Patients' valuation of the prescribing nurse in primary care: a discrete choice experiment.
BACKGROUND
Recently, primary care in the United Kingdom has undergone substantial changes in skill mix. Non-medical prescribing was introduced to improve patient access to medicines, make better use of different health practitioners' skills and increase patient choice. There is little evidence about value-based patient preferences for 'prescribing nurse' in a general practice setting.


OBJECTIVE
To quantify value-based patient preferences for the profession of prescriber and other factors that influence choice of consultation for managing a minor illness.


METHODS
Discrete choice experiment patient survey.


METHODS
Five general practices in England with non-medical prescribing services, questionnaires completed by 451 patients.


METHODS
Stated choice of consultation.


RESULTS
There was a strong general preference for consulting 'own doctor' for minor illness. However, a consultation with a nurse prescriber with positive patient-focused attributes can be more acceptable to patients than a consultation provided by a doctor. Attributes 'professional's attention to Patients' views' and extent of 'help offered' were pivotal. Past experience influenced preference.


CONCLUSIONS
Respondents demonstrated valid preferences. Preferences for consulting a doctor remained strong, but many were happy to consult with a nurse if other aspects of the consultation were improved. Findings show who to consult is not the only valued factor in choice of consultation for minor illness. The 'prescribing nurse' role has potential to offer consultation styles that patients value. Within the study's limitations, these findings can inform delivery of primary care to enhance patient experience and substitute appropriate nurse prescribing consultations for medical prescribing consultations.
Faculty of Health Sciences, University of Southampton, Southampton, UK.
Karen
K
Gerard
LSE Health, London School of Economics, London, UK.
Michela
M
Tinelli
Faculty of Health Sciences, University of Southampton, Southampton, UK.
Sue
S
Latter
School of Pharmacy, University of Queensland, Brisbane, Qld, Australia.|School of Pharmacy, University of Otago, Otago, New Zealand.
Alesha
A
Smith
School of Pharmacy, University of Bradford, Bradford, UK.
Alison
A
Blenkinsopp
D000328:Adult; D002755:Choice Behavior; D003695:Delivery of Health Care; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009726:Nurses; D057240:Patient Preference; D010593:Pharmaceutical Services / Q000458:organization & administration*; D011320:Primary Health Care / Q000458:organization & administration*; D012017:Referral and Consultation; D011795:Surveys and Questionnaires; D006113:United Kingdom
discrete choice experiment; health service delivery; nurse prescribing; patient valuation; preferences; primary health care