The Authority/Pharmacotherapy Care model: an explanatory model of the drug use process in primary care^⋆

Abstract 

Background

Drug utilization studies have proliferated and many variants exist. Few models have been presented that account for all of the different types of studies and approaches.

Purpose

This article presents the Authority/Pharmacotherapy Care model, a structural-functional model of the drug use process that illustrates the factors involved in drug utilization and the relationships between factors. The concepts of authority and transfer of authority underlie the relationships.

Methods

The drug use process is presented at the microlevel from the viewpoint of an individual who requires treatment with prescription drugs. The various categories of activity/authority (ie, level of patient care) are those of the individual, physician, pharmacist, patient, and drug. Influencing factors, both internal and external, impact upon each level of care. Three aspects must be considered at each level, which are structures, processes, and outcomes, according to Donabedian's model.

Results

The result is a structural-functional model that depicts all of the major points in the drug use process, which might be used as a framework to categorize drug utilization studies.

Conclusions

This model may be used to represent the drug use process, identify the types of drug use studies, determine pertinent factors involved in the process, understand the relationships between factors, and help in evaluating drug use.

Keywords: Model, Drug utilization, Drug use studies, Drug utilization review, Drug evaluation review, Primary care