Prediction of the Implementation of the Physician-Pharmacist Collaborative Model Using the Theory of Planned Behavior

Carter BL, Demik D, Vander Weg MW, Lundt E, Coffey C, Ardery G. Prediction of the Implementation of the Physician-Pharmacist Collaborative Model Using the Theory of Planned Behavior. Paper presented at: North American Primary Care Research Group Annual Meeting; 2011 Nov 14; Banff, Alberta, Canada.

Related HSR&D Project(s)

• IIR 07-145 – Trial of Low And High Intensity Strategies to Maintain Blood Pressure Control

Context: A physician-pharmacist collaborative model (PPCM) has been shown to improve medication management for chronic conditions. Objective: To evaluate the relationship between Theory of Planned Behavior (TPB) survey scores and the level of clinical pharmacy services to predict implementation of PPCM for chronic conditions in primary care offices. Design: A mailed survey instrument to measure TPB determinants of behavior. Setting: 27 primary care offices that are participating in the CAPTION trial. Participants: Physicians and clinical pharmacists from primary care offices. Main Outcome Measures: Baseline clinical pharmacy services at each medical office were measured using a validated instrument to quantify the level of services and allow for separation into high and low pharmacy service groups. TPB and clinical pharmacy service scores were compared to predict differences. Associations between TPB subscale scores and clinical pharmacy service scores were investigated using Pearson correlation coefficients. Differences in TPB subscale scores between physicians and pharmacists were examined with independent-samples t-tests. Results: Surveys were returned by 282 physicians (32.5%) and 35 pharmacists (77.8%). There was no relationship between "clinical pharmacy service scores" and physician TPB beliefs about implementation of pharmacy intervention in their office. Clinical pharmacists' behavioral intentions and social norms had modest correlations of 0.566 and 0.481, respectively, with clinical pharmacy service structure scores (p < .01). Pharmacists scored significantly higher than physicians on each of the TPB behavioral determinants (p < .001). Conclusions: Baseline clinical pharmacy services within a given medical office do not appear to influence a physician's willingness or perceived ability to implement PPCM. Pharmacists' intentions to implement PPCM and feelings of PPCM's social acceptability were related to existing clinical pharmacist services. Pharmacists appear to believe that it is more feasible to implement a pharmacy intervention within a medical office than their physician colleagues based on higher TPB construct