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Selecting alternate drug therapies.

M A Pilkington1, D Dolinsky

  • 1Illinois Pharmacists Association, Chicago.

Medical Care
|February 1, 1991
PubMed
Summary

Pharmacists weigh drug therapy cost most heavily but use severity and support information more often when deciding on alternative prescriptions. Patient convenience is a lesser factor.

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Area of Science:

  • Pharmacy Practice
  • Health Services Research
  • Decision Science

Background:

  • Understanding pharmacist decision-making is crucial for optimizing drug therapy selection.
  • Previous research has not fully elucidated the specific cues influencing pharmacists' choices for alternative drug therapies.

Purpose of the Study:

  • To investigate the influence of four key cues on pharmacists' likelihood of selecting alternative drug therapies.
  • To quantify the relative importance and usage frequency of cost, convenience, social support, and illness severity in these decisions.

Main Methods:

  • A survey instrument with a 2x2x2x2 crossover design and repeated measures was employed.
  • A linear prediction model was developed to analyze pharmacists' judgment policies regarding alternative drug therapies.

Main Results:

  • Sixty-four percent of the variation in pharmacists' judgment policies was explained by the model.
  • Cost of therapy was perceived as most important, but illness severity and social support were used more frequently in practice.
  • Patient convenience was consistently ranked lowest in both importance and usage.

Conclusions:

  • Pharmacists' decision-making for alternative drug therapies is complex, with a discrepancy between perceived importance and actual usage of certain cues.
  • Illness severity and social support significantly influence practical choices, while cost, though highly valued, is used less frequently.
  • The minimal use of patient convenience information warrants further investigation into its role in therapeutic decisions.

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