Investigation of patients' demand for community pharmacies: relationship between pharmacy services and patient satisfaction

Dispensation of outpatient hospital medicines by hospital only versus hospital-community pharmacies collaboration: a cross-sectional study and survey of patient's satisfaction

Goal

To describe the experience of a dispensing model of outpatient hospital medicines (OHM) via collaboration of hospital and community pharmacies, and to explore patient satisfaction with the strategy as compared with the hospital pharmacy only service.

Background

Patient satisfaction is an important component of the quality of health care.

Study

A new model of dispensing OHM was conducted in the Outpatients Unit of the Service of Hospital Pharmacy of Hospital del Mar, in Barcelona, Spain. Participants were patients on stable chronic treatment with clinical or social fragility, immunocompromised patients, and those whose residence was located at a distance from the hospital that justified drug delivery through the community pharmacy. A cross sectional study was done using an ad hoc 14-item questionnaire collecting demographic data, duration of treatment, usual mode of collecting medication, and the degree of satisfaction regarding waiting time for the collection of medication, attention received by professionals, information received on treatment, and confidentiality.

Results

The study population included a total of 4,057 patients (66.8% men) with a mean age of 53 (15.5) years, of whom 1,286 responded, with a response rate of 31.7%. Variables significantly associated with response to the survey were age over 44 years, particularly the age segment of 55-64 years (odds ratio [OR] 2.51) and receiving OHM via the community pharmacy (OR 12.76). Patients in the community pharmacy group (n = 927) as compared with those in the hospital pharmacy group (n = 359) showed significantly higher percentages of 'satisfied' and 'very satisfied' (p < 0.001) in the waiting time for the collection of OHM (88.1% vs. 66%), attention received by professionals (92.5% vs. 86.1%), and information received on treatment (79.4% vs. 77.4%). In relation to confidentiality, results obtained were similar in both pharmacy settings.

Conclusion

Dispensing OHM through the community pharmacy was a strategy associated with greater patient satisfaction as compared with OHM collection at the hospital pharmacy service, with greater accessibility, mainly due to close distance to the patient's home. The participation of community pharmacists could further optimize the care received by patients undergoing OHM treatment.

Patient satisfaction with pharmaceutical services at primary healthcare centers under the Palestinian Ministry of Health

BACKGROUND

The measurement of patient satisfaction is a vital metric that enhances stakeholders to take proactive steps in improving the quality of healthcare services within medical care systems. This study assessed patient satisfaction receiving pharmaceutical services from primary health care centers in the Palestinian Ministry of Health (PMoH) governorate directorates in the West Bank.

METHODS

A total of 938 patients, all aged 18 years or older, completed a self-administered questionnaire. The assessment of general satisfaction was based on selected questions. Analyses were conducted to explore demographic characteristics. Mean and standard deviation (S.D.) were reported. Likert method was used to average scale satisfaction. To examine statistically significant differences, Chi-square analysis and binary logistic analysis were employed.

RESULTS

56.8% of the survey respondents were women, 57.2% were 40 years or older, and 63.2% had graduated from high school. The general satisfaction score averaged 4.10 ± 0.77 indicating good satisfaction. Patients were satisfied with interpersonal relationships, with a mean score of 4.19 ± 0.70. However, satisfaction with therapy management was lower, with a mean score of 3.99 ± 0.77 indicating moderate satisfaction. A significant factor can affect patient's satisfaction such as the location of the pharmacy (OR = 1.720, P = 0.012), the waiting area (OR = 1.671, P = 0.002) and the cleanness of pharmacy (OR = 2.307, P = 0.001).

CONCLUSION

This study underlines the main components of patient satisfaction who receive pharmaceutical services in PMoH. It is highly recommended that PMoH must address patient dissatisfaction points in a total quality management plan.

Patient satisfaction and associated factor at red cross pharmacies in Addis Ababa, Ethiopia

BACKGROUND

Patient satisfaction is a crucial aspect of healthcare, reflecting the positive feelings patients experience when using a service. It serves as an indicator of the gap between expected and actual service quality from the patient's perspective. Measuring patient satisfaction is recommended for healthcare providers at all levels as it contributes to improvement efforts. In recent times, pharmacy services have evolved beyond merely supplying medications to becoming more patient-centered and caring. Given the high number of patients relying on the limited Red Cross community pharmacies in the city, this study aims to assess patient satisfaction and identify factors associated with patient satisfaction towards Red Cross Pharmacies in Addis Ababa, Ethiopia.

PATIENTS AND METHODS

Cross sectional study design was conducted from August 15 to August 30, 2022 in three Red Cross Pharmacies in Addis Ababa. Patients were selected by Convenience sampling technique. Structured questionnaire was used to assess patient satisfaction. Bivariate and Multivariate logistic regression were computed to assess statistical association between the outcome variable, and independent variables. SPSS version 21 was used for analysis.

RESULTS

Four hundred seven participants were willing and completed the study. The overall satisfaction towards Red Cross pharmacy service was 60.4%. Inadequate counselling was main reason for dissatisfaction (45%). Regarding associated factors, unavailability of some medications (Adjusted odds ratio = 0.393, 95% CI: 0.208-0.741), unfair medication cost (Adjusted odds ratio = 0.613, 95% CI: 0.607-0.910), and lack of organized pharmacy work flow (Adjusted odds ratio = 0.105, 95% CI: 0.049-0.221) were negatively associated with clients' satisfaction.

CONCLUSION

This study provides significant insights into patient satisfaction with Red Cross pharmacy services in Addis Ababa, Ethiopia, revealing an overall patient satisfaction rate of 60.4%. While a substantial number of patients had positive experiences, dissatisfaction due to inadequate counseling was a notable concern. Factors negatively associated with patient satisfaction, including medication unavailability, unfair cost, and a lack of organized workflow, further highlight the need for targeted interventions to improve patient experiences. Addressing these issues will be critical to enhance pharmaceutical care services and bridge the gap between patient needs and satisfaction.

Publics’ Perceptions of Community Pharmacists and Satisfaction with Pharmacy Services in Al-Madinah City, Saudi Arabia: A Cross Sectional Study

Background and Objectives: Pharmacists play a major role in serving patients and delivering pharmaceutical services to the community. It is unclear whether the public fully appreciates what pharmacists can do as key health care providers. This study aims to examine public perceptions of community pharmacists and levels of satisfaction with pharmacy services. Materials and Methods: A cross-sectional study was conducted on a randomly selected sample population (n = 1000) in Saudi Arabia over a period of six months from January through June 2019. A 40-item, structured, self-administered questionnaire was used, comprised of questions on the demographics characteristics of the respondents and their satisfaction with pharmacy services. Descriptive statistics were used to analyze the data. Results: The response rate of the survey was 76.92%. Public opinions were influenced by pharmacists’ availability and knowledge, service promptness, and counseling services. Overall, 80.5% of respondents agreed that community pharmacists treat them with respect. Doctors were identified as the preferred source of drug therapy consultation by 58.7% and pharmacists by 41.29%. About 72.8% of respondents agreed that pharmacists provided them with clear instructions about medication use, and 70.2% trusted pharmacists’ opinions about medications. About 62.5% of respondents expressed satisfaction with pharmacists, and 64.8% with pharmacy services. Conclusions: Customers’ opinions were influenced by pharmacists’ availability and knowledge, pharmacy service promptness, pharmacy location, waiting area, medication knowledge, and counseling. However, the public was greatly satisfied with community pharmacists’ professionalism and pharmaceutical services. This positive perception provides an opportunity for pharmacists to extend their roles as healthcare professionals.

