Relationship between assertiveness in community pharmacists and pharmacist-initiated prescription changes

Mitsuaki Ishii; Sachiko Ozone; Shoichi Masumoto; Tetsuhiro Maeno

doi:10.1016/j.sapharm.2023.06.006

Relationship between assertiveness in community pharmacists and pharmacist-initiated prescription changes

Res Social Adm Pharm. 2023 Oct;19(10):1380-1385. doi: 10.1016/j.sapharm.2023.06.006. Epub 2023 Jun 30.

Authors

Mitsuaki Ishii¹, Sachiko Ozone², Shoichi Masumoto³, Tetsuhiro Maeno⁴

Affiliations

¹ Department of Primary Care and Medical Education, Graduate School of Comprehensive Human Sciences, University of Tsukuba, 1-1-1, Tennodai, Tsukuba, Ibaraki, 305-8575, Japan. Electronic address: s2030345@u.tsukuba.ac.jp.
² Department of Primary Care and Medical Education, Institute of Medicine, University of Tsukuba, 1-1-1, Tennodai, Tsukuba, Ibaraki, 305-8575, Japan. Electronic address: sachiko-ozone@md.tsukuba.ac.jp.
³ Department of Primary Care and Medical Education, Institute of Medicine, University of Tsukuba, 1-1-1, Tennodai, Tsukuba, Ibaraki, 305-8575, Japan. Electronic address: smash422@md.tsukuba.ac.jp.
⁴ Department of Primary Care and Medical Education, Institute of Medicine, University of Tsukuba, 1-1-1, Tennodai, Tsukuba, Ibaraki, 305-8575, Japan. Electronic address: maenote@md.tsukuba.ac.jp.

PMID: 37419769
DOI: 10.1016/j.sapharm.2023.06.006

Abstract

Background: Despite the usefulness of assertiveness by healthcare professionals in improving patient safety, few studies have evaluated the assertiveness of community pharmacists. Community pharmacists' assertiveness might be associated with pharmacist-initiated prescribing changes to improve medication safety.

Objectives: Our objective was to examine which types of assertiveness-related self-expression are associated with community pharmacist-initiated prescribing changes while adjusting for possible confounding factors.

Methods: We conducted a cross-sectional survey in Japan between May and October 2022 in 10 prefectures. Community pharmacists belonging to a large pharmacy chain were recruited. The outcome variable was the frequency of community pharmacist-initiated prescription changes over 1 month. Community pharmacists' assertiveness was assessed using the Interprofessional Assertiveness Scale (IAS) and 3 sub-domains (nonassertive, assertive, and aggressive self-expression). Participants were classified into 1 of 2 categories based on medians. Demographic and clinical characteristics were compared by group with univariate analysis. A generalized linear model (GLM) was used to investigate the association between pharmacist-initiated prescription changes as an ordinal variable and pharmacists' assertiveness.

Results: Of 3346 community pharmacists invited, 963 were included in the analysis. Participants with high assertive self-expression scores had a significantly higher frequency of pharmacist-initiated prescription changes. There was no association between nonassertive or aggressive self-expression and pharmacist-initiated prescription changes. After adjustments, high assertive self-expression remained associated with a high frequency of community pharmacist-initiated prescription changes (odds ratio, 1.34; 95% confidence interval, 1.02-1.74; p = 0.032).

Conclusions: Higher assertive self-expression among community pharmacists is associated with higher frequency of pharmacist-initiated prescription changes.

Keywords: Assertiveness; Collaboration; Community pharmacist; Interprofessional; Medication safety; Prescription change.

MeSH terms

Assertiveness
Community Pharmacy Services*
Cross-Sectional Studies
Humans
Japan
Pharmacists*
Prescriptions