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Identifying Community Pharmacist Preferences For Prescribing Services in Primary Care in New Zealand: A Discrete Choice Experiment

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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.

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Acknowledgements

The authors would like to acknowledge and thank Professor Michiel Bliemer (MSc, PhD), who provided experiment design advice. We thank the pharmacists who participated in the study.

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Authors and Affiliations

  1. School of Pharmacy, University of Otago, PO Box 56, Dunedin, 9054, Otago, New Zealand

    Rakhee Raghunandan, Carlo A. Marra, June Tordoff & Alesha Smith

  2. School of Public Health, University of Sydney, Sydney, NSW, Australia

    Kirsten Howard

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  1. Rakhee Raghunandan
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Corresponding author

Correspondence to Rakhee Raghunandan.

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Funding

This research was supported by a PhD scholarship from the University of Otago, New Zealand.

Conflict of interest

The authors declare no competing interests.

Ethics approval

This study was approved by the University of Otago Human Ethics Committee (reference D17/403).

Consent to participate:

All participants were provided with participant information when they entered the online survey and consented to participate in the study.

Consent to publish

All participants were provided with participant information when they entered the online survey and consented to publication of the results of this study.

Availability of data and material (data transparency)

The data sets generated and analysed during this study are not publicly available due to constraints imposed in the Ethics process, but are available from the corresponding author on reasonable request subject to approval.

Code availability (software or custom code)

Not applicable.

Author contributions

RR designed the DCE (with advice from Prof. Michiel Bliemer) and carried out data collection. RR performed the analyses with supervision from KH; AS, CM and JT supervised the project, providing overall direction and planning. All authors contributed to the final manuscript by providing critical feedback and helping shape the research, analysis and writing of the manuscript.

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Raghunandan, R., Howard, K., Marra, C.A. et al. Identifying Community Pharmacist Preferences For Prescribing Services in Primary Care in New Zealand: A Discrete Choice Experiment. Appl Health Econ Health Policy 19, 253–266 (2021). https://doi.org/10.1007/s40258-020-00615-3

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