A pilot study to assess the need for new hospital pharmaceutical services in Algerian patients and physicians’ perspective

Objectives

The objective of this study was to assess the needs for pharmaceutical services from the perspectives of physicians and patients in the hospital setting and to contribute to the implementation of new hospital pharmacy activities.

Methods

A cross-sectional descriptive study was carried out among the doctors and patients encountered in hospital departments in Sidi Bel Abbès (Algeria); each service was evaluated using a Likert scale. Associated characteristics with an important need were evaluated by univariate analysis and binary logistic regression.

Key findings

All pharmaceutical services were important to the patients, particularly providing treatment advice and therapeutic education. Women presented an important need for insurance of the availability of pharmaceutical products (P = 0.02) and lifestyle and dietetic information (P = 0.05). High frequency of taking medication was associated with an important need for information about drug interactions (P = 0.005). Patient-oriented pharmaceutical services were not important to the physicians who considered drug information and therapeutic education to be the most important need.

Conclusions

To implement patient-centred services, it is important to improve the contact between pharmacists and physicians and to provide information about pharmaceutical services that can benefit patients. Implementation of new practices in university hospital is more feasible than in public health facilities.

Exploring satisfaction level among outpatients regarding pharmacy facilities and services in the Kingdom of Saudi Arabia; a large regional analysis

Background

Evaluation of patients`satisfaction towards pharmacy services is of utmost importance to ensure the quality of care. It helps in identifying domains requiring improvements to provide high quality pharmacy services to ensure the provision of enhanced pharmaceutical care. The current study aims to ascertain the extent of satisfaction towards pharmacy services among patients attending outpatient pharmacies in Kingdom of Saudi Arabia.

Methods

A hospital-based cross-sectional study involving 746 patients attending outpatient pharmacies of various public hospitals was conducted from 01 January to 15 February 2020. Information on socio-demographic profile of the study subjects along with their satisfaction towards outpatient pharmacy was extracted by using a 23-items questionnaire. These questions were divided into two domains including 7 questions related to the pharmacy facilities (questions from 1F to 7F) and 8 questions for pharmacy services (questions from 1S to 8S), where F and S denotes facilities and services, respectively. The cumulative satisfaction score was estimated by a 5-item Likert scale with a maximum score of 5 for each item. The relationship between demographics and satisfaction scores was evaluated by using appropriate statistics.

Results

There were 746 patients with male preponderance (58.8%). The overall satisfaction score was 2.97 ± 0.65. Satisfaction towards pharmacy services scored lower (mean score: 3.91 ± 0.77) than pharmacy facilities (mean score: 4.03 ± 0.66). Items related to patient`s counseling (3F, 2S, 3S, 6S) scored least during the analysis. Older patients (p = 0.006), male gender (p<0.001), Saudi nationality (0.035), patients attending primary care centers (p = 0.02), and patients with chronic illnesses were significantly associated with lower satisfaction score.

Conclusion

This study reported that the satisfaction level of patients attending outpatient pharmacies was low and differed among various socio-demographic groups. Approximately one-half of the patients were not satisfied with outpatient pharmacy services. These findings underscore the dire need for managerial interventions including the hiring of trained professionals, onsite training of pharmacy staff, initiation of clinical or patient centered pharmacy services, evaluation of patient`s response towards the services and appropriate controlling measures, irrespective to the type of hospitals.

Factors associated with patient satisfaction towards pharmacy services among out-patients attending public health clinics: Questionnaire development and its application

Introduction

Patient satisfaction is widely used to measure quality of healthcare by identifying potential areas for improvement. Aim of study is to assess patient satisfaction towards pharmacy services and its associated factors using newly developed questionnaire among outpatients attending public health clinics.

Materials and methods

Public Health Clinic Patient Satisfaction Questionnaire (PHC-PSQ) towards pharmacy services was developed using exploratory factor analysis and Cronbach’s α. A cross-sectional study was conducted among 400 patients visiting the pharmacy in three randomly selected public health clinics recruited via systematic random sampling. Data was collected using a set of questionnaire including PHC-PSQ. Factors associated with patient satisfaction was analysed using multiple linear regression.

Results

Final PHC-PSQ consisted of three domains (administrative competency, technical competency and convenience of location) and 22 items with 69.9% total variance explained. Cronbach's α for total items was 0.96. Total mean score for patient satisfaction was 7.56 (SD 1.32). Older age and higher education were associated with lower patient satisfaction mean score. Patients who had visited the pharmacy more than once in the past three months, perceived to be in better health status and had a more correct general knowledge of pharmacists expressed higher patient satisfaction mean score.

Conclusions

PHC-PSQ is a newly developedtool to measure patient satisfaction towards pharmacy services in public health clinics in Malaysia. Patient satisfaction was relatively high. Age, education, frequency of visit, self-perceived health status and general knowledge of pharmacists were factors significantly associated with patient satisfaction.

Examining the association between the "My Pharmacist" model and the service quality of community pharmacies

BACKGROUND

In Japan, patients can freely choose medical facilities. Many visit different medical facilities for different diseases, and for convenience, often utilize the pharmacies neighboring these facilities. Accordingly, a "My Pharmacy" model was recommended, in which patients select a single pharmacy using their own judgement to receive proper medication services. A "My Pharmacist" model, in which the pharmacist is constantly involved in the treatment of a patient, was also proposed. However, patients' evaluations of pharmacist/pharmacy services under these models have not been investigated.

OBJECTIVE

To examine how a patient's constant involvement with the same pharmacist and pharmacy is associated with their evaluation of the quality of pharmacy services.

METHODS

A cross-sectional survey using a self-administered questionnaire was conducted among patients who used pharmacies periodically. Patients evaluated the pharmacist/pharmacy services and were classified into 4 groups ("My Pharmacy/My Pharmacist," "My Pharmacy/Multiple Pharmacists," "Multiple Pharmacies/My Pharmacist," and "Multiple Pharmacies/Multiple Pharmacists") according to the form of their usage of pharmacies and pharmacists. An intergroup comparison was then performed and correlations within each group analyzed.

RESULTS

Data from 3,492 individuals using 147 pharmacies were analyzed. "My Pharmacy" users had significantly higher scores than did "Multiple Pharmacies" users on patient experience of proper medication services (e.g., identifying duplicate medication) (p < 0.001). "My Pharmacy/My Pharmacist" users scored higher than the other three groups on four evaluation factors, including "pharmacy/pharmacist's interpersonal services" ("sharing and utilizing patient information," "enhanced health support function," and "consideration towards patients"), "patient satisfaction with the pharmacy," "placing more emphasis on quality of interaction with pharmacist than on waiting time," and "attitude when visiting healthcare facilities" (all p < 0.001).

