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. 2016 Mar;149(2):90-8.
doi: 10.1177/1715163515625656. Epub 2016 Feb 11.

How do community pharmacists make decisions? Results of an exploratory qualitative study in Ontario

Paul A M Gregory  1 , Brenna Whyte  1 , Zubin Austin  1
Affiliations

How do community pharmacists make decisions? Results of an exploratory qualitative study in Ontario

Paul A M Gregory et al. Can Pharm J (Ott). 2016 Mar.

Abstract

Background: As the complexity of pharmacy practice increases, pharmacists are required to make more decisions under ambiguous or information-deficient conditions. There is scant literature examining how pharmacists make decisions and what factors or values influence their choices. The objective of this exploratory research was to characterize decision-making patterns in the clinical setting of community pharmacists in Ontario.

Methods: The think-aloud decision-making method was used for this study. Community pharmacists with 3 or more years' experience were presented with 2 clinical case studies dealing with challenging situations and were asked to verbally reason through their decision-making process while being probed by an interviewer for clarification, justification and further explication. Verbatim transcripts were analyzed using a protocol analysis method.

Results and discussion: A total of 12 pharmacists participated in this study. Participants experienced cognitive dissonance in attempting to reconcile their desire for a clear and confrontation-free conclusion to the case discussion and the reality of the challenge presented within each case. Strategies for resolving this cognitive dissonance included strong emphasis on the educational (rather than decision-making) role of the pharmacist, the value of strong interpersonal relationships as a way to avoid conflict and achieve desired outcomes, the desire to seek external advice or defer to others' authority to avoid making a decision and the use of strict interpretations of rules to avoid ambiguity and contextual interpretation. This research was neither representative nor generalizable but was indicative of patterns of decisional avoidance and fear of assuming responsibility for outcomes that warrant further investigation.

Conclusion: The think-aloud method functioned effectively in this context and provided insights into pharmacists' decision-making patterns in the clinical setting. Can Pharm J (Ott) 2016;149:90-98.

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Conflict of interest statement

Declaration of Conflicting Interests:The author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

References

    1. Law M, Ma T, Fish J, Sketris I. Independent pharmacist prescribing in Canada. Can Pharm J (Ott) 2012;145:17-24. - PMC - PubMed
    1. Frankel G, Austin Z. Responsibility and confidence: identifying barriers to advanced pharmacy practice. Can Pharm J (Ott) 2013;146:155-61. - PMC - PubMed
    1. Blake K, Madhavan S. Perceived barriers to provision of medication therapy management services (MTMS) and the likelihood of a pharmacist to work in a pharmacy that provides MTMS. Ann Pharmacother 2010;44:424-31. - PubMed
    1. Wheeler A, Crump K, Lee M, et al. Collaborative prescribing: a qualitative exploration of a role for pharmacists in mental health. Res Social Admin Pharm 2012;8:179-92. - PubMed
    1. Planas L, Kimberlin C, Segal R, et al. A pharmacist model of perceived responsibility for drug therapy outcomes. Soc Sci Med 2005;60:2393-403. - PubMed