Martine Kruijtbosch

101 Mo ra l r eason i ng pe r spec t i ves i n s i t ua t i on s o f d rug s ho r t ages a weight of zero points. Per MRP per scenario the weights were added up. A respondent could receive a maximum score per MRP per scenario of 10 points (if four considerations of one MRP were ranked) and a minimum of 0 points (if no considerations of one MRP were ranked). The three MRP ranking scores per scenario were calculated per respondent by dividing the summed weights by the maximum score. Additionally the number of times each consideration was ranked, was counted. Ethics approval The Institutional Review Board Utrecht of the division Pharmacoepidemiology & Clinical Pharmacology, Utrecht University formally approved the research. RESULTS Two hundred sixty-seven respondents (94% community pharmacists and 6% early career pharmacists practicing in community pharmacy) completed the survey. Of these respondents, 63% were women, 39% worked in a (small)chain pharmacy, 79% were primary responsible pharmacist at their pharmacy, and the median age was 42 years (IQR = 32–52 years). Reference of these characteristics to national data were included in Appendix, Table 7. No respondents ranked more than one meaningless consideration (although seven respondents ranked one), so no surveys were excluded. Handling of the drug shortage According to the survey results, pharmacists rated the likelihood of six of the nine intended actions in the three shortages almost equally (Table 3). More pharmacists were likely to make alternative drug agreements with prescribers in the Contraceptive and Osteoporosis scenarios (80% and 70%, respectively) than in the Parkinson’s scenario (55%). Slightly fewer pharmacists were likely to make agreements with other pharmacists in the Parkinson’s and Osteoporosis scenarios (39% and 41%, respectively) than in the Contraceptive scenario (50%). Finally, most pharmacists (80%) were unlikely to import an osteoporosis medicine, but they were likely to import a contraceptive and a Parkinson’s medicine (61% and 75% of pharmacists, respectively). Moral reasoning perspective considerations The principle component analysis (PCA) confirmed that the BO-, RR- and PE-considerations represented the respective MRPs. The PCA was performed using the rating data of all 267 respondents. The analysis confirmed the construct validity of the data: the KMO index was 0.75, and Bartlett’s test was statistically significant ( p < 0.000). The scree plot did not