OBJECTIVES: Recent studies suggest that drug-drug interaction messages ignored by pharmacists raise concerns about safety and impact on patient outcomes. Attitudes about the proliferation of messages they perceive as 'false-positives' could explain the inconsistency among pharmacist responses to drug interaction messages (DIMs). Our objective is to report a pilot study examining pharmacist utilization and perceptions of DIMs. METHODS: A semi-structured telephone interview protocol was developed using Likert scales assessing pharmacists' utilization and attitudes regarding DIMs. Utilization measures included perception of false positive DIMs and desensitization to DIMs. Attitude assessments included confidence, usefulness, and satisfaction with the drug interaction programs, and influence of liability concerns. A convenience sample of 44 West Virginia pharmacists responded during March 2002. ANOVA was used to analyze relationships among variables in this descriptive study. RESULTS: Among respondents, 36.4% perceived that 21-30% of DIMs were insignificant; 13.5% perceived that >50% of DIMs were insignificant. Using a 5-point scale (1=not at all, 5=very much), pharmacists reported desensitization to DIMs (median=4.0). Pharmacists perceiving DIMS as more insignificant also reported greater desensitization to DIMs (F=3.04, p<.05). Pharmacists found the programs useful (median=4.0), were somewhat confident (median=3.5) or satisfied with the programs (median=3.0). Those who found the program more useful (F=6.38, p<.05), or were more confident (F=3.09, p<.05) or satisfied with the program (F=6.95, p<.05), were significantly less desensitized to DIMs. Also, the more desensitized to DIMs, the more the pharmacist was influenced by liability concerns in deciding to report a DIM to the patient and/or physician (F=4.54, p<.01). CONCLUSIONS: These pilot results suggest further research is warranted. Pharmacist utilization of drug interaction programs is inconsistent; this may be influenced by attitudes towards DIMs. Information regarding attitudinal barriers can provide content for pharmacist training or for vendor development of drug interaction programs.