CONCLUSION

The findings indicate that highly tailored, in-person services provided by "My Pharmacists" are associated with not only with the degree of patients' overall satisfaction, but also their evaluation of "the quality of pharmacist services."

Comparison of patient satisfaction with pharmaceutical services of postal pharmacy and community pharmacy

Background

The growing drive in South Africa to contain medicine cost has seen the emergence of postal pharmacy as an alternative mechanism to dispense chronic medicines. Patient satisfaction with pharmaceutical services has received limited attention in South Africa.

Aim

The aim of this study was to compare the level of patient satisfaction with pharmaceutical services between postal and community pharmacies.

Setting

The research was conducted in the eThekwini Municipality, KwaZulu- Natal Province, South Africa in July and August 2014.

Methods

A cross-sectional quantitative study using a randomised, telephonic questionnaire survey was conducted. Selected land telephone numbers were called until a sample size of 250 community pharmacy participants and 125 postal pharmacy participants was obtained.

Results

Nine hundred and five telephone calls were made to obtain a sampling frame of 375 (41.44%) respondents, 250 for community and 125 for postal. After adjusting overall satisfaction by removing financial satisfaction, there was no significant difference between satisfaction in the two groups (p = 0.471). Postal pharmacy participants reported a higher level of financial satisfaction (p = 0.001). Community pharmacy participants reported a higher level of satisfaction with counselling or explanation (p = 0.028) and less medicine wastage (p < 0.001).

Conclusions

Patient satisfaction with pharmaceutical services provided by either community or postal pharmacy was not significantly different. However, community pharmacies tend to address patients' specific concerns more effectively. With the move to National Health Insurance, policymakers need to ensure that they provide high-quality pharmaceutical services and are more inclusive of community pharmacies to deliver quality care.

What Do Customers Demand from Drug Stores in Japan? Construct Validity and Factor Structure of a Cross-Sectional Survey

Studies concerning patient demands are mainly conducted at hospitals and pharmacies, whereas few surveys have been conducted on drug stores. The demand for drug stores is estimated to be increasing with growing needs for self-medication. Thus, conducting a customer survey at drug stores is thought to be valuable. The aim of the current study was to clarify the structure of customers’ demands for drug stores. The survey was conducted on 190 customers of 19 drug stores in Japan. The questionnaire consisted of 24 items using a 9-point Likert scale. The IBM SPSS Statistics version 23 (IBM Japan, Tokyo, Japan) and Amos version 5 (IBM Japan, Tokyo, Japan) were utilized to perform factor analysis. Gender did not influence the response to each question. Factor analysis showed that the structure of customers’ demands consisted of three factors: (1) an explanation about medicine, (2) staff’s manners, and (3) location of drug stores. Because fit indices suggested a good fit, this three-factor solution was adopted as the final factor structure. This study demonstrated the structure of customers’ demands for drug stores, with the potential for use in promotion of self-medication.

A qualitative study on pharmacists' perception on integrating pharmacists into private general practitioner's clinics in Malaysia

BACKGROUND

Private general practitioners in Malaysia largely operates as solo practices - prescribing and supplying medications to patients directly from their clinics, thus posing risk of medication-related problems to consumers. A pharmacy practice reform that integrates pharmacists into primary healthcare clinics can be a potential initiative to promote quality use of medication. This model of care is a novel approach in Malaysia and research in the local context is required, especially from the perspectives of pharmacists.

OBJECTIVE

To explore pharmacists' views in integrating pharmacists into private GP clinics in Malaysia.

METHODS

A combination of purposive and snowballing sampling was used to recruit community and hospital pharmacists from urban areas in Malaysia to participate either in focus groups or semi-structured interviews. A total of 2 focus groups and 4 semi-structured interviews were conducted. Sessions were audio recorded, transcribed verbatim and thematically analysed using NVivo 10.

RESULTS

Four major themes were identified: (1) Limited potential to expand pharmacists' roles, (2) Concerns about non-pharmacists dispensing medicines in private GP clinics, (3) Lack of trust from consumers and private GPs, (4) Cost implications. Participants felt that there was a limited role for pharmacists in private GP clinics. This was because the medication supply role is currently undertaken in private GP clinics without the need of pharmacists. The perceived lack of trust from consumers and private GPs towards pharmacists arises from the belief that healthcare is the GPs' responsibility. This suggests that there is a need for increased public and GP awareness towards the capabilities of pharmacists' in medication management. Participants were concerned about an increase in cost to private GP visits if pharmacists were to be integrated. Nevertheless, some participants perceived the integration as a means to reduce medical costs through improved quality use of medicines.

CONCLUSION

Findings from the study provided a better understanding to help ascertain pharmacists' views on their readiness and acceptance in a potential new model of practice.

Community pharmacy in Lebanon: A societal perspective

Objective:

To assess patients’ attitudes towards the community pharmacist’s role and determine their negative and positive reactions towards community pharmacists in Lebanon.

Methods:

A cross-sectional study, conducted between January and April 2016, was designed to assess the general public satisfaction with the services provided by the community pharmacies. It was carried out, using a proportionate random sampling of Lebanese community pharmacies from each district. Two sided statistical tests were used to compare between group percentages, Wilcoxon test for quantitative variables with non-homogeneous variances or non-normal distribution, and Student’s t-test for quantitative variables of normal distribution and homogeneous variances. The ANOVA test was used to compare between three groups or more, and Pearson correlation coefficient were used to correlate between quantitative variables.

Results:

a total of 565 participants completely answered the survey questions with a response rate of 94%. The bivariate analysis showed that the patient perception index was positively and significantly correlated with the patient level of expectation index, the overall pharmacy experience and the patient’s reason for visiting the pharmacy (p<0.001 for all 3 variables) but was negatively correlated with the barriers for asking questions significantly (p=0.032). On the other hand, this perception index was significantly and positively associated with the number of pharmacy visits, the age categories, the level of education and the family monthly income (p<0.05 for all variables).

Conclusion:

Public perception and attitude toward community pharmacist in Lebanon is poor despite highly qualified pharmacists. Aspects of pharmacy services most relevant to patients were respect, empathy, a friendly staff, listening carefully, giving quality time, responding quickly to their needs and respecting their privacy. The ministry of Health in Lebanon, along with the Lebanese Order of Pharmacists should educate the pharmacist about working on the different issues patients are complaining about in order to play a more important role in the society and become the number one trusted health care professional.

Patients'/Clients' Expectation Toward and Satisfaction from Pharmacy Services

OBJECTIVE

Satisfaction is becoming a popular health-care quality indicator as it reflects the reality of service or care provided. The aim of this study was to assess the level of patients' expectation toward and satisfaction from pharmacy service provided and to identify associated factor that might affect their expectation and satisfaction.

