Unmet needs in the medication use process: perceptions of physicians, pharmacists, and patients.
OBJECTIVE
To explore the perception of unmet needs in the medication use process from the perspectives of three of the principal participants in the process--physicians, pharmacists, and patients--and to identify the individual(s) or strategy(ies) perceived to be the best or most likely candidate(s) to resolve the problems identified.


METHODS
Physicians (primary care, cardiology, oncology, and obstetrics/gynecology specialties), pharmacists (community and health-system settings), and patients from four medium-sized U.S. cities. The survey instrument was modified for each group.


METHODS
The medication use process was divided into nine steps, based on a previous study. A two-part question was framed for each step. In part A, respondents were asked to indicate their level of agreement (on a 5-point scale) about whether the step was being conducted appropriately. In part B, those who disagreed with a statement in part A were asked their opinions on the best possible candidate or strategy for improving that step.


RESULTS
Both physicians and pharmacists identified four areas of unmet needs: timing of physician visit, patient counseling, patient use of medications, and patient monitoring. Each group held itself primarily responsible for the resolution of most of these problems. Patients did not identify any unmet needs from the survey. In responses to open-ended questions, however, they cited medication cost, appropriateness, access, and convenience as problems.


CONCLUSIONS
Providers and patients reported substantially different perspectives on medication use problems and on improving the process. Addressing the unmet needs identified in this study will require better understanding, communication, and collaboration among physicians, pharmacists, and patients.
Law
Anandi V
AV
Center for Pharmacy Practice Research and Development, College of Pharmacy, Western University of Health Sciences, Pomona, CA 91766-1854, USA. alaw@westernu.edu
Ray
Max D
MD
Knapp
Katherine K
KK
Balesh
Jeffrey K
JK
D000328:Adult; D001291:Attitude of Health Personnel; D003710:Demography; D004363:Drug Utilization; D006801:Humans; D033183:Interdisciplinary Communication; D008509:Medication Systems; D008875:Middle Aged; D017060:Patient Satisfaction; D010361:Patients; D010593:Pharmaceutical Services; D010595:Pharmacists; D010820:Physicians; D011795:Surveys and Questionnaires; D014481:United States