title: A thematic analysis for how patients, prescribers, experts, and patient advocates view the prescription choice process.
abstract: BACKGROUND
  Typically, patients are unaware of the cost consequences regarding prescribing decisions during their clinical encounter and rarely talk with their physicians about costs of prescription drugs. Prescription medications that are deemed by patients to be too costly when the costs become known after purchase are discontinued or used at suboptimal doses compared to prescription medications that are deemed to be worth the cost.
  
  
  OBJECTIVE
  To learn more about the prescription choice process from several viewpoints, the purpose of this study was to uncover and describe how patients, prescribers, experts, and patient advocates view the prescription choice process.
  
  
  METHODS
  Data were collected via 9 focus group interviews held between April 24 and July 31, 2007 (3 with patients, 3 with prescribers, 2 with experts, and 1 with patient advocates). The interviews were audiotaped and transcribed. The resulting text was analyzed in a descriptive and interpretive manner. Theme extraction was based on convergence and external divergence; that is, identified themes were internally consistent but distinct from one and another. To ensure quality and credibility of analysis, multiple analysts and multiple methods were used to provide a quality check on selective perception and blind interpretive bias that could occur through a single person doing all of the analysis or through employment of a single method.
  
  
  RESULTS
  The findings revealed 5 overall themes related to the prescription choice process: (1) information, (2) relationship, (3) patient variation, (4) practitioner variation, and (5) role expectations. The results showed that patients, prescribers, experts, and patient advocates viewed the themes within differing contexts.
  
  
  CONCLUSIONS
  It appears that the prescription choice process entails an interplay among information, relationship, patient variation, practitioner variation, and role expectations, with each viewed within different contexts by individuals engaged in such decision making.
authors.affiliation: University of Minnesota, College of Pharmacy, 7-155 WDH, 308 Harvard Street, S.E., Minneapolis, MN 55455, USA. scho010@umn.edu
authors.forename: Jon C
authors.initials: JC
authors.lastname: Schommer
authors.forename: Marcia M
authors.initials: MM
authors.lastname: Worley
authors.forename: Andrea L
authors.initials: AL
authors.lastname: Kjos
authors.forename: Serguei V S
authors.initials: SV
authors.lastname: Pakhomov
authors.forename: Stephen W
authors.initials: SW
authors.lastname: Schondelmeyer
mesh_terms: D001291:Attitude of Health Personnel; D002755:Choice Behavior; D017144:Focus Groups; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D008910:Minnesota; D010344:Patient Advocacy; D010820:Physicians / Q000458:organization & administration / Q000523:psychology; D010818:Practice Patterns, Physicians' / Q000458:organization & administration*; D055553:Prescription Drugs / Q000191:economics / Q000627:therapeutic use*; D024382:Professional Role; D014922:Wisconsin
chemical_list: D055553:Prescription Drugs