METHODS

A cross-sectional study was conducted on 287 patients, who were served in five pharmacies of Gondar University Hospital in May 2015. Data regarding socio-demographic characteristics and parameters that measure patients' expectation and satisfaction were collected through interview using the Amharic version of the questionnaire. Data were entered into SPSS version 21, and descriptive statistics, cross-tabs, and binary logistic regressions were utilized. P < 0.05 was used to declare association.

FINDINGS

Among 287 respondents involved in the study, 149 (51.9%) claimed to be satisfied with the pharmacy service and setting. Two hundred and twenty-nine (79.4%) respondents have high expectation toward gaining good services. Even though significant association was observed between the pharmacy type and patients level of satisfaction, sociodemographic characteristics of a patient were not found to predict the level of satisfaction. There is a higher level of expectation among study participants who earn higher income per month (>(2000 Ethiopian birr [ETB]) than those who get less income (<1000 ETB).

CONCLUSION

Although patients have a higher level of expectation toward pharmacy services, their satisfaction from the service was found to be low.

Perceptions of pharmacists and patients on information provision and their influence on patient satisfaction in Japanese community pharmacies

RATIONALE, AIMS AND OBJECTIVES

The provision of information is now considered a major area in pharmacist-patient interactions. However, few reports have simultaneously evaluated patient and pharmacist perceptions with regard to the pharmacist's information provision. The aims were to clarify the perceptions of pharmacists and patients regarding information provision and the level of influence of those perceptions on patient satisfaction.

METHODS

A cross-sectional survey with respect to information provision was conducted for patients and pharmacists in community pharmacies in Fukuoka Prefecture, Japan. In total, 407 patient-pharmacist pairs were included in a t-test and multilevel analysis.

RESULTS

The levels of patient perception regarding information provision were significantly higher than the levels of pharmacist perception in all variables. The pharmacists' perceived level of information provision concerning medication effects had a negative and significant association with patient satisfaction, while the patients' perceived level of information provision by the pharmacist had a positive and significant association with patient satisfaction. Higher patient expectations regarding the level of information provision concerning medication side effects and older age of the pharmacist were adversely related to patient satisfaction. Both pharmacist and patient perceptions of the information provision by pharmacists personalized to the patient had positive associations with patient satisfaction.

CONCLUSIONS

Pharmacist perceptions related to the information provision were not associated with patient satisfaction. The present study highlights accurate information provision, building good patient-pharmacist relationships, and improving pharmaceutical care in community pharmacy settings.

Predictive Factors of Patient Satisfaction with Pharmacy Services in South Korea: A Cross-Sectional Study of National Level Data

OBJECTIVES

Patient satisfaction has emerged as a prerequisite to improving patients' health behaviors leading to better health care outcomes. This study was to identify predictive determinants for patient satisfaction with pharmacy services using national-level data.

METHODS

A cross-sectional evaluation was conducted using 2008 Korean National Health and Nutrition Examination Survey (KNHANES) data. To assess the predictive factors for patient satisfaction with pharmacy services, an ordinal logistic regression model was conducted adjusting for patient characteristics, clinical comorbidities, and perception of health.

RESULTS

A total of 9,744 people, a representative sample of 48.2 million Koreans, participated in the 2008 KNHANES, of whom 2,188 (23.6%) reported visits to pharmacy within the last 2 weeks prior to the survey. Of the patients who visited the pharmacy, 74.6% reported to be either "very satisfied" or "satisfied," and 25.4% responded as being "neutral," "dissatisfied," or "very dissatisfied." A multivariate ordinal logistic regression analysis with weighted observations revealed that patients with fair perception of health (adjusted OR 1.32; 95% CI 1.01-1.74; p<0.05) and those with middle to low family incomes (adjusted OR 1.34; 95% CI 1.02-1.76; p<0.05) were more likely to be satisfied with pharmacy services, and employment-based insurers were less likely to be satisfied with pharmacy services (adjusted OR 0.80; 95% CI 0.65-0.97; p<0.05).

CONCLUSION

Our findings indicated that three out of four patients expressed satisfaction toward pharmacy services. Middle to low family incomes, fair perception of health, and employee insured individuals were significant predictors of patient satisfaction with pharmacy services.

A non-clinical randomised controlled trial to assess the impact of pharmaceutical care intervention on satisfaction level of newly diagnosed diabetes mellitus patients in a tertiary care teaching hospital in Nepal

Background

Patient satisfaction is the ultimate goal of healthcare system which can be achieved from good patient-healthcare professional relationship and quality of healthcare services provided.

Study was conducted to determine the baseline satisfaction level of newly diagnosed diabetics and to explore the impact of pharmaceutical care intervention on patients’ satisfaction during their follow-ups in a tertiary care teaching hospital in Nepal.

Methods

An interventional, pre-post non-clinical randomised controlled study was designed among randomly distributed 162 [control group (n = 54), test 1 group (n = 54) and test 2 group (n = 54)] newly diagnosed diabetes mellitus patients by consecutive sampling method for 18 months. Diabetes Patient Satisfaction Questionnaire was used to evaluate patient’s satisfaction scores at baseline, three, six, nine and, twelve months’ follow-ups. Test groups patients were provided pharmaceutical care whereas control group patients only received their usual care from physician/nurses. The responses were entered in SPSS version 16. Data distribution was not normal on Kolmogorov-Smirnov test. Non-parametric tests i.e. Friedman test, Mann-Whitney U test and Wilcoxon signed rank test were used to find the differences among the groups before and after the intervention (p ≤0.05).

Results

There were significant (p < 0.001) improvements in patients’ satisfaction scores in the test groups on Friedman test. Mann-Whitney U test identified the significant differences in satisfaction scores between test 1 and test 2 groups, control and test 1 groups and, control and test 2 groups at 3-months (p = 0.008), (p < 0.001) and (p < 0.001), 6-months (p = 0.010), (p < 0.001) and (p < 0.001), 9-months (p < 0.001), (p < 0.001) and (p < 0.001) and, 12-months (p < 0.001), (p < 0.001) and (p < 0.001) follow-ups respectively.

Conclusion

Pharmaceutical care intervention significantly improved the satisfaction level of diabetics in the test groups compare to the control group. Diabetic kit demonstration strengthened the satisfaction level among the test 2 group patients. Therefore, pharmacist can act as a counsellor through pharmaceutical care program and assist the patients in managing their disease. This will not only modify the patients’ related outcomes and their level of satisfaction but also improve the healthcare system.

Clients' expectations from and satisfaction with medicine retail outlets in Gondar town, northwestern Ethiopia: a cross-sectional study

Purpose

The aim of this study was to assess clients’ level of expectation from and satisfaction with medicine retail outlets (MROs) in Gondar town, northwestern Ethiopia.

Patients and methods

An institutions-based cross-sectional study was conducted from April 20 to May 5, 2014, by sampling five pharmacies and eight drug stores through simple random sampling. Clients, 424, who came to the MROs during the study period were included in the study. Data were collected using structured questionnaires measuring expectations and satisfaction of clients using a Likert scale of 1–5 through face-to-face interviews.

