The missing path to gain customers loyalty in pharmacy retail: The role of the store in developing satisfaction and trust

Barriers and motivational factors for engaging in novel opioid and medication disposal-related services in community pharmacies

OBJECTIVE

This study aimed to explore and identify motivational factors and barriers for pharmacy personnel participation in specific opioid mitigation programs, using the Theory of Planned Behavior (TPB) as an investigational framework.

METHODS

A naturalistic inquiry method was employed involving semi-structured interviews with pharmacy personnel to assess their intentions, attitudes, normative beliefs, and behaviors towards participating in naloxone dispensing and provision of at-home drug disposal solutions. Purposive sampling was utilized to recruit participants, with saturation achieved after 12 interviews. Interviews were transcribed and coded to identify recurring themes.

RESULTS

Four primary themes emerged: 1) the value and benefits of helping others, emphasizing societal, patient, and environmental benefits; 2) limits and barriers to participation, including financial concerns, management support, and time constraints; 3) pharmacists' intrinsic motivators, highlighting personal motivations and differentiation between programs for specific patient types; and 4) program implementation challenges and strategies.

CONCLUSION

The findings underscore the applicability of the TPB in understanding pharmacy engagement in opioid abatement programs. Despite facing barriers such as financial considerations and time constraints, the overall positive attitudes towards the programs indicate a strong motivation to contribute to public health efforts. Addressing identified barriers and leveraging motivators could enhance participation, potentially mitigating the opioid crisis. Future research should incorporate patient perspectives to fully understand the impact and effectiveness of pharmacy-led interventions, such as naloxone dispensing and disposal solutions, in opioid misuse prevention.

From symbiosis to independence: Investigating changes in the relationship between general practitioners' presence and pharmacies' market size in Slovakia

Using the Slovak pharmacy retail market case, this study examines the evolving interdependency between general practitioners (GPs) and pharmacies. Traditionally, they have operated symbiotically, with pharmacy revenues heavily reliant on prescriptions. However, the development of the market structures of these providers after the liberalization of the pharmacy retail market in 2005 raises a question about the stability of this relationship. By analyzing entry thresholds as a measure of the market size required for pharmacies to cover their entry costs, the study reveals that the dependency of pharmacies on the presence of GPs has diminished over time. In the initial year following the liberalization, the presence of a GP decreased the market size sufficient to cover entry costs for the first pharmacy by about 83% compared to a market without a GP. However, in 2019, this effect decreased to approximately 65%. This could imply worsened coverage of pharmaceutical services in small and rural areas with GPs as the entry decision of pharmacies is less elastic towards their presence.

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.

The role of perceived service quality and price competitiveness on consumer patronage of and intentions towards community pharmacies

BACKGROUND

When consumers choose a service provider, they trade-off their perceptions of service quality with their perceptions of the cost of engaging with the service provider. For community pharmacy owners and managers, it is important to understand the relative impact on loyalty of providing the extra resources to improve service quality versus forsaking gross profit by discounting prices. The aim of this study was to explore the relative effects of consumers' perceptions of service quality (pSQ) and price competitiveness (pPC) on patronage loyalty (patronage history of the rated pharmacy), patronage disloyalty (patronage history at other pharmacies) and loyalty intentions.

METHODS

This was a cross-sectional study conducted within Australia using an online survey administered to members of a consumer marketing panel. Eligible participants were adults taking 2 or more prescription medicines and had attended a community pharmacy within the past 4 weeks. Participants were asked to rate the pharmacy they had last visited, self-report patronage history of that and other pharmacies and report the brand of pharmacy visited. Previously validated scales were used for consumers' perceptions of service quality (pSQ) and loyalty intentions. New scales were developed for pPC and self-reported patronage loyalty and disloyalty. Confirmatory Factor Analysis (CFA) was used to validate the measurement model. Structural Equation Modelling (SEM) with robust estimator (EQS) was used to test the relationships between the variables. Sensitivity analysis, in the presence of covariates were performed with multivariate regression analysis with bootstrapping.

