Skip to main content
Log in

Preferences of Community Pharmacists for Extended Roles in Primary Care

A Survey and Discrete Choice Experiment

  • Original Research Article
  • Published:
PharmacoEconomics Aims and scope Submit manuscript

Abstract

Background: Major changes in the roles and responsibilities of pharmacists across the world are occurring. A new Scottish Community Pharmacy contract was introduced in April 2006, following the introduction of a similar contract in England in 2005. This contract encourages greater involvement in medicines management and other clinical cognitive roles, whilst retaining a supply function.

Objective: To use a discrete choice experiment (DCE) to examine the strength of preference of community pharmacists for existing and potential new roles, prior to the introduction of the new contract.

Study design: The DCE was a component of a larger questionnaire, which assessed demography, workload, attitudes to, and satisfaction with, proposed new roles, and current levels of activity. Attributes and levels for the DCE were based on the recent policy document for Scotland, The Right Medicine, and informed consensus, respectively. Scenarios were organised into pairs, and pharmacists were asked “Which job would you prefer?” The questionnaire was mailed to all pharmacists working in the community setting in Scotland (n = 1621), as identified from a telephone survey. The questionnaire was totally anonymous, and two reminders were sent.

Results: There was an overall response rate of 56.4% (914/1621). Community pharmacists preferred to work in an extended pharmacy team, to have strong integration with secondary care, and to provide a minor illness advice service. In 2003, they would forgo an annual income of £3443, £2183 and £2798, respectively to achieve this. However, overall, the pharmacists preferred more income to less. Repeat dispensing, chronic disease management, offering health promotion services, and the number of prescriptions dispensed per month were not significant predictors of job choice.

Conclusion: Community pharmacists placed the highest value on organisational aspects of their work, and having a first contact primary care role. Although total income was important, there were indications that they would be prepared to forgo income to attain their preferred job.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Table I
Fig. 1
Table II

Similar content being viewed by others

References

  1. Scottish Executive. The right medicine: a strategy for pharmaceutical care in Scotland. Edinburgh: Scottish Executive, 2001

    Google Scholar 

  2. Department of Health. Pharmacy in the future: a vision for pharmacy in the new NHS. London: Department of Health, 2000

    Google Scholar 

  3. Welsh Assembly Government. Remedies for success: a strategy for pharmacy in Wales. Cardiff: Welsh Assembly Government, 2002

    Google Scholar 

  4. Bond CM, Laing A, McKee L, et al. Evolution and change in community pharmacy. Aberdeen: Community Pharmacy Research Consortium, 2003

    Google Scholar 

  5. Hassell K. Contemporary workforce patterns and historical trends: the pharmacy labour market over the last forty years. Pharm J 2002; 269 (7213): 291–296

    Google Scholar 

  6. Bond C, Scott A, Inch J, et al. Examining alternatives for the remuneration of community pharmacy: report to Scottish Pharmaceutical General Council Research Trust. Aberdeen: University of Aberdeen, 2003

    Google Scholar 

  7. Inch J, Bond C, Lee A, et al. Scottish community pharmacists’ current involvement in and attitudes towards’ extended service’ provision: a national survey. Int J Pharm Pract 2005; 13: 289–301

    Article  Google Scholar 

  8. Ryan M, Farrar S. Eliciting preferences for health care using conjoint analysis. BMJ 2000; 320: 1530–1533

    Article  PubMed  CAS  Google Scholar 

  9. Ryan M, Gerard K. Using discrete choice experiments in health economics: moving forward. In: Scott A, Maynard A, Elliott R. Advances in health economics. Wiley: Chichester, 2002

    Google Scholar 

  10. Scott A. Eliciting GPs’ preferences for pecuniary and non-pecuniary job characteristics. J Health Econ 2001: 20; 329–347

    Article  PubMed  CAS  Google Scholar 

  11. Zwerina K, Huber J, Kuhfeld W. A general method for constructing efficient choice designs. Durham (NC): Duke University, 1996

    Google Scholar 

  12. Carlsson F, Martinsson P. Design techniques for stated preference methods in health economics. Health Econ 2003; 12: 281–294

    Article  PubMed  Google Scholar 

  13. Inch J, Bond C, Lee A, et al. Scottish Community Pharmacists’ current involvement in and attitudes towards’ extended service’ provision: a national survey. Int J Pharm Pract 2005; 13: 289–301

    Article  Google Scholar 

  14. Rosen S. The theory of equalising differences. In: Ashenfelter O, Layard R, editors. Handbook of labour economics. Vol I. Amsterdam: North Holland, 1986: 641–692

    Chapter  Google Scholar 

  15. Briggs AH, Gray AM. Handling uncertainty when performing economic evaluations of health care interventions. Health Technol Assess 1999; 3 (2): 1–134

    PubMed  CAS  Google Scholar 

  16. Ratcliffe J. The use of conjoint analysis to elicit willingness to pay: proceed with caution? Int J Technol Assess Health Care 2000; 16: 270–290

    Article  PubMed  CAS  Google Scholar 

  17. Skjoldborg US, Gyrd-Hansen D. Conjoint analysis: the cost variable. An Achilles’ heel? Health Econ 2003; 12: 479–492

    Article  Google Scholar 

  18. Lancsar E, Savage E. Deriving welfare measures from discrete choice experiments: inconsistency between current methods and random utility and welfare theory. Health Econ Lett 2004; 13: 901–907

    Article  Google Scholar 

  19. Lancsar E, Savage E. Deriving welfare measures from discrete choice experiments: a response to Ryan and Santos Silva. Health Econ Lett 2004; 13: 919–924

    Article  Google Scholar 

  20. Ryan M. Deriving welfare measures in discrete choice experiments: a comment to Lancsar and Savage (1). Health Econ Lett 2004; 13: 909–912

    Article  Google Scholar 

  21. Santos Silva JMC. Deriving welfare measures in discrete choice experiments: a comment to Lancsar and Savage (2). Health Econ Lett 2004; 13: 913–918

    Article  Google Scholar 

  22. Scott A. Identifying and analysing dominant preferences in discrete choice experiments: an application in health care. J Econom Psyc 2002; 23: 383–398

    Article  Google Scholar 

  23. Lloyd AJ. Threats to the estimation of benefit: are preference elicitation methods accurate? Health Econ 2003; 12: 393–402

    Article  PubMed  Google Scholar 

Download references

Acknowledgements

This study was funded by the Scottish Pharmaceutical General Council (SPGC) Research Trust. The research was conducted whilst Anthony Scott was at the Health Economics Research Unit (HERN). HERN is funded by the Chief Scientists Office of the Scottish Executive Health Department. The authors thank Verity Watson for assistance with the design of the experiment and two anonymous referees for helpful comments. The views in this paper are those of the authors and not the SPGC or the Scottish Executive. Christine Bond has received two separate unrestricted research grants from the SPGC. The authors have no other conflicts of interest to declare.

Author information

Authors and Affiliations

Authors

Rights and permissions

Reprints and permissions

About this article

Cite this article

Scott, A., Bond, C., Inch, J. et al. Preferences of Community Pharmacists for Extended Roles in Primary Care. Pharmacoeconomics 25, 783–792 (2007). https://doi.org/10.2165/00019053-200725090-00006

Download citation

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.2165/00019053-200725090-00006

Keywords

Navigation