Results

Out of the total 424 interview encounters, 422 (99.5% response rate) questionnaires were included in the analysis, of which 61.1% were of males. The overall mean expectation of respondents toward MRO setting and services was 3.82 and that of satisfaction of the respondents was 3.02. More than three-quarters (76.8%) of the respondents expected medicines in affordable prices from MROs, but nearly half (44.8%) were not satisfied with it. Much more than half (58.5%) of the respondents were dissatisfied with the comfort and convenience of private counseling area. Also, nearly half (47.6%) of the respondents claimed that pharmacy professionals did not provide information regarding the storage condition of medications. There was statistically significant difference in overall expectation (t=2.707, P=0.007) and satisfaction (t=2.260, P=0.024) with the setting and services of MROs between respondents who claimed to know the difference between a pharmacy and a drug store and those who claimed they did not.

Conclusion

Clients’ expectation from MRO services was high, with average satisfaction. The overall expectation and satisfaction of the respondents toward MROs were lower in those who reported they did not know the difference between a pharmacy and a drug store than in those who claimed to know the difference. Supportive supervision by the town’s health bureau on the MROs is recommended to help improve clients’ satisfaction.

Australian mental health consumers' and carers' experiences of community pharmacy service

BACKGROUND

Many Australians with anxiety or depression experience issues accessing pharmacological treatment even though community pharmacies are remunerated to supply subsidized medicines and provide medicine management services.

OBJECTIVE

To obtain insight into the quality of community pharmacy services from the perspectives of mental health consumers and carers.

METHODS

A computer-assisted telephone interview was used to gauge perceptions of pharmacy service using frameworks of service quality and patient-centred care. A convenience sample of 210 consumers and carers from three Australian states completed an interview comprising rating scales, multiple choice checklists and open-ended questions to explore their experience of pharmacy services.

RESULTS

Participants were consumers experiencing on-going mental health condition(s) (n = 172), carers for someone who experienced a mental health condition (n = 15) or both (n = 23). For 60% of participants, medicines were dispensed within ten minutes of arriving at the pharmacy, and 36% received verbal advice. The majority of participants were not asked by pharmacy staff whether they experienced side-effects, and 60% reported rarely or never receiving written medicine information. However, the majority of participants reported that their expectations were met despite the absence of such services. Qualitative data showed that participants valued high-quality services that reflected patient-centred care, and they were inclined to engage with these services particularly if they perceived them as surpassing basic expectations.

DISCUSSION AND CONCLUSIONS

Participants clearly valued high-quality pharmacy service yet did not routinely expect it. When service exceeded expectations, community pharmacies were viewed as safe health-care spaces to seek advice on mental health and well-being. This study has positive implications for the role of pharmacists.

Comparison of factors influencing patient choice of community pharmacy in Poland and in the UK, and identification of components of pharmaceutical care

BACKGROUND

Several factors, which are components of pharmaceutical care, can influence a patient's choice of a community pharmacy store and contribute to frequent visits to the same pharmacy.

OBJECTIVES

To compare factors that influence a patient's choice of pharmacy in Poland and in the UK, to identify which of them are components of pharmaceutical care, and to relate them to patient loyalty to the same pharmacy.

METHODS

A self-administered, anonymous questionnaire was distributed to clients visiting pharmacies in Poland and the UK January-August 2011. Comparisons were performed using chi-square tests and logistic regression. All statistical analyses were performed using SPSS 20.0.

RESULTS

The response rate was 55.6% (n=417/750; 36 pharmacies) and 54.0% (n=405/750; 56 pharmacies) in Poland and in the UK, respectively. The most frequently reported factors, as defined by a percentage of responders, were in Poland: 1) location (84%); 2) professional and high-quality of service (82%); 3) good price of medicines (78%); and 4) promotions on medicines (66%). In the UK, the most commonly reported factors were: 1) professional and high quality of service (90%); 2) location (89%); 3) good advice received from the pharmacist (86%); and 4) option of discussing and consulting all health issues in a consultation room (80%). Good advice and an option of discussing personal concerns with a pharmacist are components of pharmaceutical care. Thirty-eight percent of patients in Poland and 61% in the UK declared visiting the same pharmacy.

CONCLUSION

Components of pharmaceutical care are important factors influencing the patient's choice of pharmacy in the UK and, to a lesser degree, in Poland. Additionally, more patients in the UK than in Poland are committed to a single pharmacy. Therefore, implementing the full pharmaceutical care in Poland may contribute to an increase in patient loyalty and thus strengthen competitiveness of pharmacy businesses.

A study investigating the level of satisfaction with the health services provided by the Pharmacist at ENT hospital, Eastern Region Alahsah, Kingdom of Saudi Arabia

The current study aims to evaluate the patient's level of satisfaction with health care services provided by the pharmacist at Aljaber ENT hospital, Eastern Region Alahsah, Kingdom of Saudi Arabia. A cross sectional study was planned from 1st March 2011 until 31st May 2011. A 27 item questionnaire was used, scoring of the responses was done to classify the patient satisfaction into sublevels. The maximum possible score was 36; those scoring less than twenty were graded as poor satisfaction level followed by moderate satisfaction level 21-25, good satisfaction level 26-30 and high satisfaction level 31-36. Statistical package for social science version 13® was used to analyze data, One-way ANOVA and independent sample t-test were applied to see the differences in the level of satisfaction. Every third patient visiting pharmacy was given a chance to participate in this study. A total of N = 991 patients were randomized using the pharmacy appointment number. Of whom 657 patients have shown willingness to participate in this study. The response rate of this study was 66.30%, most of the respondents 383 (58.1%) were male ranging from the age group of 21-40 years with a mean age of 32 years SD 9.73. The mean score for all patients was 26.15 SD ±3.4. Among all the demographic variables a significant difference in satisfaction level was found among in terms of age (df = 8, F = 8.36, p = <0.001(∗)), gender (t = -4.089, df = 656, p=<0.001(∗)) and race (df = 2, F = 8.47, p = <0.001. The satisfaction level among Saudi nationals was least in comparison to Egyptians and others. In general, it is seen that respondents of age 56-60 years were most satisfied with the healthcare services provided by the pharmacist. In addition, the satisfaction level was higher among female patients in comparison to men.

Prevalence and Usage of Printed and Electronic Drug References and Patient Medication Records in Community Pharmacies in Malaysia

This study aimed to determine the availability and usage of printed and electronic references and Patient Medication Record in community pharmacy. It was conducted for over 3 months from 15 January to 30 April 2007. Ninety-three pharmacies participated. Structured questionnaires were mailed to community pharmacies. Six weeks later a reminder was sent to all non responders, who were given another six weeks to return the completed questionnaire. Outcomes were analyzed using descriptive statistics and chi-square test of independence. Almost all the pharmacies (96.8%) have at least Monthly Index of Medical Specialties (MIMS) while 78.5% have at least MIMS ANNUAL in their stores. Only about a third (31.2%) of the pharmacies were equipped with online facilities of which the majority referred to medical websites (88.9%) with only a minority (11.1%) referring to electronic journals. More than half (59.1%) of the pharmacists kept Patient Medication Record profiles with 49.1% storing it in paper, 41.8% electronically and 9.1% in both printed and electronic versions. In general, prevalence and usage of electronic references in community pharmacies were rather low. Efforts should be increased to encourage wider usage of electronic references and Patient Medication Records in community pharmacies to facilitate pharmaceutical care.