RESULTS

Surveys were completed by 303 participants. Most consumers had visited the rated pharmacy more often than once monthly and most had visited only 1 or 2 pharmacies in the past 12 months for prescription medicines. Overall, participants rated pSQ, pPC highly and expressed high loyalty intentions. The SEM was a good fit for the data. The model predicted 12%, 15% and 69% of the variation in patronage loyalty and patronage disloyalty and loyalty intentions, respectively. The effect of pSQ on patronage was 0.38 (p < 0.05) for loyalty and -0.38 (p < 0.05) on disloyalty whereas the effect of pPC was marginal. The total effect of pSQ and pPC on loyalty intentions was 0.64 (<0.05) and 0.20 (p < 0.05) and in sensitivity analyses, no other covariate, including pharmacy brand was significant.

CONCLUSION

In order to drive loyalty behavior and generate loyalty intentions, providing a high-quality service appears to be far more effective than creating perceptions that the pharmacy has competitive prices. This finding affords a motivation for both discount AND non-discount brand pharmacies to undertake the steps needed to improve service quality.

From purely physical to purely online pharmacies: exploring different shopper profiles and discussing some widespread beliefs

Purpose

Up until now, some internet shopper profiles based on certain findings have been generally accepted. It is widely believed that internet shoppers tend to be more innovative, less averse to risk, more variety-seeking, more information-seeking, more impulsive and more interested in pursuing convenience. This paper aims to discuss some of these assumed characteristics by contrasting and comparing customers of three different types of pharmacies.

Design/methodology/approach

Three exploratory-descriptive design studies are conducted to profile customers from three different types of pharmacies in Mexico. Data from three samples are assessed, including 198 customers of physical drugstores without an e-channel, 150 customers of physical pharmacies with an e-channel and 271 customers of online pharmacies.

Findings

Shoppers from physical pharmacies purchase more food and drinks than actual medicine. Shoppers from physical pharmacies with e-channels tend to use the internet to acquire information about pharmaceutical products but do not make purchases online; they prefer to obtain products immediately from a physical drugstore instead of waiting for delivery from an e-channel. Contrasting with the two former customer types, shoppers who use e-pharmacies are specific in the numbers and types of products they purchase, medicines being the main priority.

Originality/value

The three types of customers and their preferred shopping platforms may show important profile differences. Despite the evidence in previous literature, shoppers at physical pharmacies are not necessarily non-convenience oriented (time and effort), noninformation analyzing, non-price conscious or less positive in their attitude about shopping; instead, they may simply be averse to technology.

The main influencing factors of customer satisfaction and loyalty in city express delivery

At present, customers’ low satisfaction and loyalty to city express service have restricted the development of city express. It is particularly important to analyze the factors causing customers’ low satisfaction and loyalty, which will promote the development of city express industry effectively. Based on SERVQUAL model and CCSI model, this paper constructs a new evaluation index system from the perspective of service quality. Through this new system, this paper first explores the factors that affect customers’ satisfaction and loyalty, respectively, by fuzzy analytic hierarchy process (AHP) and hierarchical regression analysis, taking the expected and perceived service quality as conversion variables. And then it analyzes the common factors that affect customers’ satisfaction and loyalty comprehensively. These two analyses will provide reference for solving the problem of low customer satisfaction and loyalty of city express enterprises. The results show that popularity and credibility, delivery time commitment, and mailing security are the common main factors affecting customer satisfaction and loyalty. Easy-to-understand receipts, the three-level index corresponding to the empathy dimension, is the most significant factor affecting customers’ loyalty in city express industry; Delivery time commitment, the three-level index corresponding to the reliability dimension, is the most significant factor affecting customers’ loyalty in city express industry.

