The pharmacist as patient educator.

I n this issue of the CJHP, pharmacist Marie Craig shares her experience in educating and supporting patients at the Arthritis Clinic in Newmarket, Ontario. 1 This important role for pharmacists is well recognized by our Canadian professional and academic associations, as it is globally. In 1997, the World Health Organization (WHO) introduced the role of teacher as 1 of the 7 key responsibilities of pharmacists. 2,3 In their professional capacity, pharmacists continue to provide information and advice on medications to patients and their caregivers. However, nonad-herence to therapy remains high, with some studies reporting that more than 50% of patients do not take their medications as prescribed. 4 In addition to the negative impact on patients' quality of life, the financial impact of nonadherence has been estimated at $100 billion per year in the United States. 5 Why does nonadherence continue to be so prevalent? The reasons why patients may not adhere to therapy are complex. In spite of the abundance of drug and disease information that is available to consumers, both in print and online, there is sometimes a gap in the information that a particular patient requires, or the information provided by various sources may conflict. 6 When this happens, patients may resort to their own beliefs about how a medication may or may not help them, which results in self-regulation of medications, sometimes without their health care providers' knowledge. 6,7 Many factors influence a patient's decision to be nonadher-ent to therapy. Just as we realize the importance of understanding patients' experience of their illness (their subjective response to a disease), we need to also understand patients' medication-taking experience. This is determined by their lifetime exposure to unique cultural and health beliefs, as well as previous experiences with health care providers and with medicines. 8 All of these factors influence patients' medication-taking behaviour. Research indicates that patients must be able to rationalize the need for their medication, which can influence if and when they will take it. 6 To have a positive influence on the patient's medication experience, pharmacists and other health care providers need to shift away from providing general information about drugs and simply expecting patients to adhere to prescribed therapy toward " learning how they can contribute to the patient's decision-making process related to their medications ". 9 This requires individualized education, such as that provided by Craig to her patients with arthritis. The …