Patients' perception, views and satisfaction with pharmacists' role as health care provider in community pharmacy setting at Riyadh, Saudi Arabia

OBJECTIVES

This study will provide guiding information about the population perception, views and satisfaction with pharmacist's performance as health care provider in the community pharmacy setting in Riyadh, Saudi Arabia.

METHOD

The study was conducted in Riyadh, Saudi Arabia, from July through December 2010. A total of 125 community pharmacies in Riyadh city were randomly selected according to their geographical distribution (north, south, east, and west). They represent about 10-15% of all community pharmacies in the city. The questionnaire composed of 8 items about patients' views and satisfaction with the pharmacists' role in the current community pharmacy practice. The questionnaire was coded, checked for accuracy and analyzed using the Statistical Package for Social Sciences (SPSS) version 17.0 for Windows (SPSS Inc., Chicago, Illinois).

RESULTS

The response rate was almost 85% where 2000 patients were approached and 1699 of them responded to our questionnaire. The majority of respondents is young adults and adults (82.8%), male (67.5%) and married (66.9%). Seventy one percent of respondents assured that community pharmacist is available in the working while only 37.3% of respondents perceived the pharmacist as a mere vendor. About 38% assured sou moto counseling by the pharmacist, 35% reported pharmacist plays an active role in their compliances to treatments, 43% acknowledged the role of pharmacist in solving medication related problems, 34% considered the pharmacist as a health awareness provider and 44.6% felt that pharmacist is indispensable and an effective part of the health care system.

CONCLUSION

The image and professional performance of community pharmacist are improving in Saudi Arabia. The Saudi patients show better satisfaction, perception and appreciation of the pharmacists' role in the health care team. However, extra efforts should be paid to improve the clinical skills of the community pharmacists. Community pharmacists need to be able to reach out to patient, assess their hesitations and promptly offer solution which was appreciated by the patients as the survey indicates. They should play a pro-active role in becoming an effective and indispensable part of health care. Furthermore, they should be able to advice, guide, direct and persuade the patient to comply correct usage of drugs. Finally, community pharmacists should equip themselves with appropriate knowledge and competencies in order to tender efficient and outstanding pharmaceutical health care.

Consumer attitudes towards community pharmacy services in Saudi Arabia

Objective

The purpose of this study was to determine consumer attitudes towards community pharmacy and their preferences for the introduction of new services.

Methods

A self-completion questionnaire was developed and 1,144 consumers in 55 community pharmacies were invited to complete it. The questionnaire covered consumers' choice of pharmacy; their perceptions of, and actual interactions with, community pharmacists; advice from pharmacists about general health and prescribed medicines; and privacy in the pharmacy. Respondents were asked for their views about five possible new services.

Setting

The study was based in community pharmacies in Riyadh City, Saudi Arabia.

Key findings

The response rate was 79.6%. Fifty-nine per cent of respondents often or sometimes visited a particular pharmacy. One-quarter of respondents perceived community pharmacists as having a good balance between health and business matters, while 56.1% thought pharmacists were more concerned with the business. The majority of respondents (69.7%) said they felt comfortable asking the pharmacist for advice. Just under half (44.8%) felt that pharmacists allowed them enough time to discuss their problem fully and listened well. In addition, 58.5% of respondents indicated that their pharmacists showed sensitivity to privacy by speaking more quietly across the counter. In 14.4% of situations pharmacists were reported to use a private area within the pharmacy when discussing personal or private matters. Most respondents (65.2%) indicated that their pharmacist was willing to discuss their health problems and tried to understand their feelings. Consumers' priorities for new services were: monitoring blood pressure; measuring weight, height and temperature; monitoring blood sugar; and monitoring cholesterol.

Conclusion

This study showed that most pharmacy customers feel comfortable seeking advice from their pharmacist. Although many pharmacists were reported to show sensitivity to a possible lack of privacy in the pharmacy, few respondents reported that their pharmacy had a private area for discussion. Customers' views on possible new services were generally positive, with the exception of patient medication records.

Assessment of patient satisfaction with pharmaceutical services in a Nigerian teaching hospital

Objective

To assess patients' satisfaction with pharmaceutical services using an“ideal referent” model, and to further explore the validity of an existing patient satisfaction instrument.

Method

A cross-sectional survey was conducted with a sample of 500 outpatients recruited consecutively at the University of Benin teaching hospital, Nigeria. A self-completion questionnaire that employed a Likert-type scale was used. Data were used to calculate scores on a scale that ranged from 20 to 100, with an assumed midpoint of 60. Descriptive statistics on the sample characteristics and questionnaire items were computed including means, standard deviations and frequency distributions. Varimax rotation with Kaiser normalisation was employed in principal factor analysis. Student's t-test and one-way ANOVA were used for inferential statistics.

Key findings

The instrument reliability was determined to be 0.9641 and was comparable to the reference study. Nearly half of the patients (46%) rated the amount of time the pharmacist offered to spend with them as poor. About one-third rated promptness of prescription service as poor. Only 49% felt satisfied with the pharmaceutical services. Overall, pharmacy services received a satisfaction rating of 56.04±24.49, below the midpoint. Perceived satisfaction was significantly higher in “friendly explanation” than in “managing therapy” (t=3.916; P&lt;0.0001).

Conclusion

The study provides evidence that patients experience low satisfaction with current pharmaceutical services at the study hospital. The sociodemographic characteristics of patients were not associated with their level of satisfaction. We further confirm the validity of the patient satisfaction questionnaire in a Nigerian practice setting.

Study of two-dimensional barcode prescription system for pharmacists' activities of NHI contracted pharmacy

To lower the cost and enhance the quality of healthcare service, the Taiwan government launched National Health Insurance (NHI) in 1995 and the System of Separation of Medicine and Pharmacy in 1997. After the separation of dispensing and prescribing (SDP), pharmacists in NHI-contracted pharmacies have the right to fill prescriptions from a clinic. This means that pharmacists in NHI-contracted pharmacies have four more activities than previously. How to improve the additional activities remains an issue to be solved. Today, in most countries, patients deliver a written prescription to the pharmacy of their choice. The pharmacist validates the prescription and dispenses the drug. In this paper, we describe an automatic data collection system, the two-dimensional barcode prescription system (2DBPS) for pharmacists. The system allows patients to deliver a paper prescription with a 2D barcode issued by a clinic to the pharmacy of their choice. The pharmacist scans in the 2D barcode, validates the prescription, and dispenses the drug. Evaluation of the 2DBPS showed that most pharmacists use it to execute additional activities and it was more efficient than before. Moreover, the easy-to-use 2DBPS is accepted and appreciated by pharmacists. We can thus conclude that the aim of the 2DBPS is to reduce the workload of pharmacist in data processing. It will help pharmacists to expand their role beyond simple dispensing and data processing to providing pharmaceutical care services.