Community pharmacist's perspective regarding patient-centred communication in conjunction with pharmaceutical practice: a cross-sectional survey

Effective communication between pharmacists and patients is essential for therapeutic success. The pharmacist's perspective may differ from that of the patient in terms of effective communication. Our study aimed to assess the communication efficiency in the pharmacist-patient relationship from the pharmacists’ perspective. We hypothesize that the community pharmacist's perspective can lead to relevant aspects of patient-centred communication and their profession. A cross-sectional study was conducted through an online questionnaire addressed to pharmacists. A number of 506 questionnaires were collected, evaluated, analyzed and interpreted. The questionnaire focused on the following main issues: degree of job satisfaction, essential skills of a pharmacist working in a community pharmacy, different aspects of pharmacist-patient communication, shared decision-making, patient monitoring plan and other elements related to a patient under treatment (healthy lifestyle, receptivity to counselling, loyalty and appreciation of pharmaceutical services). The pharmacist's efficiency in communication with the patient and professional education were also targeted in the study. There are no significant differences between job satisfaction in women compared to men. However, the job satisfaction increases with the average age. Caregiver, communicator and life-long learner were identified as essential skills of a pharmacist. Pharmacists participating in the study generally perceive themselves as good communicators with the patient. Nevertheless, many particular aspects of communication with patients can be greatly improved. The lack of training in the spirit of the „patient-centred communication” concept has been identified. Still, more than a third of the respondents are missing the need for professional training. A periodic evaluation of the efficiency of pharmacist-patient communication in the community pharmacy is necessary. The degree of subjectivity of the pharmacist from this perspective and self-sufficiency would be significantly diminished if the pharmacists had access to the results of the periodic evaluations.

Exploring the Relationship Between Hospital Service Quality, Patient Trust, and Loyalty From a Service Encounter Perspective in Elderly With Chronic Diseases

Based on the service encounter perspective, this study combines theoretical foundations for such factors as service quality and the characteristics of the hospital service industry to develop a research model scale to investigate whether the quality of hospital services affects patients' perceptions of health service encounters, trust, and loyalty. Nowadays, with the advancement of medical technology, patients pay more attention to the quality of medical services and good service encounters provided by healthcare professionals in order to establish positive patient relationships; hospitals need to improve their own service quality and establish good patient trust relationships so that doctor-patient satisfaction and loyalty can be improved. In a review of related literature, this study found that most past studies focused on issues related of quality of medical services and patient satisfaction, but ignored those related to the relationship between medical service encounters and patient trust and loyalty, as well as the lack of scientific measurement markers for service encounters in the Chinese medical service industry. Therefore, this study uses the Service Encounter Perspective and Service Quality Theory Development Research Scale to collect and analyze data for a typical case of a Chinese tertiary hospital. Finally, this study explores the relationship between the four variables of service quality, service encounter, trust, and loyalty by means of a questionnaire and statistical analysis of the data. Finally, it is concluded that the higher the service quality of the hospital, the higher the customer trust, the higher the service encounter, and in the greater the doctor-patient loyalty.

Awareness, Familiarity, and Pharmacist Trust: A Structural Equation Model Analysis

Background: Trust in health care professionals is critical in the health care system and is needed for a patient to seek care, reveal sensitive information, and follow a specified treatment plan, among other things. Objective: To better understand trust in community pharmacists, this research develops a model of how patient awareness of the different community pharmacy roles (role awareness) and pharmacist familiarity influences pharmacist trust. Methods: A survey of pharmacy patients in Nova Scotia, Canada, occurred in November and December 2019, with quota sampling used to achieve representativeness by age, gender, and household income. A total of 640 usable surveys were obtained. Consistent partial least squares was deployed to test and refine the model. Results: Overall, the final model highlights that both role awareness and pharmacist familiarity influence patient assessments of pharmacist trust and explains 38.7% of its variance. Pharmacist familiarity has a stronger influence than role awareness on pharmacist trust. Results of the consistent partial least squares multigroup analysis found no statistically significant differences in the model based on patient gender. Conclusion: This research provides a means to capture interpersonal trust in community pharmacists and identifies 2 key determinants of such trust. This research also provides guidance on how to assess pharmacist trust, the value of patients knowing their pharmacist, and the value of patient awareness of the roles of the various professionals behind the counter. Such knowledge will help pharmacy managers, associations, and regulatory authorities develop evidence-informed plans to assess, rebuild, and sustain trust.

