Trying to prevent and correct drug therapy problems: A survey of Michigan community pharmacists.

Patients' medication use outcomes may be improved by pharmacists' provision of prospective drug utilization review and pharmaceutical care. Both concepts emphasize the identification, correction and prevention of drug-therapy problems. These activities may be viewed as goal behaviors because barriers exist which thwart their volitional aspects. The purpose of this study was to examine the relationships predicting community pharmacists' attitudes, social norm, intention to try and behavioral expectations to prevent and correct drug-therapy problems. The purposeful behavior model of goal-directed actions served as the theoretical framework. Two mail surveys gathered information from a sample of Michigan community pharmacists (n = 1110). One survey examined intention to try and the other survey examined choice among means. An estimated response rate of 66.6 percent was obtained. Respondents were typically male, possessed B.S. degrees, had practiced pharmacy about 19 years and filled approximately 125 prescriptions per day. Independent and chain pharmacists were equally represented, although slightly more staff pharmacists responded than managers or owners. Attitudes were positive and intention to try preventing and correcting drug-therapy problems was high. Attitudes toward success and process were predictive of attitude toward trying. Intention to try was predicted by attitude and social norm toward trying after controlling for opportunity. Self-schemata moderated the predictors of intention to try. Two factors identified as medium and high effort represented the means to prevent and correct drug-therapy problems. Medium effort means were predicted directly by pharmacists' self-efficacy, instrumental belief and affect toward means. Self-efficacy, instrumental belief and the interaction of self-efficacy and affect toward mean were the significant positive predictors of high effort means. High schematic pharmacists were more likely to pursue high effort means. Apothecary pharmacists were also more likely to pursue high effort means. In conclusion, community pharmacists intend to provide prospective drug utilization review and its barriers are not strongly perceived. The framework of self-efficacy, instrumental belief and affect toward means should be considered when studying pharmacists' behavior. Finally, self-schemata appears to play an important moderating role in predicting pharmacists' behavior.PhDPharmacyUniversity of Michigan, Horace H. Rackham School of Graduate Studieshttp://deepblue.lib.umich.edu/bitstream/2027.42/103755/1/9409687.pdfDescription of 9409687.pdf : Restricted to UM users only