ABSTRACT
Pharmacists play an important role in recommending nonprescription products. The objective of the study presented in this paper was to gain an understanding of pharmacists' decision-making process when recommending nonprescription analgesics for an adult with a simple, tension, or migraine headache. The inclusive value (IV) parameters of the nested structure and a likelihood ratio test were used to determine whether pharmacist decision making was consistent with a nested (hierarchical) decision process or a nonnested structure. A national study was conducted across 1,500 randomly selected Australian community pharmacies (68.3% usable response rate). Principal components analysis with varimax rotation was employed on a list of statements concerning pharmacists' recommendation of the active ingredient(s) and brand as well as criteria to evaluate before recommending a nonprescription analgesic. Factor scores were calculated and used along with pharmacist demographics as explanatory variables in a technique called discrete choice modeling. The IV parameters of the nested structure and the associated standard errors for each type of headache were examined. The likelihood ratio test was considered appropriate for the tension headache model. Hence, the model was fitted with and without the restriction that the IV parameters are fixed at one and was not found to be significantly different from zero at the 5% significance level. On the basis of the examination of the IV parameters, the relatively large standard errors, and the nonsignificant likelihood ratio test (in the case of a tension headache), there was not sufficient evidence to suggest that the data were consistent with a nested structure for each type of headache. The data were more likely to be consistent with a multinomial logit (MNL) model, which means that after evaluating a patient, pharmacists choose the nonprescription analgesic brand. The use of discrete choice modeling enabled the researchers to specify a tree structure of choices and hence model pharmacists' recommendation behavior of nonprescription analgesics for an adult with a simple, tension, or migraine headache. The findings from this research have implications for educators, professional associations, and pharmaceutical companies.