Systematic review on the effects of the physical and social aspects of community pharmacy spaces on service users and staff

Aim:

This systematic review aimed to provide new insights into how pharmacy spaces, or the architecture of pharmacies, are experienced by pharmacy service users and staff. The review sought to identify environmental factors which may influence service users’ and staff participation in community-based pharmacy health services.

Method:

Ten databases were searched for English language publications, using a combination of search terms relating to pharmacy service users and staff; pharmacy spaces; and health and social care outcomes. Data from the final selected studies were extracted, thematically analysed using a narrative approach and the quality of each study assessed using the Integrated quality Criteria for the Review of Multiple Study designs (ICROMS).

Results:

80 articles reporting 80 studies published between 1994 and 2020 were identified; they were from 28 countries, involving around 3234 community pharmacies, 13,615 pharmacy service users, 5056 pharmacists and 78 pharmacy health staff. Most studies (94%) met the ICROMS minimum score, and half did not meet the mandatory quality criteria. Four themes likely to influence service users’ and staff experiences of pharmacy health services were identified: (1) privacy; (2) experience of the physical environment; (3) professional image; and (4) risk of error.

Conclusion:

To optimise the delivery and experience of pharmacy health services, these spaces should be made more engaging. Future applied research could focus on optimising inclusive pharmacy design features.

Effects of Demographic Characteristics and Consumer Behavior in the selection of Retail Pharmacies and Over-the-Counter Medicine

Aim

The study aimed to provide new insights into consumer behaviour by identifying the key demographic factors that influence the choice of pharmacy and over-the-counter (OTC) medicine.

Materials and Methods

A cross-sectional study was conducted in an urban area (Thessaloniki, Greece), surveying a convenience sample of 314 consumers with a structured questionnaire. Data analysis was conducted using the chi-square test, one-way analyses of variance (ANOVAs) and Spearman's rho correlation coefficient.

Results

Respondents with a lower educational level and retired consumers tended to make their purchases in a single pharmacy (p < 0.001). Older participants were more likely to consider the pharmacy staff and additional services to be important factors (p < 0.01). Students were the only group to prefer a formal relationship with the pharmacy staff (p < 0.001). Participants with a lower educational level tended to know exactly what they would buy (p < 0.05), whereas women made more unscheduled purchases of OTCs (p < 0.05). Respondents with a higher income assigned more importance to the product's country of origin (p < 0.05) and manufacturing company (p < 0.01) and less importance to the pharmacist's opinion than those of a lower income (p < 0.05).

Conclusions

The educational level, occupation and age of consumers have a marked effect in their selection of pharmacy, and along with gender and personal income, in their choice of OTC medicine. Our findings yield implications for the management of community pharmacies.

Determinants of Satisfaction with Services, and Trust in the Information Received in Community Pharmacies: A Comparative Analysis to Foster Pharmaceutical Care Adoption

