Identifying Community Pharmacist Preferences For Prescribing Services in Primary Care in New Zealand: A Discrete Choice
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ORIGINAL RESEARCH ARTICLE
Identifying Community Pharmacist Preferences For Prescribing Services in Primary Care in New Zealand: A Discrete Choice Experiment Rakhee Raghunandan1 · Kirsten Howard2 · Carlo A. Marra1 · June Tordoff1 · Alesha Smith1 Accepted: 30 September 2020 © Springer Nature Switzerland AG 2020
Abstract Objective Given increasing patient populations, general practitioner (GP) workforce constraints and increasing demand for health services in New Zealand (NZ), the development and provision of pharmacist prescribing services may need to increase to improve people’s access to medicines. A discrete choice experiment (DCE) was utilised to determine community pharmacist preferences for prescribing services in primary care in NZ, and to understand how these factors could improve the provision of pharmacist prescribing services. Methods A D-efficient design generated 30 labelled choice questions in three blocks of ten, and three alternatives per choice question. The online DCE was emailed to practising community pharmacists in NZ. The DCE included two attributes with five levels (prescribing model, educational requirements) and three attributes with three levels (location, professional fee, change in income). A mixed multinomial logit model was used to estimate preferences. Results A total of 264 respondents completed the survey with 2640 observations for analyses. This DCE found pharmacists preferred pharmacy services with the following characteristics: ability to prescribe using minor ailments and independent prescribing models relative to the pharmacist-only medicines prescribing model; prescribing education by accredited learning modules relative to PGDipClinPharm + PGCertPharmPres; remuneration via a professional fee; and pharmacist prescribing services located in community pharmacies rather than in GP practices. Conclusions Prescribing policy could incorporate these pharmacist preferences to help develop accessible and effective pharmacist prescribing services that not only improve access to medicines, but also address inequity of access to medicines in NZ. These DCE results are encouraging as they signal that the community pharmacists also see themselves and their pharmacies as part of the prescribing team in primary care in NZ.
1 Introduction Given increasing demand for health services, New Zealand (NZ) and other countries have introduced non-medical prescribing (NMP) to facilitate timely access to medicines [1, 2]. NMP is the legislative extension of prescribing rights to health professionals other than medical doctors, thereby Electronic supplementary material The online version of this article (https://doi.org/10.1007/s40258-020-00615-3) contains supplementary material, which is available to authorized users. * Rakhee Raghunandan [email protected] 1
School of Pharmacy, University of Otago, PO Box 56, Dunedin 9054, Otago, New Zealand
School of Public Health, University of Sydney, Sydney, NSW, Australia
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Key Points for Decision Makers Community pha
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