Introduction
Today's focus within health service development is to effectively target pharmaceutical care. In addition, there is a need to further explore the patient's perspective of disease and treatment. In this context, a 12-item quantitative scale, the Intrinsic Desire for Information (IDI), was originally extracted, using factor analysis, from a larger 50- item questionnaire administered to 501 patients exploring patient's desires for medical information¹. This present study aims to refine and validate the IDI scale through a novel method of interfacing quantitative and qualitative data in a further patient sample, to develop a potentially valuable tool to predict the specific drug information needs for individual patients.

Methods
Patients in three London teaching hospitals were interviewed at the bedside (n = 299) using the 12-item IDI scale and a series of open questions concerning patients' information preferences. Responses to the latter were transcribed into QSR NUD*IST software for qualitative coding and analysis. This resulted in an index of coded themes which described the amount and perceived purpose of drug related information. Demographic data were recorded, which were interfaced with the index.

Results
The IDI-scale was subjected to secondary factor analysis using principal components extraction and oblique rotation, which suggested the existence of two secondary factors; a 5-item factor (F1) describing the "extent of information desired" and a second 3-item factor (F2) describing an "inhibited desire for knowledge about illness/drugs". Reliability analysis for F1 showed coefficient alpha=0.7 and for F2 coefficient alpha=0.5. The mean factor scores for F1 and F2 were used for a dichotomy split into "high score" or "low score" for each case. Factor 1 showed significant correlations with F2 (r=0.23, p<0.01); age (r= -0.43, p<0.01); and school leaving age (r= 0.274, p<0.01). The derived factor scores were imported into the coded qualitative index for further analysis. The "high scorers" emphasised the amount and quantity of factual information wanted, supporting the validity of the extracted factor F1. Whilst the "low scorers" sometimes wanted information, they more often expressed anxieties and wanted reassurance of the drug's benefits. This contrasts with the more pro-active tendencies of the "high scorers", who did have concerns, but generally not the emotional dimension of the "low scorers". Factor 2 relates more to the behavioural aspects of information needs with the qualitative analysis suggesting that F2 is more concerned with 'knowledge' as an issue, and the individual's concept of knowledge, rather than propositional information or data. This dimension is reflected in F1 but as a discrete 'quantitative' construct.

Discussion
The methodology employed in this study involved importing quantitative summative demographic data into a qualitative data base and re- analysing both the quantitative and qualitative data at this interface, to validate the quantitatively derived scales. Age seems to be a predominant factor associated with patient desire for information, although our data suggest that educational and socio- economic status is also influential. Factor 1, "the extent of information desired" may have value in targeting receptive patients, or in identifying those who may be refractory to drug information. Both factors need further validation and testing in clinic, particularly with reference to deeper demographic characteristics. The refined tool will help to increase quality in pharmaceutical care by more effectively targeting pharmacy services founded on evidence based results.

Reference

1. Duggan C., Bates I. "The development and evaluation of a survey tool to explore patients' perceptions of their prescribed drugs and their need for drug information". International Journal of Pharmacy Practice. 2000 (in press).