[Validation of a questionnaire on patient satisfaction with the dispensing service in community pharmacies]

OBJECTIVE

To analyze the validity and reliability of a patient satisfaction questionnaire about drug dispensing in Argentine community pharmacies.

DESIGN

Descriptive, cross-sectional study.

SETTING

Community pharmacies of Argentina that voluntarily agreed to take part in the study.

PARTICIPANTS

All patients or their careers who attended the pharmacies during the period of the study (March and April, 2006) and knew how to read and write.

MAIN MEASUREMENTS

Scores on the satisfaction scale of the questionnaire.

RESULTS

Twenty-seven pharmacies from 6 provinces of Argentina took part; 473 questionnaires were obtained with a 72.4% response rate. Factorial analysis revealed one single component that explained 54.8% of total variance. A 0.90 Cronbach's alpha coefficient was obtained and Pearson's correlation between each of the items and the total score on the scale showed that all items correlated with each other (P<.01). Patients expressed additional comments in 124 questionnaires (26.2%). These concerned the quality of care received and other aspects, such as gratitude, cost of medicines, insufficient stock, and friendliness.

CONCLUSIONS

The questionnaire, in showing evidence of content validity, validity as internal structure, validity related to other variables, and reliability, could assess patient satisfaction with the drug dispensing service in the community pharmacies of Argentina.

Designing pharmacy services based on grocery store patron preferences

OBJECTIVE

To assess preferences of grocery store patrons concerning pharmacy services and identify study participant characteristics that may predict the success of pharmacy services in the community setting.

DESIGN

Self-administered survey.

SETTING

Central Ohio from December 16, 2005, to January 12, 2006.

PARTICIPANTS

163 grocery store patrons.

INTERVENTIONS

Eight grocery store survey events.

MAIN OUTCOME MEASURES

Responses to survey items about (1) perceived importance of 28 pharmacy services, (2) identification of the 3 most important services, (3) frequency of grocery store and pharmacy use, (4) preferred methods of advertising pharmacy services, and (5) socioeconomic demographics. Preferred services delineated by various demographics also were analyzed.

RESULTS

A total of 163 surveys were returned from study participants. Nine services appeared in both the top 12 overall preferred services and the 12 highest-ranked services. Statistically significant differences were observed among services ranked as important or very important by age, race, employment, income, caregiver status, and prescription drug coverage status. The three advertising tools selected most frequently included: weekly grocery store ads (68.6%), in-store signs (51.0%), and flyers attached to prescription bags (36.0%).

CONCLUSION

Grocery store patrons would like a wide range of nontraditional pharmacy services that could be implemented into community pharmacies. Pharmacies in grocery stores need to provide both traditional and expanded pharmacy services to meet the desires and expectations of current and potential patients, and expanded marketing methods should be considered.

[Investigation on patient satisfaction at community pharmacies: analyzing questionnaire survey by structural equation modeling and multiple regression analysis]

Separation of the dispensing function and the prescribing function, Iyaku Bungyo, has been progressing in Japan. We are now witnessing the advent of a new society where patients select pharmacists and their satisfaction is recognized as one of the healthcare outcome indicators. It is necessary to clarify which factors affect patients' satisfaction with the services provided at community pharmacies and how they do so. A survey was conducted among 104 community pharmacies and their patients around the Tokyo metropolitan area in Japan. The questionnaire comprised 11 items (observed variables), each with a five-grade scale. With the transformed data-oriented pharmacy, the percentage of being not unsatisfactory was examined in two multivariate analyses of the relation and structure of patient satisfaction with a community pharmacy. Structural equation modeling (SEM) with factor analysis (FA) was performed using the observed variables and latent factors. Multiple regression analysis was performed with comprehensive satisfaction as an independent variable, examining the factors that affect comprehensive satisfaction with the pharmacy. The result of the FA indicated three latent factors of instruction on the use of drugs, quality of staff, and environment, based on which SEM model was constructed with a relatively high goodness of fit index. The result of multiple regression analyses indicated almost all variables such as satisfaction with reception by the pharmacist affected the comprehensive satisfaction, but privacy did not show a significant effect. These results, notably the relationship between each variables and latent factors, suggested the importance of higher skills of pharmacists, service qualities at pharmacies, and their functions adjusted to the community.

Consumer satisfaction with community pharmacies in Warri, Nigeria

BACKGROUND

Consumer satisfaction is likely to affect the image of the pharmacist and pharmacy profession. Efforts should not only be made to track consumer satisfaction with pharmacy services but also to improve it where needed.

OBJECTIVE

To investigate consumer satisfaction with community pharmacies in a Nigerian city.

METHODS

A cross-sectional survey of a consecutive sample of 700 pharmacy consumers at 35 randomly selected community pharmacies was conducted. Data were gathered on consumer demographics and their satisfaction with the community pharmacies using a 32-item rated instrument that combined pharmaceutical care and traditional pharmacy items. Descriptive statistics was computed on sample characteristics and the questionnaire items. Inferential statistics used Student's t test and one-way ANOVA.

RESULTS

The response rate for the survey was 71.9% (503/700). Cronbach's alpha test of reliability was computed to be 0.980. Of the respondents, 298 (59.2%), 284 (56.5%), and 101 (20.1%) rated their satisfaction as excellent regarding availability of genuine drugs, the pharmacist, and household consumer goods, respectively. The mean total score for pharmaceutical care items was found to be 3.50+/-1.32, while the mean total score for traditional pharmacy items was computed to be 3.56+/-1.34 (midpoint=3, range=1 to 5). Consumers' income status was associated with their satisfaction, with the lower income earners experiencing higher satisfaction (F=2.668, P=.050).

CONCLUSION

Consumers in this survey experienced moderate service satisfaction with their community pharmacy encounters. The consumers were most satisfied with the pharmacists' professional attitude but dissatisfied with the provision of nondrug services in the community pharmacy. These services are mainly health promotion activities that are advocated under pharmaceutical care philosophy. There is an opportunity for the community pharmacies to introduce new services and enhance their consumer loyalty.

Current state of community pharmacy in Japan: practice, research, and future opportunities or challenges

OBJECTIVE

To describe the activities related to pharmaceutical care and research in community pharmacies in Japan.

FINDINGS

Japan is an aging society; the proportion of elderly people aged at least 65 years was 19.9% in 2005 and is expected to rise to 26.0% by 2015. This increase will result in ballooning healthcare costs. To curb the huge and rapidly increasing expenditure on medical treatment, many structural reforms have been undertaken in Japan. The healthcare services in community pharmacies will also undergo reforms to meet social needs and patient/customer requirements. In 2006, the undergraduate pharmacy program offered by universities was changed to a 6 year program, including 6 months of clinical training in both hospitals and community pharmacies. This change should provide an opportunity for community pharmacists and academics to communicate with each other, and we anticipate that it will further the research in community pharmacies. Accreditation programs will also improve the level of health care.

