Effect of social influences on pharmacists' intention to report adverse drug events

Objectives: To identify the groups or individuals that influence pharmacists' decision making to report adverse drug events (ADEs), determine the differences in social influence or subjective norm between intenders and nonintenders, and determine the relationship between subjective norm toward reporting serious ADEs and practice and demographic characteristics. Design: Nonexperimental cross-sectional study. Setting: Texas during June and July 2009. Participants: 1,500 Texas pharmacists. Intervention: As part of a larger survey, 3 and 18 items were used to assess pharmacists' intentions and subjective norm, respectively, to report serious ADEs to the Food and Drug Administration (FDA). Main outcome measure: Pharmacists' subjective norm toward reporting serious ADEs. Results: The survey had a response rate of 26.4% (n = 377). Most pharmacists intended to report serious ADEs that they would encounter (15.87 +/- 4.22 [mean +/- +/- SD], possible range 3-21, neutral = 12). The mean subjective norm scores were moderately high and positive (28.75 +/- 9.38, 1-49, 16), indicating that the referents had a moderate influence on pharmacists regarding reporting serious ADEs to FDA. FDA had the greatest (34.82 +/- 12.16) and drug manufacturers the lowest (21.55 +/- 13.83) social influence. The most important salient referents (important others) in pharmacists' decisions to report serious ADEs were FDA, patients, pharmacy associations, pharmacy managers/bosses, and hospitals and hospital groups. Gender (female equals higher), pharmacists' years of experience (negative correlation), and knowledge of ADE reporting (positive correlation) were associated with subjective norm. Conclusion: Pharmacists had a moderately high subjective norm, suggesting that ADE reporting intentions is influenced by others and that the opinions of others are of great importance in pharmacists' intentions regarding ADE reporting. The main drivers of subjective norm were FDA, patients, pharmacy associations, and managers/bosses.