Patient’s satisfaction with community pharmacy services, and patients’ trust in the information received in community pharmacies are important drivers of pharmaceutical care adoption. An online questionnaire assessing patient satisfaction with the services received in pharmacies and trust in the pharmacist’s advice, along with their determinants, was administered to 343 Romanian chronic and non-chronic patients. Using various statistical tests, exploratory factor analysis, and robust regression we explored determinants of satisfaction and trust. We found that satisfaction with services is predicted by pharmacists’ attitude (β = 631, p < 0.001), low waiting time (β = 0.180, p < 0.001), affordable cost of the drugs (β = 0.09, p = 0.009), and drug availability (β = 0.157, p < 0.001). At the same time, trust in the information received is driven by pharmacists’ attention (β = 0.610, p < 0.001), whether the patient received precautionary information (β = 0.425, p < 0.001), low waiting time (β = 0.287, p < 0.001), and whether the respondent is a chronic patient or not (non-chronic patients express more trust, β = 0.328, p = 0.04). Our study expands the existing paradigm that sees trust as a simple predictor of satisfaction by showing that trust and satisfaction are predicted by different variables, and thus they should be addressed using different strategies. In fact, we found that they share only one predictor—waiting time, highly significant in both cases. Our findings show that, without prioritizing trust in the information received in community pharmacies to reduce information asymmetry between patient and pharmacist, the focus only on patient satisfaction may lead to a scenario in which community pharmacies will end up to be better integrated in the business sector and not in the public health system.

Sustainable Business Models in Hybrids: A Conceptual Framework for Community Pharmacies’ Business Owners

Community pharmacies have recently been asked to contribute to sustainable healthcare systems through active participation in an integrated model of care and by playing a major educational role for environmental conservation. Therefore, dramatic changes in their institutional context have led to increasing competition in the drugs retail sector and a shift toward a service-oriented business. These factors urge rethinking of the business model of these hybrid organizations, which combine a profit-oriented, social, and more recently addressed, environmental identity. This paper aims at discussing a sustainable business model (SBM) that could allow community pharmacies to contribute to public health through pharmacists’ current role and development of that role. The effects of the COVID-19 pandemic suggest that human health should be at the center of the sustainable development agenda; the pandemic raises questions about the traditional role of community pharmacies, such as extending patient-oriented services. The SBM for community pharmacies represents an opportunity to enhance their role among the healthcare workforce, especially in a time of global pandemics. In addition, the SBM can support community pharmacies to integrate sustainability in day-to-day pharmacy practice, although it should be customized based on the contextual characteristics of the business and on differences between countries, such as health policies and regulations.

Community Pharmacy Engagement in Diabetes Prevention: Key Informant Interviews with Pharmacy Executives

Introduction

Even though evidence-based diabetes prevention interventions exist, more than 1 in 3 Americans have prediabetes; the use of pharmacies has been explored as a way to reach and care for this population. The objective of this study was to analyze factors that influence adoption of type 2 diabetes prevention programs by community pharmacies.

Methods

We conducted 21 semistructured interviews in 2018 with decision makers from 11 independent pharmacies in 6 US states and the District of Columbia and from 10 chain pharmacies operating in 1 state, multiple states, and nationwide. We identified participants by using purposive sampling. We used qualitative methods to analyze data and conducted interviews until we reached saturation.

Results

Multiple themes emerged: 1) initiation of services is more likely if initial financial support is received; 2) patient demand for services, actual or perceived, is paramount; 3) diabetes prevention services often fit within the existing operations of a pharmacy and allow maximum use of resources; 4) customer loyalty is a clearly articulated advantage against competition; and 5) engagement in diabetes prevention affirms an expanded role and the value of pharmacies to serve communities.

Conclusion

Pharmacies are well situated to deliver diabetes prevention programs to communities. Although considerable opportunity exists for pharmacies to address diabetes prevention, more could be done to reduce barriers to their use.

Determining patient preferences of community pharmacy attributes: A systematic review

OBJECTIVE

Patient selection of community pharmacy is based on a multitude of factors. With increasing competition and rapidly changing face of pharmacy, identification of these factors is critical for patient satisfaction and financial success. This systematic review summarizes patient preferences for different attributes of community pharmacy.

DATA SOURCES

Systematic review of peer-reviewed studies conducted on U.S. population, published from 2005 to 2018 in EBSCO, PubMed, and EMBASE, was conducted to identify attributes of community pharmacy that determine patient patronage.

