Physician attitudes toward pharmacists counseling patients on adverse drug reactions

The attitudes of physicians in a university teaching hospital toward pharmacist counseling of patients regarding adverse reactions to prescribed medications were studied. A questionnaire mailed to 120 physicians in each of the three groups affiliated with the Medical College of Virginia Hospitals (teaching faculty, house staff, and community practitioners with attending privileges) listed 56 potential adverse reactions associated with commonly prescribed medications in 13 therapeutic categories. For each physician group, half of the questionnaires pertained to inpatient and half to outpatient situations. The physicians were asked whether their patients should be informed about the possible reactions and, if so, if the physician alone, the pharmacist alone, or both should do the counseling. When "pharmacists only" and "both" data were combined for the 199 responses, over 50% of the respondents accepted pharmacists as patient counselors for all listed reactions except the three pertaining to antipsychotic agents. Class of medication significantly influenced attitude (p less than 0.05), with pharmacist participation in counseling being most acceptable for reactions involving anticoagulants, antibiotics, and analgesics, and least acceptable for those involving antipsychotics, cardiac glycosides, and antianxiety agents. Acceptability also was influenced by physician type (p less than 0.05), being lowest among community physicians, and was slightly higher in outpatient versus inpatient situations (p less than 0.05). The study indicates that physicians will accept pharmacist counseling with respect to adverse drug reactions, especially on a partnership basis.