Needs analysis of practicing pharmacists in drug utilization review (DUR) and patient counseling

Warren Richards, Purdue University

Abstract

Government has passed the OBRA '90 legislation which mandates that pharmacists perform DUR and counsel patients. Practicing pharmacists have received little formal training in these processes. To provide appropriate continuing education (CE) programs to pharmacists, their specific needs had to be established. An initial query of seven pharmacists from academe, practice, and industry suggested an appropriate make-up for a Delphi panel and areas of pharmacist expertise to examine. The Delphi Method was used to recruit an expert panel and to reach consensus on criteria and standards used to judge the performance of practicing pharmacists. In the first iteration, the 30-member panel focused on the direct knowledge the pharmacist should possess and the areas of expertise relevant to practice functions. The second iteration reviewed the 221 items in the consolidated data and measured the confidence of the expert respondents. Remarks of the panel members were included as part of feedback to the panel. A Likert-type scale was used to quantify the expert opinions. After the third iteration, consensus had been reached on a total of 169 of 221 items on the criteria and standards required to perform DUR and counsel patients. A total of 3113 randomly selected pharmacists in ambulatory practice from five states were surveyed to establish their perceived needs in relation to the criteria and standards developed by the Delphi panel. The 1065 pharmacists who responded (34.2% net return rate) expressed ability to perform DUR and to counsel patients on 106 of 141 items. On 35 of the 141 individual items, however, a lack of confidence in performance ability was expressed. A total of 467 (43.8%) pharmacists included specific CE requests with their responses. Although pharmacists claimed to be able to counsel patients, 85 (18% of those requesting help) still requested CE help with counseling. Another 134 (28.7%) requested help on disease state symptoms and treatments. An additional 119 (25.5%) requested help with interactions. Pharmacists will be utilizing CE to help them prepare for their role as drug therapy counselor.

Degree

Ph.D.

Advisors

Blank, Purdue University.

Subject Area

Pharmaceuticals

COinS