STUDY SELECTION

Studies conducted between 2005 and 2018 on U.S. population that examined attributes in choosing a pharmacy were eligible for this systematic review.

DATA EXTRACTION

Data were independently extracted, assessed, and evaluated by 2 reviewers. Any disagreements were resolved by the third reviewer. Data obtained included year, setting, number of patients, data collection and evaluation methods, and relevant results and outcomes.

RESULTS

Of the 713 papers identified, 10 articles met the inclusion criteria and were included in this systematic review. Majority of the studies used surveys to examine key attributes that influence patients' selection of a pharmacy. Pharmacist traits like friendly, helpful, trustworthy, professional, competent, caring, knowledgeable, responsive, and approachable are critical attributes that influence a patient's selection of pharmacy. Convenience (i.e., location, hours of operation, wait time, stock availability) also influenced patients' selection of pharmacy. Cost and contract with insurance were other important factors. Availability of auto-refills appeared consistently in the studies. Medication safety (detecting drug interactions) quality metrics also appeared high among patients' preferences.

CONCLUSION

The results of this review found that a relationship with a respectful, friendly, competent pharmacist represents important pharmacist-related attributes in the process of pharmacy selection. Important pharmacy-related attributes include cost, convenience, and wait times. Availability of auto-refill service was also a frequently reported attribute in this review.

Service quality and perceived customer value in community pharmacies

A patient's perception of the service provided by a health care provider is essential for the successful delivery of health care. This study examines the value created by community pharmacies-defined as perceived customer value-in the prescription drug market through varying elements of service quality. We develop a path model that describes the relationship between service elements and perceived customer value. We then analyze the effect of perceived customer value on customer satisfaction and loyalty. We use data obtained from 289 standardized interviews on respondents' prescription fill in the last six months in Germany. The service elements personal interaction (path coefficient: 0.31), physical aspect (0.12), store policy (0.24), and availability (0.1) have a positive significant effect on perceived customer value. Consultation and reliability have no significant influence. We further find a strong positive interdependency between perceived customer value, customer satisfaction (0.75), and customer loyalty (0.71). Thus, pharmacies may enhance customer satisfaction and loyalty if they consider the customer perspective and focus on the relevant service elements. To enhance benefit, personal interaction appears to be most important to address appropriately.

Community pharmacy customer segmentation based on factors influencing their selection of pharmacy and over-the-counter medicines

Background

Within the competitive pharmacy market environment, community pharmacies are required to develop efficient marketing strategies based on contemporary information about consumer behavior in order to attract clients and develop customer loyalty.

Objectives

This study aimed to investigate the consumers' preferences concerning the selection of pharmacy and over-the-counter (OTC) medicines, and to identify customer segments in relation to these preferences.

Methods

A cross-sectional study was conducted between February and March 2016 on a convenient quota sample of 300 participants recruited in the metropolitan area of Thessaloniki, Greece. The main instrument used for data collection was a structured questionnaire with close-ended, multiple choice questions. To identify customer segments, Two-Step cluster analysis was conducted.

Results

Three distinct pharmacy customer clusters emerged. Customers of the largest cluster (49%; 'convenience customers') were mostly younger consumers. They gave moderate to positive ratings to factors affecting the selection of pharmacy and OTCs; convenience, and previous experience and the pharmacist's opinion, received the highest ratings. Customers of the second cluster (35%; 'loyal customers') were mainly retired; most of them reported visiting a single pharmacy. They gave high ratings to all factors that influence pharmacy selection, especially the pharmacy's staff, and factors influencing the purchase of OTCs, particularly previous experience and the pharmacist's opinion. Customers of the smallest cluster (16%; 'convenience and price-sensitive customers') were mainly retired or unemployed with low to moderate education, and low personal income. They gave the lowest ratings to most of the examined factors; convenience among factors influencing pharmacy selection, whereas previous experience, the pharmacist's opinion and product price among those affecting the purchase of OTCs, received the highest ratings.

