Patient views of therapeutic interchange of ACE inhibitors in Australian primary care: a qualitative study.
OBJECTIVES
In Australia, therapeutic interchange of angiotensin-converting enzyme (ACE) inhibitors could generate savings for patients and the Pharmaceutical Benefits Scheme (PBS). The PBS subsidises nine drugs in the ACE inhibitor class. These drugs are therapeutically equivalent, but the price varies between each drug. Patients are key players in successful therapeutic interchange programmes, but little is known about their views. This study aims to explore patient views of therapeutic interchange of ACE inhibitors in Australian primary care.


DESIGN
Qualitative exploratory research study using semi-structured interviews, asking participants about therapeutic interchange and their attitude towards hypothetically switching ACE inhibitors. Data were analysed thematically.


SETTING
Australian primary care.


PARTICIPANTS
Fourteen adults in Australia currently taking an ACE inhibitor, recruited via general practices and pharmacies, social media and professional networks.


FINDINGS
Five key themes were identified: participants' limited understanding of medication; the expectation that a new drug would be 'the same'; the view that choice, convenience and fear of change outweigh the cost; altruism; and trust in health professionals, particularly participants' own general practitioner (GP).


CONCLUSIONS
Patients' limited understanding of medication changes poses a barrier to therapeutic interchange. Clinicians should explore patients' understanding and expectations of therapeutic interchange. Counselling from trusted health professionals, particularly GPs, could ameliorate concerns. Policymakers implementing therapeutic interchange programmes should ensure a trusted GP directs medication changes.
['Marshall|Tessa|T|0000-0003-2634-1172', 'Lim|Hok|H|', 'Lau|Phyllis|P|']
D000328:Adult D000806:Angiotensin-Converting Enzyme Inhibitors D001291:Attitude of Health Personnel D001315:Australia D058005:General Practitioners D006801:Humans D011320:Primary Health Care D036301:Qualitative Research
primary care health policy hypertension qualitative research