Adoption of pharmaceutical care: Application of the diffusion of innovation model

                         Airmet, Donelle Elaine; PhD

                         IDAHO STATE UNIVERSITY, 2001

                         HEALTH SCIENCES, PHARMACY (0572)
 

                         Little theory-based research has been done, despite the decade-old pharmaceutical care paradigm shift,
                         to assess pharmacists' reasons for adoption or rejection of pharmaceutical care. Using Rogers' Diffusion
                         of Innovation model, pharmacist innovation-decision stage and perceptions of pharmaceutical care were
                         assessed. Pharmaceutical care cannot be provided without physician support, therefore physician
                         attitudes and experience with pharmacists' expanded roles were obtained. Comparing pharmacist and
                         physician perceptions allows identification of perceived barriers and attitude differences toward
                         pharmacist roles. A questionnaire, mailed to 1,200 randomly selected pharmacists and physicians in
                         Minnesota and Idaho, contained questions evaluating aspects of the model. Response rate was 29.2
                         percent (n = 350), including 153 pharmacists and 146 physicians. Thirty-five percent of pharmacists
                         reported adoption, while 36 percent were undecided and 29 percent had rejected pharmaceutical care.
                         Lack of personnel resources (65%) and lack of reimbursement (61%) were the two most often cited
                         reasons for rejection. Pharmacists mean assessments of the benefits of pharmaceutical care on the five
                         scales of the model (relative advantage, complexity, compatibility, observability, and trialability) ranged
                         from 3.07–3.80 (range 1–5, 5 = strongly agree). Physicians were consistently more
                         negative (p ≤ .01) toward pharmacists providing clinical pharmacy, pharmaceutical care, and
                         collaborative practice agreements then were pharmacists. Attitudes toward 33 pharmacy services
                         (traditional, expanded and pharmaceutical care) yielded significant differences (p ≤ .01) between the
                         two professions for 30 items. Regression analyses found perceived compatibility, year of graduation,
                         attending continuing education on pharmaceutical care, and reading institutionally related journals to be
                         significant predictor variables for pharmacist adoption of pharmaceutical care. Variables influencing
                         physician support of pharmacist provision of pharmaceutical care included perception of contact with
                         clinical pharmacists and pharmacists in general, perception of pharmaceutical care services, and
                         frequency of seeking additional information from a retail pharmacist. This study demonstrates usefulness
                         of the model in understanding factors associated with adoption of pharmaceutical care. Additionally,
                         findings suggest the significant perceptual differences between pharmacists and physicians regarding
                         the value of pharmaceutical care.

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