Conclusions

The community pharmacy market comprised of distinct customer segments that varied in the consumer preferences concerning the selection of pharmacy and OTCs, the evaluation of pharmaceutical services and products, and demographic characteristics.

Factors affecting pharmacy engagement and pharmacy customer devotion in community pharmacy: A structural equation modeling approach

Background:

The concept of customer engagement and devotion has been applied in various service businesses to keep the customers with business However, a limited number of studies were performed to examine the context of customer engagement and devotion in pharmacy business which focus on the impact of customer perceptions about pharmacists, perceived quality of pharmacy structure, medication price strategy on pharmacy engagement and pharmacy customer devotion in a pharmacy providing pharmaceutical care to the customers.

Objective:

This study aimed to assess a conceptual model depicting the relationships among customer perceptions about pharmacists, pharmacy quality structure, medication price, customer engagement, and customer devotion. And also aimed to assess and measure if there is a direct or indirect relationship between these factors.

Methods:

A quantitative study was conducted by using self-administered questionnaires. Two hundred and fifty three customers who regularly visited the pharmacy were randomly recruited from a purposively selected 30 community pharmacies in Bangkok. The survey was completed during February to April 2016. A structural equation model (SEM) was used to assess the direct and indirect relationships between constructs.

Results:

A total of 253/300 questionnaires were returned for analysis, and the response rate was 84%. Only perceptions about pharmacist in customers receiving professional pharmacy services was statically significant regarding relationship with pharmacy engagement (beta=0.45). Concurrently, the model from empirical data fit with the hypothetical model (p-value = 0.06, adjusted chi-square (CMIN/DF)=1.16, Goodness of Fit Index (GFI)=0.93, Comparatively Fit Index (CFI)=0.99, and Root Mean Square Error Approximation (RMSEA)=0.03).

Conclusion:

The study confirmed the indirect positive influence of customer perceptions about pharmacist on pharmacy customer devotion in providing pharmacy services via pharmacy engagement It was customer perceptions about pharmacist that influenced customer retention, positive word of mouth and constructive advice to pharmacies, not quality of pharmacy structure and medication price. To create a long term impact on community pharmacy business, pharmacist is the key success factor.

Community Pharmacy-Based Inducement Programs Associated With Better Medication Adherence: A Cohort Study

BACKGROUND

Inducement programs can promote customer loyalty; however, the clinical effects of these programs are unknown.

OBJECTIVE

To examine relationships among inducement program use, medication adherence, and health outcomes.

METHODS

Alberta residents with ≥ 1 physician visit for diabetes or hypertension between April 2008 and March 2014 were eligible for this study and included if they were new statin users and alive at least 455 days after the first statin dispensation. Group assignment was based on whether all statin dispensations in the first year were obtained from pharmacies with or without inducement programs. Discontinuation was defined as no statin dispensations between 275 and 455 days after the first statin dispensation. Acute coronary syndrome (ACS) hospitalizations or deaths were identified between 456 days and 3 years after the first statin dispensation. Multivariable regression analyses were conducted to examine relationships among inducement program use, discontinuation, and ACS events.

RESULTS

Among the 159 998 new statin users, mean age was 60.2 (±13.7) years and 67 534 (42%) were women. Statin discontinuation occurred in 22 455 (28.9%) of 77 803 inducement group participants and 25 816 (31.4%) of 82 195 noninducement group participants (adjusted odds ratio = 0.88; 95% CI = 0.86-0.90). Risk of an ACS event was similar between groups (adjusted hazard ratio = 1.00; 95% CI 0.92-1.08); however, discontinuing statin therapy was associated with a higher risk of an ACS event (adjusted hazard ratio = 1.27; 95% CI = 1.16-1.39).

CONCLUSIONS

Inducement programs are associated with better adherence and not directly associated with risk of health outcomes.