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Identifying New Zealand Public Preferences for Pharmacist Prescribers in Primary Care: A Discrete Choice Experiment

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Abstract

Background and Objective

Given increasing patient populations, general practitioner workforce constraints and the growing demand for health services in New Zealand (NZ), the development and provision of pharmacist prescribing services could be used to improve people’s access to medicines. A discrete choice experiment (DCE) was utilised to determine NZ public preferences for pharmacist prescribing services in primary care in NZ.

Methods

A D-efficient DCE design generated 20 choice questions in four blocks of five questions with three labelled alternatives per choice question. The online DCE used a NZ general public online research panel administered by an external organisation (SurveyEngine). The DCE included six attributes with two attributes each with two levels (location of consultation and consultation type), three levels (type of service and operating hours) and four levels (waiting time and cost).

Results

Nine hundred and twenty-four respondents completed the survey with 4620 observations available for analyses. Respondents preferred pharmacist prescribing services with the following characteristics: optimisation of medicines and changes to only current medicine service types (relative to repeat prescribing); lower consultation costs, shorter waiting times, longer operating hours and consultation by appointment (relative to walk-in and wait clinic).

Conclusions

Prescribing policy could incorporate these public preferences to help develop accessible and effective primary care prescribing services utilising the skills of pharmacist prescribers to improve and reduce inequities in access to medicines in NZ. These results suggest the NZ public see pharmacists as part of the primary care prescribing team and are willing to utilise them if these services are implemented.

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Acknowledgements

The authors acknowledge and thank Prof. Michiel Bliemer (MSc, PhD) and Prof. John Rose (PhD), who provided experiment design advice.

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Authors and Affiliations

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

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

  2. School of Public Health, Faculty of Medicine and Health, University of Sydney, Sydney, NSW, Australia

    Kirsten Howard

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  1. Rakhee Raghunandan
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Correspondence to Rakhee Raghunandan.

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Funding

This research was supported by a New Zealand Pharmacy Education and Research Foundation grant (Reference 309). Rakhee Raghunandan was supported by a PhD scholarship from the University of Otago, New Zealand. The funders had no role in the design and conduct of the study; collection, management, analysis and interpretation of the data; preparation, review or approval of the manuscript; and decision to submit the manuscript for publication.

Conflicts of Interest

Rakhee Raghunandan, Kirsten Howard, Carlo A. Marra, June Tordoff, and Alesha Smith have no conflicts of interest that are directly relevant to the content of this article.

Ethics Approval

This study was approved by the University of Otago Human Ethics Committee (Reference D19/019).

Consent to Participate

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

Consent for Publication

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

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

Authors’ Contributions

RR designed the DCE (with advice from Prof. Michiel Bliemer and Prof. John Rose). 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 New Zealand Public Preferences for Pharmacist Prescribers in Primary Care: A Discrete Choice Experiment. Patient 15, 77–92 (2022). https://doi.org/10.1007/s40271-021-00529-9

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