Pharmacists' experience with the exception drug status (EDS) program in Saskatchewan
Perepelkin, Jason Paul
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In 1999, Saskatchewan Health sanctioned licensed pharmacists in the province to initiate Exception Drug Status (EDS), also referred to as prior approval, requests on behalf of their patients. The objectives of this study were to obtain pharmacists’ opinions about the benefits of the EDS program to stakeholders, and to identify factors associated with pharmacists initiating a request.In the fall of 2004, a census of community-pharmacy managers in Saskatchewan was conducted using a postal questionnaire, consisting of an introductory letter, two survey mailings and one reminder card. The questionnaire consisted primarily of seven-point Likert scale questions, and was analyzed using descriptive statistics and frequencies, followed by non-parametric analysis using Mann-Whitney U and Kruskal-Wallis tests; post-hoc analysis was carried out using the Bonferroni test.A response rate of 82.6% was achieved. Those living in Saskatoon or Regina made up 39% of respondents, with another 39% located in centres of less than 5,000 people.A majority of respondents (63%) agreed or strongly agreed the EDS program benefited patients and the Drug Plan (64%). Only 15%, 37% and 39% of respondents agreed or strongly agreed EDS benefits pharmacists, physicians and the health care system respectively.Factors that were important or very important to pharmacists in deciding whether they would initiate an EDS request on behalf of their patient were: the ability of the pharmacist to obtain the required information to initiate the EDS request (77%); their ability to contact the prescribing physician (70%); and patient centred concerns such as the ability to pay (74%) or the patient had exceeded their deductible (66%). However, time (39%) was not as important relative to other factors in whether the pharmacist would apply for EDS on behalf of their patient.The majority of respondents agreed or strongly agreed that changing the policy in 1999 was beneficial to patient care (71%), while it also contributed substantially to their administrative workload (87%). The results of this study indicate community pharmacy managers in Saskatchewan acknowledge that the Exception Drug Status process is beneficial for their patients. While pharmacists were supportive of the benefits of an EDS program, their apprehensions towards the program lie in the administrative processes, particularly in obtaining the required information, from physicians, to submit a claim. There is also concern with the methods pharmacists must use to apply for EDS, which can be burdensome and prolong the administrative process.To enhance pharmacists’ support for the program it may be necessary to develop strategies designed to reduce the administrative workload associated with the program, and to streamline the efficient communication of required information between the prescriber and pharmacist. Alternatively, financial compensation to pharmacists for their expertise and efforts might be considered; although this would not address the workload and communication concerns of pharmacists, it does provide recognition for their professional role in securing appropriate drug therapy for their patients.
DegreeMaster of Science (M.Sc.)
SupervisorDobson, Roy T.
CommitteeSari, Nazmi; Remillard, Alfred J. (Fred); Foldvari, Marianna; Backman, Allen; Shevchuk, Yvonne
Copyright DateAugust 2005