Psychosocial factors associated with pharmacists’ end-of-life medication counseling and dispensing

Abstract

ObjectiveIn 2015, California legalized physician-assisted suicide through passing the End of Life Option Act (ELOA). This study aimed to identify and describe the psychosocial factors associated with pharmacists’ intention to counsel and dispense end-of-life medications. MethodsData were collected using a 51-item questionnaire that was mailed to 2,000 registered community pharmacists in California. The study collected data on TPB constructs (attitude, subjective norm [SN], and perceived behavioral control [PBC]), behavioral and control beliefs, perceived obligation, and demographic and practice characteristics. Hierarchical linear regression was used to identify the factors associated with the pharmacists’ intention. ResultsA total of 353 responses (19.4% response rate) were received from respondents with an average age of 50.4 ± 14.8 years. Most of the respondents were women (53.1%) and religious (56.4%). Most pharmacies did not currently stock ELOA medications (n = 197, 56.1%), and most pharmacists had never been presented with an ELOA prescription in their practice (n = 319, 90.4%). The pharmacists had a positive intention (mean = 8.24 ± 4.6, range: 2-14), attitude (mean = 17.15 ± 6.9, range: 4-28), SN (mean = 1.1 ± 4.5; range: –9 to 9), and PBC (mean = 1.85 ± 3.5; range: –6 to 6) to dispense ELOA medications. Attitude (β = 0.570, P < 0.001), SN (β = 0.238, P < 0.001), and perceived obligation were statistically significant predictors of the pharmacists’ intention to dispense ELOA medications for patients with a valid prescription but PBC (β = 0.022, P = 0.531) was not. ConclusionInterventions to promote pharmacists’ counseling and dispensing of ELOA medications should focus on developing strong intention. Improving pharmacists’ attitude, SN, and perceived obligation is critical to increasing their willingness to dispense ELOA medications.