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Community Pharmacist Preferences for Providing a Dose Administration Aid Service in Australia: A Discrete Choice
Rakhee Raghunandan1,2, Parisa Aslani3, Timothy F Chen3
1Leeder Centre for Health Policy, Economics and Data, School of Public Health, Faculty of Medicine and Health, University of Sydney, Sydney, NSW, 2006, Australia. rakhee.raghunandan@sydney.edu.au.
Introduction:
Dose administration aids (DAAs) support medication taking, yet little is known about how pharmacists perceive DAA benefits and challenges. This study aimed to explore community pharmacists' preferences for attributes of a DAA service and how these influence their decision to provide this service.
Methods:
A discrete choice experiment (DCE) was conducted to elicit pharmacists' preferences. Participants completed 12 choice questions, each presenting three alternatives: two DAA services and no DAA service. The questions included seven attributes: patient type, patient control over their medicines, impact on patient medication adherence, staff time, patient co-payment, government reimbursement fee and presence of a cap on government funded DAA services per pharmacy.
Results:
A total of 615 community pharmacists completed the DCE survey. All attributes, except patient type and co-payment, significantly influenced preferences. Pharmacists were more likely to provide a DAA service (compared with no DAA service) when it was associated with higher government funding (pharmacy owners: OR 1.054, 95% CI 1.046-1.063, p < 0.001; non-owners: OR 1.041, 95% CI 1.036-1.046, p < 0.001). Pharmacists were less likely to provide a DAA service if there was a cap on the number of funded DAA services (OR 0.905, 95% CI 0.862-0.950, p < 0.001), or additional staff time was required (OR 0.981, 95% CI 0.976-0.986, p < 0.001).
Conclusion:
This DCE identified two key policy-related barriers to pharmacist provision of DAA services: inadequate government reimbursement and caps on the number of funded DAA services. These findings highlight community pharmacists' preferences and trade-offs, offering valuable guidance to inform future redesign and implementation of more sustainable and equitable DAA services provided via community pharmacy.
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