So far we have discussed theories and models around engaging with patients which makes the process sound easy however we all know that it’s not. Starting a conversation with a patient about their health behaviours can be difficult as they may not have thought about changing their behaviour or they may not want to change.

The first step is to set the scene to prompt patients to think about their lifestyle and the benefits of improving their health. This can be done by displaying posters, leaflets or undertaking health awareness activities in the pharmacy which relate to a local or national health campaign, for example National Obesity Awareness Week.

For help on setting up a health campaign refer to the Healthy Living Pharmacy page on NumarkNet.

By setting the scene it makes it easier to approach patients as you could say “Are you aware we are running a campaign this week about how to maintain a healthy weight … do you know how many calories you should be eating a day?” or “I saw you looking at the healthy weight promotion….” this allows you to enter into a conversation with a patient about their diet and possibly move onto other health behaviours. Try to do this with every patient so it doesn’t appear that you are singling anyone out and patients don’t feel like they are being targeted because they might be a little overweight.

Anything can prompt a conversation, a story in the newspaper or on the news, a change in legislation. An example could be “did you see the recent news on the changes to the weekly recommended alcohol units … do you know what the recommended levels are?”

Think about opportunities to talk about health improvement when you are having conversations with patients, they may mention something that enables you to lead into discussing their lifestyle, for example if they mention they have booked a holiday for next year and want to get into shape, this will give you the opportunity to discuss getting more active and the weekly exercise recommendations or the current advice for safe sun exposure.

Another opportunity you could adopt is targeting certain groups of patients on a weekly or monthly basis, for example for a whole month you could ask every patient that brings in a new prescription if they smoke and with those that say yes you can then discuss the benefits of stopping.

Before entering into a conversation with a patient it is important you ask for their permission, e.g. “may I talk to you about…” or “can I ask you a couple of questions ….” This gives the patient the opportunity to say yes or no and if they say yes you know that they are receptive to any information you may provide.

Often people do not associate their current health behaviours with future health problems as they feel it either won’t happen to them or it’s too far in the future. Therefore you need to make it personal for them, try to relate it to a current issue that they might be experiencing or a goal they want to achieve. Change is difficult and a person needs to be motivated to want to change and see the benefits from the start otherwise they will not succeed.

During a conversation you should be aware of the body language, facial expressions and tone of voice the patient is projecting as this will indicate how receptive to change they are. If a patient is answering your questions with one word answers or avoiding eye contact they are showing signs of not wanting to engage in the conversation. In this situation it is better not to pursue the conversation but to try again another day.

Some patients will be vocal in not wanting to engage and just say they are not interested therefore you should cut the conversation short but remember to leave the door open for them to come back and discuss the issue at a later date. You could use a phrase such as “I understand you may not have time to talk about it at the moment but if you want to discuss the matter please come back” At this stage it may be appropriate to provide them with a leaflet to take away and read at their leisure however it’s not always appropriate. 

For example a patient who smokes may say to you they understand all of the health problems that smoking can cause but they enjoy smoking and don’t want to give up. In this scenario further information will not change the patient’s behaviour and could cause them to become irritated. You could ask if they had considered harm reduction rather than stopping and if they wanted further information they should come back to the pharmacy.

Think about other situations where you could start a conversation, e.g. patients asking for P medicines or GSL treatments.

Don’t let rejection put you off as not all patients will want to discuss their health behaviours or want to change but some will appreciate your help and advice.