emotions; D005260:Female; D006801:Humans; D008297:Male; D054539:Medication Therapy Management / Q000458:organization & administration*; D008875:Middle Aged; D009042:Motivation; D010595:Pharmacists / Q000523:psychology*; D010607:Pharmacy Service, Hospital / Q000458:organization & administration*; D024382:Professional Role; D011369:Professional-Patient Relations; D011582:Psychological Theory; D036301:Qualitative Research; D055815:Young Adult
keywords: Communication Accommodation Theory (CAT); communication; hospital pharmacist; patient