Survey Response

The overall response rate, including two surveys completed over the telephone, was 48% (257 of 537). Of the 625 surveys mailed (excluding pediatricians), one was returned from a non-physician; 70 other addresses were deleted from the denominator (624) because correct addresses or phone numbers were not available (the physicians could not be contacted). We excluded an additional 17 physicians who reported that they did not make any decisions concerning prescription drugs (n = 11) or that they no longer practiced medicine (n = 6). Therefore, our final sample size was 537 for this article.

Demographic characteristics of respondents are listed in Table 1. A total of 150 of 349 (a 43% adjusted response rate) physicians from Minnesota responded, and 107 of 188 (a 57% adjusted response rate) from North Dakota responded. The age and sex of responding physicians in this sample were similar to the national averages.
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Physicians whose medical specialties were emergency medicine, family practice (including geriatrics), general practice, gynecology, internal medicine (including geriatrics), obstetrics

and gynecology, or obstetrics alone were considered to be gen-eralists. Physicians reporting any other medical specialties were considered to be specialists.

Table 1 Sample Demographics and Characteristics of Physicians’ Practices

Physician Characteristic Value
Age, mean ± standard deviation (n = 244) 48 ± 9 years
Gender (n = 249), male (n = 173) 69%
Physicians specialty (n = 256)
Generalist 71%
Specialist 29%
Practice location (n = 234)
Urban 69%
Rural 31%
No. of physicians practicing (practice size) (n = 246)
Small (1-4 physicians) 17%
Medium (5-150 physicians) 59%
Large or very large (>150 physicians) 24%
Use of computer order entry
when prescribing (n = 252) 40%
Use of PDA when prescribing (n = 250) 34%
No. of formularies prescribed from (n = 249)
Less than six 30%
Six or more 27%
Unknown 43%
Percentage of patients enrolled in Medicare (n = 195)
0-25% 34%
26-50% 49%
51-98% 17%

Physicians’ Familiarity with Medicare Part D

On a Likert-type scale, physicians were asked to rank their familiarity with Part D (1 = poor familiarity; 3 = average or moderate familiarity; 5 = outstanding familiarity). Approximately half (46%) of the physicians indicated that their familiarity with Part D was less than average (Likert-type scale response < 3). Another 41% indicated that their familiarity was average (Likert-type scale response = 3). Only 13% of physicians reported that their familiarity with Part D was either above average or outstanding (Likert-type scale response > 3).

In bivariate analyses using Fisher’s Exact Test, generalists, compared with specialists, were almost three times (P = 0.03) as likely to report “above average” or “outstanding familiarity” with Medicare Part D (Likert-type scale response > 3 with cells collapsed).
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Table 2 Physicians’ Responses (in Percent) to Questions Addressing Their Perceived Responsibility For Advising Patients about Medicare Part D

Physicians’ Perceived Responsibility

On a Likert-type scale, physicians were asked to rank to what extent they thought it was their responsibility to advise seniors whether or not to enroll in Medicare Part D (Table 2). Physicians were also asked to rank to what extent they thought it was their responsibility to advise seniors about plan selection (see Table 2). The actual wording of the questions is included as footnotes to Table 2.

Although only 13% of physicians indicated that they perceived it was their responsibility to advise patients about Part D enrollment, 45% reported rendering advice about Part D enrollment to at least some of their senior patients and 21% reported rendering advice to more than half of their senior patients (Table 3). Only 2% of physicians reported a responsibility to advise patients about plan selection; however, 21% reported providing such advice to at least some of their senior patients and 2% reported providing such advice to more than half of their senior patients (see Table 3). suhagra 100

Table 3 Percentage of Patients Who Were Being Counseled by Physicians about Medicare Part D

The actual wording of the questions is included as footnotes to Table 3.

Access to Information

Physicians were asked if they had access to a list of pertinent information when trying to help seniors enroll in a Medicare Part D plan. As shown in Table 4, physicians were generally aware of certain information, such as the patient’s medication regimen, but they were significantly less aware of other information. The actual wording of the questions is included as footnotes to Table 4.

Perceived Responsibility and Access to Information

For this section, the response categories “strongly agreed” and “agreed” were collapsed and were referred to as “agreed;” similarly, the categories “strongly disagreed” and “disagreed” were collapsed and were referred to as “disagreed.”In bivariate analyses using Fisher’s Exact Test, we found the following:

• Of the physicians who agreed that they possessed information about patients’ annual drug costs, 24% thought that it was their responsibility to advise seniors about Part D enrollment. By comparison, of the physicians who were neutral or who disagreed about possessing information about patients’ annual drug costs, only 12% thought that it was their responsibility to advise seniors about Part D enrollment (P =0.048).
• Of the physicians who agreed that they possessed information about the content of the formulary that would best serve the patient, 32% thought that it was their responsibility to advise seniors about Part D enrollment, compared with 12% of physicians who were neutral or who disagreed about possessing information about the content of the formulary that would best serve the patient (P = 0.01).
• Of the physicians who agreed that they possessed information about the plan that was least expensive for the patient, 41% thought that it was their responsibility to advise seniors about Part D enrollment, compared with 11% of the physicians who were neutral or who disagreed about possessing information about the plan that was least expensive for the patient (P = 0.0001).

Physicians who “agreed” or “strongly agreed” (with cells collapsed) that they possessed information about the patient’s medication regimen were more likely to advise more than 0% of their senior patients in their practice about enrollment (76% vs. 57%; P = 0.007). Internal consistency (reliability) between perceived responsibility and access to information was considered good, with a Cronbach alpha of 0.73.
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Access to Information and Technology Usage

In bivariate analyses using Fisher’s Exact Test, respondents who reported using either computer order entry or a PDA (e.g., a Palm Pilot) or both, when prescribing were more than three times (P = 0.002) as likely to “agree” or “strongly agree” (with cells collapsed) that they possessed information about the patient’s annual drug costs.

Table 4 Physicians’ Responses (in Percent) to Questions about Access to Information

Physicians who reported using a PDA when prescribing were almost three times as likely (P = 0.01) to “agree” or “strongly agree” (with cells collapsed) that they possessed information about the content of the formulary that would best serve the patient.

Perceived Responsibility and Physician Specialty

In bivariate analyses using Fisher’s Exact Test, generalists, as compared with specialists, “agreed” or “strongly agreed” (with cells collapsed) that they possessed information about the patient’s medication regimen (72% of generalists vs. 42% of specialists; P < 0.0001), and they were also more likely to advise more than 0% of their senior patients in their practice about Part D enrollment (71% vs. 53%; P = 0.02). There was a statistically significant difference in the use of a PDA between generalists and specialists (39% vs. 21%; P = 0.006) when prescribing. buy tadacip

Perceived Responsibility and Formulary Usage

In bivariate analyses using Fisher’s Exact Test, physicians who prescribed from six or more formularies (with cells collapsed), as opposed to physicians who prescribed from less than six formularies (with cells collapsed) in a typical week, “agreed” or “strongly agreed” (with cells collapsed) that they possessed information about the patient’s medication regimen (70% vs. 52%; P = 0.03). They were also more likely to advise more than 0% of their senior patients in their practice about enrollment (79% vs. 62%; P = 0.048). However, there was no statistically significant difference between these two groups (physicians prescribing from six or more formularies and physicians prescribing from fewer than six formularies) in terms of using information technology (computer order entry or a PDA or both) when prescribing.