Madam, Poor patient counselling and lack of compliance to treatment remains one of the major constraints in the field of health care in our country.^1,2 In the light of this statement, counselling patients and educating them regarding their treatment modalities must stand as a central task for health care providers. The significance of counselling patients has been enforced by authors in order to prevent unjust restrictions, doubts and negative thoughts, and to promote obedience in the intake of medicines.³ Despite the sincerity of doctors to treat their patients, there exists a wide communication gap between what patients intend to know and what doctors explain to them. This leaves the patients doubtful, resulting in a denial to follow their medical prescriptions.
Evidence suggests that patient education can reduce anxiety and increase satisfaction levels in patients undergoing critical therapies.⁴ Jay et al demonstrated in his study on obese patients that improved quality of physician counselling motivated patients to lose weight and change their lifestyle.5 It was further affirmed that lack of time and poor training of physicians were the potential reasons for lack of adequate patient counseling.⁵
Unfortunately, even major health care institutions¹ rarely acknowledge the importance of patient counselling. Although a professional responsibility, the set-up of our public sector hospitals does not allow our physicians to serve up to standards. The heavily crowded wards with continuous inflow of patients never leave an opportunity for the doctor to explain and educate the patients of their illnesses.² These patients face financial constraints in seeking private health care, leaving them with no choice but to prefer the public sector hospitals.
Patient counselling must be regarded as one of the essential components of the overall drug use process. The patient must be clarified of the incentive, manner of intake, therapeutic as well as the side effects of the drug prescribed. Substandard patient counselling can diverge the patient from following the regimens. This badly affects the prognosis of the disease.
The aim of this letter is to emphasize the importance of patient counselling amongst the health care providers, which can not only increase compliance in drug intake by patients, but will also have an impact in the prognosis of their disease. Measures need to be taken for effective implementation of the system. Effectual coordination between patients, doctors and pharmacists is required to develop appropriate patient counselling. Considerable research is needed to assess the roles of physicians in management of patient care and to ensure the development of effective physician guidelines.

Akhtar Amin Memon, Anis Rehman, Faryal Tahir
Medical Students, Dow Medical College, DUHS, Karachi.

1.Rafique G, Azam SI, White F. Diabetes knowledge, beliefs and practices among people with diabetes attending a university hospital in Karachi, Pakistan. East Mediterr Health J 2006; 12: 590-8.
2.Saeed A, Ibrahim H. Reasons for the Problems faced by Patients in Government Hospitals: results of a survey in a government hospital in Karachi, Pakistan. J Pak Med Assoc 2005; 55: 45-7.
3.Galletti F, Sturniolo MG. Counselling children and parents about epilepsy. Patient Educ Couns 2004; 55: 422-5.
4.Poroch D. The effect of preparatory patient education on the anxiety and satisfaction of cancer patients receiving radiation therapy. Cancer Nurs 1995; 18: 206-14.
5.Jay M, Gillespie C, Schlair S, Sherman S, Kalet A. Physicians\\\' use of the 5As in counselling obese patients: is the quality of counselling associated with patients\\\' motivation and intention to lose weight? BMC Health Serv Res 2010; 10: 159.