Table 1.

Clinical Scenario Focus Group Prompts

Scenario	Focus group prompt
Scenario 1	Mr. A is a 75-year-old man who has heart disease. He tells his doctor that he is more tired than usual. The doctor checks some blood tests, prescribes him a testosterone cream to use every day because it may help reduce his tiredness, and tells the patient to follow up for his physical in a year. (A 30-day supply of testosterone costs $200). The patient is worried because his pharmacists told him that testosterone may increase his risk of having another heart attack.19–22
Scenario 2	Ms. S is a 65-year-old retired woman who has high cholesterol and diabetes. She has taken the same medication, called pravastatin, to lower her cholesterol for the past 10 years. She gets a call from a pharmacist who works at her doctor’s office telling her that a medicine more effective at lowering her cholesterol and preventing heart attacks and strokes, called atorvastatin (Lipitor), is available.23,24 He asks her to switch to the new medication. The new medication costs $10 more a month.
Scenario 3	Mr. R is a 68-year-old newly retired man. He receives a letter in the mail from his new Medicare Advantage insurance plan telling him that a medicine called clopidogrel (Plavix) that his doctor prescribed is no longer necessary and will not be covered by his insurance. He’s been taking this medicine since his heart attack 10 years ago. He does not understand why his doctor would refill this medicine if he did not need it.
Scenario 4	Mrs. T is a 70-year-old woman who takes a medicine once a day called omeprazole (also known as Prilosec) for acid reflux. She has been taking this medication for the past 3 years and feels that it works well to control the chest discomfort she was experiencing from acid reflux, which was very bothersome to her and prevented her from eating what she wanted. Her doctor recently recommended that she stop the medication or switch to a different medicine that she would need to take twice a day, due to the concern that long-term use of omeprazole may increase her risk of fracturing a bone25–27 and may also be associated with the onset of dementia (ie, Alzheimer’s disease).28,29