Service quality, outpatient satisfaction and loyalty in community pharmacies in Turkey: A structural equation modeling approach

Background

The sustainability of community pharmacy services is dependent on service quality, patient satisfaction, and patient loyalty. While community pharmacies are perceived as medical units in terms of drug dispensing, they are also businesses that engage in social interaction with patients.

Objectives

To propose a certain model to evaluate the impact of different service factors on the level of satisfaction and to reveal the relationship between satisfaction and loyalty.

Methods

This cross-sectional study was conducted in the province of Afyonkarahisar, Turkey, between March 20, 2022, and December 30, 2022. The research data were collected with a questionnaire that included demographic information, selected service factors, satisfaction, and loyalty. The data obtained from 402 participants were analyzed using structural equation modeling (SEM).

Result

The mean age of the participants was 32.02 ± 11.81, 53.9% were female, 58.7% were employed, 54.1% had a bachelor's degree, 11.7% had a chronic disease, and 16.1% were taking medication regularly. The findings of the study showed that communication and attitude (β = 0.22; t = 3.90), medicine supply (β = 0.43; t = 7.62), and pharmacy environment (β = 0.26; t = 4.23) positively affected patient satisfaction in community pharmacies. Service promptness did not have a significant effect on patient satisfaction (β = 0.07; t = 1.18). The most effective service factor on patient satisfaction was medicine supply (β = 0.43). In addition, the research results determined that patient satisfaction strongly affects patient loyalty in community pharmacies (β = 0.72, t = 11.24).

Conclusions

While community pharmacies can increase patient satisfaction through service factors, they can increase patient loyalty by improving patient satisfaction. Community pharmacies that want to have satisfied and loyal patients should focus more on service factors. Community pharmacies should not only meet the medical expectations of patients but also meet their social expectations.

Conjunctival Impression Cytology and Tear Film Changes in Sarcoidosis: A Subjective and Objective Diagnosis Study

Objectives

To evaluate sarcoidosis-induced tear film changes using subjective and objective diagnostic tests, particularly conjunctival impression cytology (IC), and to compare the results with healthy individuals.

Materials and Methods

This study evaluated clinical data collected between January 2019 and January 2021 from 57 right eyes of 57 sarcoidosis patients without ocular involvement (Group 1) and 33 right eyes of 33 healthy individuals with similar demographic characteristics (Group 2). The Schirmer I test, tear break-up time (TBUT), fluorescein staining, and conjunctival IC were all performed as part of the conjunctival and corneal examinations following a thorough ophthalmological examination. The Ocular Surface Disease Index (OSDI) was used to assess subjective ocular symptoms.

Results

The mean ages in Groups 1 and 2 were 49.26±3.18 and 51.91±2.89 years, respectively (p=0.720). The mean Schirmer I test, TBUT, and OSDI scores differed significantly (p<0.05 for all), with Group 1 having a significantly higher percentage of dry eyes than Group 2. Group 1 had significantly higher Nelson's grading system grades than Group 2 based on conjunctival IC analysis (p=0.001). There were no significant differences in visual acuity (p=0.17) or intraocular pressure (p=0.14) between groups.

Conclusion

Sarcoidosis patients had significantly higher Nelson grades in conjunctival IC, as well as significantly higher percentages of dry eye as determined by the Schirmer I test, TBUT, and OSDI. Reduced tear quantity and quality may destabilize the tear film layer, resulting in a variety of ocular symptoms.