Appropriateness of drug-specific Rx-to-OTC switches: Factors influencing pharmacists' opinions
Abstract
The overall objective of this study was to assess, on a drug-specific basis, the influence of: (1) demographic and practice-related characteristics, (2) perceptions of various individual criteria for evaluating the appropriateness of an Rx-to-OTC switch, and (3) attitude toward the Rx-to-OTC switch trend, on perceptions of the overall appropriateness of a drug-specific Rx-to-OTC switch. An instrument was designed wherein pharmacists were asked to judge overall appropriateness of switching metaproterenol, cimetidine, ibuprofen, and nystatin. The pharmacists were then asked to judge the appropriateness of switching these products based on the FDA switch evaluation criteria of safety, effectiveness, and labeling, and other proposed criteria including perceived product market need, counseling need, and pharmacy profitability after a switch. Attitude towards consumer self-medication, switched products, future switching of drug products, economics of switched products, and patient counseling for Rx, OTC, and switched products were determined using 31 attitudinal items. A national sample of 1,161 pharmacists were reached with the mailed survey instrument for a net response rate of 34.8 percent after four followups. Pharmacists approved of switching of only ibuprofen out of the four drugs included in the study. Demographic and practice-related characteristics had little or no influence on pharmacists' overall drug-specific switch judgements. Six evaluation criteria were tested and safety criteria was most highly correlated with overall drug-specific switch judgement. Product market need, a proposed switch evaluation criteria, had an influence on pharmacists' overall drug-specific switch judgement which was similar to the influence of the FDA switch evaluation criteria. Pharmacists' overall switch judgement was not overly influenced by perceived post-switch profitability of the drug product. Although pharmacists favored the increasing consumer self-medication trend, they did not have confidence in consumers' ability to self-medicate. Furthermore, they favored Rx-to-OTC switching of drug products without favoring the direct use of these products by consumers. Demographic and practice variables, ratings on switch evaluation criteria, and attitudinal items when combined together were better predictors of pharmacists' overall switch judgement (R$\sp2$ $>$.40) than when taken individually.
Degree
Ph.D.
Advisors
Schondelmeyer, Purdue University.
Subject Area
Pharmaceuticals
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