Martine Kruijtbosch

105 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 TABLE 4: Continued Consideration a PCA components MRP b 1 2 3 C5 Whether the patient is willing to pay the extra cost of an imported oral contraceptive 0.129 0.409 -0.103 BO O4 That I do not deviate from the Fracture Prevention Guideline of The Dutch College of General Practitioners 0.070 0.401 0.242 RR C9 Whether I run the risk of a complaint from a disciplinary court for healthcare 0.399 0.400 0.142 RR P4 That in the case of Parkinson's medication I never deviate from the KNMP Drug Substitution Guideline 0.111 0.347 0.332 RR C1 That I adhere to the advice regarding this shortage on the Farmanco website -0.046 0.344 0.095 RR C12 The expected duration for which the patient cannot use ethinylestradiol/levonorgestrel 0.03/0.150 mg tablets 0.174 0.193 -0.015 PE P5 That Parkinson’s can worsen when the patient receives alternative treatment 0.043 0.053 0.615 PE O12 That the patient worries that he will break a bone again 0.197 0.037 0.582 PE P7 That I can trust the quality of imported levodopa/carbidopa 125 mg tablets -0.002 0.147 0.564 PE P9 Whether I can do something for this patient with my pharmaceutical expertise 0.055 -0.152 0.535 PE C3 That every patient has equal access to this oral contraceptive -0.003 0.143 0.533 PE C10 Whether I can answer the care question of this patient with my pharmaceutical expertise -0.037 -0.018 0.464 PE O10 Whether there is evidence that alternative bisphosphonates are equally effective 0.118 0.168 0.461 PE C2 That the patient may suffer from menstrual pain without contraception 0.041 -0.111 0.383 PE P10 That I adhere to the advice/prescription of the treating prescriber 0.024 0.283 0.318 RR P1 That every patient has equal access to levodopa/carbidopa 125 mg 0.004 0.187 0.244 PE a Considerations: • C (1–13) = Considerations of Contraception drug shortage scenario • P (1–13) = Considerations of Parkinson’s drug shortage scenario • O (1–13) = Considerations of osteoporosis drug shortage scenario b Moral reasoning perspectives (MRPs): • BO = Business orientation MRP • RR = Rules and regulations MRP • PE = Professional ethics MRP c Underlined component correlations are eligible values (i.e. values are ≥ 0.35 or the difference between the correlations is > 0.2 if a statement loaded highly on more than one component) d M = Meaningless consideration