An examination of the theory of reasoned action and pharmacists' intention to provide medication counseling

Abstract

Although it has been shown that counseling can benefit patients and pharmacists alike, it is well documented that pharmacists are reluctant to counsel patients about medications. This study was conducted to explain and predict pharmacist's counseling intentions and behavior using Fishbein and Ajzen's Theory of Reasoned Action (TRA), with the intention of explaining why pharmacists do not counsel as often as they could. The main goal of the study was to provide a better understanding of pharmacists' counseling behavior. A random sample of 317 Maryland pharmacists completed a questionnaire that measured their attitudes and subjective norms towards intention to provide counseling. Self-reports of behavior were collected through interviews from a sub-sample of 52 pharmacists. Three hypotheses dealing with pharmacists' attitudes and subjective norms towards their intention to counsel and the relationship between intention to counsel and their reported counseling behavior were developed and tested. Results indicated that pharmacists have positive attitudes and subjective norms towards counseling, that attitude was a better predictor of counseling than subjective norm and that demographic characteristics could influence pharmacists' counseling intentions. Reported counseling behavior through interviews differed from perceived counseling intentions. Overall, the results indicated that pharmacists have positive counseling behaviors. However, the results explained a small amount of variance. A new or modified version of the model depicting the Theory of Reasoned Action could be used to explain more of the behavior. The results have implications for designing interventions that may improve counseling and also affect medication costs. There are implications also for improving patient compliance, mandatory counseling, federal and private insurance programs. Practitioners and pharmacy students may benefit through continuing education programs that use the knowledge about attitudes and subjective norms. The patient counseling role of pharmacists may be stressed and pharmacists encouraged to counsel.