The organization of pharmacist–patient interactions in an HIV/Aids clinic

The provision of healthcare in the context of HIV/Aids is a challenge to health professionals. Pharmacists play an important role in providing information, education and counselling to encourage adherence to antiretroviral (ARV) treatment regimens. However, there is little research which provides insights into the structure and organization of pharmacist–patient interactions and communication, and no research of this nature in the context of antiretroviral treatment. It is important to research pharmacist–patient interactions in order to understand the mechanisms of communication specific to this profession and improve communication processes. This paper presents results from a data corpus of video-recorded pharmacist–patient interactions in a South African HIV/Aids clinic pharmacy. Conversation analytic tools were used to determine the overall organizational structure of the interactions and expand on various templates suggested in the literature, specifically Pilnick's (2001) template for advice-giving sequences in pharmacy interactions. A new template for interactions is proposed which includes additional structures and sequences. Specifically, interactions contained multiple cycles of delivery of instruction, patient response, and verification of understanding. These pharmacy interactions appeared to be influenced by context and disease-related factors, which has implications for pharmacy practice.