Lon N. Larson

Development and validation of an instrument to measure patient satisfaction with pharmacy services.

A research program was undertaken to develop and validate a multidimensional measure of patient satisfaction with pharmacy services. A self-administered questionnaire consisting of 44 Likert-type attitudinal items was adapted from the Patient Satisfaction Questionnaire developed by Ware et al. In an iterative scale development process, the adapted questionnaire and its revisions were evaluated in three successive studies conducted on convenience samples (n = 30,313,489) of individuals in attendance at family practice clinics in a southwestern city. Methods used to construct multi-item scales measuring separate dimensions of service included principal components factor analysis and item analyses. Acquiescent response set (ARS), the tendency to agree with statements of opinion regardless of content, was measured by the method of matched pairs of items. A partial correlation matrix which controlled for ARS was used as the data in a principal components factor analysis in an effort to reduce the biasing effect of ARS on factor analytic outcomes. Dimensions of satisfaction identified were Explanation, Consideration, Technical Competence, Financial Aspects, Accessibility, Drug Efficacy, OTC (over-the-counter) Product Availability, and Quality of the Drug Product. Questionnaire revision is suggested to confirm the validity of the latter two dimensions. Future research should examine the relationship between separate dimensions of satisfaction and other patient attitudes and behaviors, and the convergence between this instrument and other measures of patient satisfaction with pharmacy services.

Physician prescribing decisions: The effects of situational involvement and task complexity on information acquisition and decision making

This research utilized conjoint analysis and an analysis of information acquisition to examine the effects of situational involvement and task complexity on physicians decision-making process. The predictive accuracy of the linear model in predicting drug choice across situations was also assessed. A contingency model for the selection of decision strategies was used as a framework in the study. A sample of forty-eight physicians was asked to indicate their preferences and choices for hypothetical anti-infective drugs. Situational involvement was manipulated by telling physicians in the experimental group via the written scenario to assume that his/her decision would be reviewed and evaluated by peers and (s)he would be asked to justify drug choice. Task complexity was manipulated by varying the number of drug alternatives in a choice set. Results of the study indicated that physicians shifted from using compensatory to noncompensatory decision-making processes when task complexity increased. The effect of situational involvement on the decision-making process was not supported. However, physicians in the two groups were found to differ in choice outcomes and the attention given to specific drug attribute information. Finally, the linear model was found to be robust in predicting drug choice across contexts.

Pharmacy Participation in Third-Party Contracts

Third-party prescription coverage is becoming an important facet of pharmacy practice. Pharmacy managers must be able to evaluate contracts and to decide which contracts are more profitable. This paper presents a methodology for evaluating and comparing third-party contracts. An example demonstrates the proposed methodology, and a specific contract is identified as more advantageous.

Succeeding in Academe-Self-Management and Passion

I am honored to be writing the “old timer’s” perspective on beginning a career in academe. I find the academic life to be very fulfilling. I love learning and being a part of a community of learners. I delight in working with students, and I am awed to find myself in a position to touch their lives. I believe that, as an educator, I am part of a noble mission and that society benefits from my work. The academic life is not a life of leisure; if done right, it requires lots of hard work, but the rewards are tremendous (nonmonetary rewards, that is). My theme is simple: moving up the ranks as a professor requires self-management–more specifically, being “flexibly focused” and balancing personal and community goals–but deriving fulfillment from the work requires passion. Before developing these ideas, I want to explain who I am and why I wanted to write this essay. As I write this, I am in my seventeenth year of teaching. Before my academic career, I worked eight years in community health planning and health insurance. My discipline is social and administrative pharmacy. I have taught at two disparate institutions: the University of Arizona and Drake University. Scholarship and graduate education were

Using Economic Evaluation to Improve the Quality of Care: An Attitudinal Outcome in a Pharmacoeconomics Course

ABSTRACTSince treatment decisions made on behalf of an individual patient consume resources from a shared pool of funds, they affect-and may even harm-the health of the population or community. For health professionals and students who are accustomed to disregarding cost in the name of quality this is a difficult concept to accept. Yet it must be accepted if limited resources are to be used to achieve their maximum benefit. To this end, an attitudinal or affective outcome was added to a course in pharmacoeconomics; specifically, in making drug use decisions or recommendations, the student, realizing that resources are limited, considers the opportunity cost and the welfare of the community. This paper describes the rationale for such an outcome, the methods used to accomplish it, and the success achieved.