NHPCO NewsLine Summer 2020 - 23

telling them that they are doing a
great job, and forgetting that this
is kind of a scary thing for them to
be doing is helpful. My favorite
part of doing telehealth is the look
on their faces when they first sign
on and they look surprised that
you are there, and they are there,
and you are online together.
The biggest thing I would say for
our teams, especially during this
time, is that you may be the only
clinical person that they see that
whole week. The more you can
give permission to other members
on your team to cross lines, cross
boundaries, without crossing
outside scope of practice the
better. We use a transdisciplinary
approach. So, all our disciplines
are cross-trained. When I call,
asking about how they are
holding up, how their mood has
been, as a pharmacist I am trying
to cover as much as I can so that I
can tee up my colleagues and
their disciplines. And I always
think, would I be surprised if they
were hospitalized this next week?
If so, then those patients get a
quick check back by another team
member to add another
viewpoint. That is generally how
we plan our cadence for visits.
Regarding medication
management, this is a skill that
everyone on our teams need to

know. Targeted review and
reconciliation are important.
Some things I encourage would
be getting beyond the list. When
you are using video with your
patients, have them take a
minute and go get their meds. So,
they are holding up bottles,
showing you their pill box. The
more you can say, show me don't
just tell me, is really important.
One thing that is applicable now
is asking how they are getting
their meds? Are they leaving the
house and trying to physically go
to the pharmacy? That is a risk
factor. Is it possible to get them
delivered? It is important to ask
about Over The Counter (OTCs)
medications. They might be
getting prescriptions delivered,
but they are walking down the
street going into a retail store to
get OTCs. We need to think, what
can we do to minimize their risk
of exposure?
We have found that this has been
a useful time to address some
deprescribing opportunities with
our patients. For example, as they
are getting close to running out of
that third anti-hypertensive
medicine that they are on, and
their blood pressures are trending
low, we have been working with
their primary physician to let that
go. We can say, why don't we just

do a trial, don't even rewrite the
prescription, we just try it and we
will be monitoring them closely
and set parameters to notify the
physician. Physicians have been
much more open to these
deprescribing opportunities lately.
I am calling this COVID lemonade.
We are going to make lemonade
out of this situation and try to get
people off some of these meds
that they do not need to be on.
We use active listening and
open-ended questions to assess
how people are coping with their
situation. For example, I ask, "Tell
me how you manage a bad day?"
I like to keep that question openended because you never know
what people might say.
Sometimes it has to do with their
mood and their emotion. "What
do you do when it's a rough day?"
"What do you do when you have a
lot of pain?"
Pay attention now, especially to
those medication use behaviors
because sometimes when people
are at home alone with things
that are dark and tough as they
are right now, you can see coping
mechanisms such as alcohol or
other substances. We are paying
attention to that as we are
talking to our patients about
their medications.

Newsline / Summer 2020

23
NHPCO NewsLine Summer 2020

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