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Descriptions of pharmaceutical consultation have been confined largely to the use of mnemonics such as WWHAM, AS METTHOD and ENCORE
These approaches provide the pharmacist with a rigid structure to use when questioning patients about their symptoms, but, although useful, serve to make the symptom or disease the focus of the consultation rather than the patient.
Who is it for? What are the symptoms? How long has it been going on? Action taken? Medicines taken?
Age of the patient? Self or for someone else? Medicines being taken? Exactly what do you mean (by the symptom)? Time and duration of the symptom? Taken any action (medicine or seen a healthcare practitioner)? History of any disease? Other symptoms? Doing anything to alleviate or worsen the symptom?
Evaluate the symptom, its onset, recurrence and duration. No medication is always an option. Care when dealing with specific patient groups, notably the elderly, the young, nursing mothers, pregnant women, those
receiving specific medication such as methotrexate and anticoagulants, and those with a particular disease, for example, renal impairment. Observe the patient for signs of systemic disturbance and ask
about presence of fever, loss of weight and any accompanying
physiological disturbance. Refer when in doubt. Explain any course of action recommended.
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