DISCUSSION

The healthcare system should undergo reforms to address the problems related to Japan's low birth rate and the needs of an aging population. Such reforms are also required to ensure a healthy aging society and should not have adverse effects on socially vulnerable children and the elderly. Pharmacists should contribute to the development of a healthcare system for an aging society by providing appropriate pharmaceutical care. Since a large number of prescriptions are dispensed through community pharmacies, pharmacists have a greater opportunity to improve health care. In addition, pharmacist associations are encouraging their members to actively participate in home medical care services. An effective community healthcare program should reduce the need for institutional care.

CONCLUSIONS

Although Japanese pharmacists are not fully capable of providing pharmaceutical care at this stage, they will play a crucial role in ensuring a healthy aging society in the future, particularly in the community setting.

[Assessment of quality as perceived by users of an outpatient pharmaceutical care unit]

OBJECTIVE

To assess quality of care by an Outpatient Pharmaceutical Care Unit (OPCU) from patient satisfaction regarding the unit s premises and activities.

METHOD

A transversal study performed at the OPCU using a patient survey. Patient opinions were obtained regarding structural aspects, pharmaceutical care, patient information, overall satisfaction, and preference for care in the OPCU or pharmacy office. The response variable was the presumed choice for the OPCU or traditional pharmacy office. A multivariate analysis using logistic regression was used to evaluate the independent effect of variables.

RESULTS

In all, 256 surveys were administered, of which 195 were assessable. Response rate was 76%. Responses with highest scores included communication and interaction with professionals (4.8 points on average) and care received (4.5 points). Worst assessments included OPCU s timetable (3.8 points) and location (3.9 points); 98.4% of patients were satisfied or very satisfied with care received, and only 18.4% would switch to the pharmacy office if allowed to. The multivariate analysis suggested that variables associated with the pharmacy office choice included a negative rating of OPCU s location (OR 9.8, CI 1.3-76.8) and a negative rating of information delivered (OR 4.1, CI 1.7-9.8); p < 0.05.

CONCLUSIONS

Information received and OPCU s location had the greatest impact on patient satisfaction. Patient remarks and suggestions were very useful to identify areas of improvement, and to introduce modification suiting their views.

Assessing the pharmaceutical care needs of asthmatic patients

OBJECTIVES

To measure patients' perceptions of their care needs, by developing a tool to assess these needs and evaluate its utility in community pharmacy practice.

METHOD

A survey tool comprising 37 items was developed to assess asthmatic patients' perceptions of their health-related needs, using data from literature reviews and expert opinions. The tool was piloted on 25 patients to ensure the content of the questionnaire was valid. Changes were made following piloting and the modified tool was then tested in the main study, on 101 patients from thirteen community pharmacies in Portugal. Data from this phase were subjected to factor analysis and reliability testing.

RESULTS

118 asthmatic patients were recruited, of which 101 questionnaires were eligible for analysis. From these, 40 were male (39.6%) and 61 were female (60.4%). The mean age of respondents was 41 years (sd = 19.02). The first changes made to the survey tool included the adding of items relevant to patients recruited in the pilot and the simplification of the scaling used. The survey tool was then subjected to factor analysis and reliability testing. Six scales emerged, which described the need for GP support, specialist support, pharmacist support, nurse support, other carers' support and written support. Internal consistency was good (Cronbach's coefficient alpha ranged from 0.81 to 0.93). Although there were no significant associations between educational level and other factors, other attributes influenced the communication between pharmacist and physician (chi2 = 6.972; P = 0.031). Patients with a lower level of education (up to six years) valued communication between these two professionals more than among patients with higher education. The patient's age group was associated with an expressed need for explanation of inhaler technique (chi2 = 6.494; P = 0.039). There was extended need in both oldest and youngest patients. There was a significant difference between high and low scorers to the factor 'pharmacist's role in asthma' (F1) and patients treated by either specialist or GP (chi2 = 4.935; P = 0.026). There were differences between those who were bothered by their asthma or not and their perceptions of 'Pharmacist's ideal role in asthma' (F1 & 3) (chi2 = 5.967; P = 0.051).

CONCLUSION

The tool needs further development to ensure its validity and utility in practice. This will provide greater insight into patients' perceptions of their healthcare needs, which can allow health professionals to target their interventions. Such a tool may then be used in pharmacies that intend to change their current practice, to raise pharmacists' awareness of patients' demands. Developing ways to meet those needs will ultimately lead to an increased quality service and therefore 'client' satisfaction.

Classification of Pharmaceutical Services from the Viewpoint of Patient Satisfaction/Dissatisfaction

A survey was conducted to examine what the public expects of pharmacists. We created 26 questions based on 26 different situations that patients encounter at pharmacies in order to assess patient satisfaction/dissatisfaction. Some questions were designed to compare pairs of symmetrical situations. The survey was carried out in February and March 2001. The surveys were conducted with patients and/or patients' relatives who brought their prescriptions to pharmacies and with employees of pharmaceutical companies and their family members. A factor analysis extracted two factors among the 26 variables, the first being patient dissatisfaction and the second being patient satisfaction. However, factor loadings for some paired situations were not necessarily symmetrical and thus the absolute values of the scores were not equal. The results suggest that satisfaction on one side does not entail dissatisfaction on the other side and thus satisfaction and dissatisfaction can be examined as separate and distinct entities. Based on these results, we classified pharmaceutical services into two types. The first type is referred to as instrumental service. In this situation patients do not feel great satisfaction even if such service is provided. However, they feel great dissatisfaction if the service is not provided. The second type is referred to as expressive service. These patients feel some satisfaction if such service is provided, however, they do not feel a fatal dissatisfaction if the service is not provided. Our research documents that when examining data based on the assumption that there is a different dimensionality for patient satisfaction and dissatisfaction, it is possible to gain insights into new aspects of pharmaceutical services that are otherwise impossible to assess.

Antibiograms: Hospitals, Part 1 Pharmaceutical Care in Japan Practice Guideline Implementation

To help readers monitor the most important developments in specialized areas of pharmacy practice in organized health systems, Hospital Pharmacy commissions Basic Bibliographies by guest editors, who have expertise in their respective fields. These guest editors survey the relevant literature and rank approximately 15 to 20 references that represent the most significant research and practice contributions in their areas. The more fundamental are listed first so that persons with limited time can select reading appropriate to their needs. A cumulative index to Basic Bibliography topics will be published semiannually in June and December.

[A study of pharmacists' consciousness toward separation of medical practice from pharmaceutical dispensing]

Separation of medical practice from pharmaceutical dispensing had been a system with just the notation without the reality even after Showa era, although its concept was brought into Japan along with European medicine in Meiji era. Since 1970's, its concept has been prevailing gradually, and the so-called separation rate currently has reached to 47 percent. Increasingly keen attention has been paid recently by the public toward medicine in general. Taking into consideration these facts, a questionnaire survey was conducted for dispensing pharmacists in order to find out where pharmacists stand at present. Most of pharmacists (98.3%) answered that they practice patient counseling either by documents or by verbal communication, and that they take patient profiles. They said that patients could enjoy a proper medical treatment (32.9%) as well as a rational prescribing (14.3%). For a question asking what pharmacists should do to promote the separation of medical practice from pharmaceutical dispensing, 40.3% of them answered that they should make progress in their knowledge on drug therapy.