Int J Pharm Pract 2002:10:191-200
Health Economics Research Unit, University Medical Buildings, University of Aberdeen, Foresterhill, Aberdeen, Scotland AB25 2ZD
Cristina Ubach, MSc, research assistant
Angela Bate, MSc, research fellow
Mandy Ryan, PhD, MRC senior fellow
Department of General Practice, University of Aberdeen
Terry Porteous, BSc, MRPharmS, research pharmacist
Christine Bond, PhD, MRPharmS, professor of primary care (pharmacy)
Roma Robertson, MSc, research assistant
Correspondence: Dr Ryan
Int J Pharm Pract 2002:10:191-200
Original Papers
Using discrete choice experiments to evaluate alternative electronic prescribing systems
CRISTINA UBACH, ANGELA BATE, MANDY RYAN, TERRY PORTEOUS, CHRISTINE BOND and ROMA ROBERTSON
Objective
— To assess the relative importance to pharmacists and general practitioners
(GPs) of different characteristics of electronic prescribing systems.
Methods — A discrete choice experiment (DCE) was used to obtain
preferences for the following attributes of an electronic prescribing
scheme: "typical response time", "frequency of slow responses", "frequency
of unscheduled downtime", "length of unscheduled downtime", "frequency
of scheduled downtime", and "frequency of lost/corrupted data". Preferences
of GPs and pharmacists were compared using the Likelihood ratio test and
the Wald statistic. The rate at which respondents were willing to trade
between attributes and benefit scores for different systems were estimated.
Rationality of responses and theoretical validity of responses to the
DCE were also assessed.
Subjects and setting — 199 pharmacists and 197 GPs in Scotland.
Key findings — The usable response rate for the DCE was 42.4 per
cent. Preferences of pharmacists and GPs were significantly different.
Given the units of measurement, the most important attribute for pharmacists
was "length of unscheduled downtime" whereas for GPs it was "typical response
time". Evidence was found of rationality of responses and theoretical
validity.
Conclusions — All technical attributes of an electronic prescribing
system assessed in this study were considered by the respondents to be
important. Discrete choice experiments provide useful information on the
relative importance and trade-offs between attributes as well as benefit
scores for different systems. The preferences of pharmacists and GPs are
significantly different. Future research should investigate the nature
of the benefit function, the assumption of trading across attributes and
the external validity of the technique.