During the consultation

• Information gathering

Consider how to include exploration of a patient’s sensory needs during the initial stage of the consultation. It might be helpful to develop a standard ‘script’.

For example: ‘Before we start, I want to make sure that I am communicating with you as effectively as possible. Can you advise me what works best for you in terms of your vision and/or hearing?’

For patients with visual impairment, it is important to reassure them that the consultation room will protect their privacy and that their information will be treated with strict confidence.

For those with hearing impairment, it is important that the room is illuminated so that your face – especially your mouth – is illuminated. Face the patient at all times when talking to them and avoid covering your mouth, especially if you are taking notes or turning to check the computer or other information source.

If the patient cannot see your face or mouth, they will be less likely to understand what you are saying. Do not shout at patients with hearing impairment. For more information, read Signhealth’s “12 tips”.

Translation services are available for patients with hearing impairment. However, it might not be possible to access a translator at the time of the consultation. Online BSL translation services exist, but access depends upon where each pharmacy is located. It is important to try to establish whether the patient consents to the involvement of a translator.

• Decision making

Consider which treatment option is likely to be the most effective for the patient while placing the least amount of burden upon them.

Some formulations are less user-friendly for people with visual impairment. For example, liquids that need to be measured can be problematic, so consider whether there is a suitable solid dosage form available to treat their symptom or condition.

Medicine burden can be reduced by using once or twice daily dosing regimens and timing the dosing to coincide with existing medicine dosing times and/or when a carer (informal or formal) might be present to assist if required.

The use of medical devices (e.g. inhalers, eye and ear drops) can also be problematic for people with visual impairment and sufficient time needs to be spent working with the patient to make sure they can use these devices effectively.

• Assistive technology

A wide range of products, technology and strategies exist for use by people with sensory impairment to facilitate their safe and effective use of medicines (see Table 2). What assistive technologies does your pharmacy stock that could be used to support the patient’s medicine use?

• Information giving

It is important to provide information in a format that suits the patient’s needs and abilities. For example, a person with visual impairment might prefer to have it dictated into their phone or recording device rather than written down. Or they might request written information using large font with colour contrast, pictures or diagrams.

Colour contrast can be provided using printed documents, or on handwritten information using a highlighter pen (try to establish which colour works best for the individual). To save coloured ink, select the text to be contrasted and highlight it. Many PMR systems have a large font option – find out how to use this.

For people with hearing impairment, their first language is often BSL rather than English, so their English reading ability may be low.

Therefore, written information provided to BSL users should use simple language and the patient’s understanding information should be checked using Teach Back or similar. It is also important when using images or illustrations to ensure that they are interpreted correctly.

Accessible product information leaflets are available for all licensed medicines.