Satisfaction and expressed needs of pharmaceutical care services and challenges recognized by patients in South Korea

Involving patients in medicines optimisation in general practice: a development study of the “PREparing Patients for Active Involvement in medication Review” (PREPAIR) tool

Background

Many patients have multiple health conditions and take multiple medications (polypharmacy). Active patient involvement may improve treatment outcomes and ensure patient-centred care. Yet, patient involvement remains a challenge in clinical practice. We aimed to develop and pilot test a questionnaire-based preparation and dialogue tool, the PREparing Patients for Active Involvement in medication Review (PREPAIR) tool, to encourage the involvement of patients with polypharmacy in medicines optimisation in general practice.

Methods

We conducted a literature review followed by a co-production process to develop the tool: a workshop with six GPs and pilot testing, including observations and interviews, with 22 patients, three GPs and three practice staff. During this process, we made continuous adaptations to the prototype. We analysed the qualitative data thematically, focusing on the development process and mechanisms of impact.

Findings

The final PREPAIR tool included five items concerning the patient’s experience of 1) adverse drug reactions, 2) excess medication, 3) unnecessary medication, 4) medication satisfaction and 5) medication-related topics to discuss with the GP (open-ended question). The applied workflow during testing was as follows; the patient completed the PREPAIR tool at home, to encourage reflection on the medication, and brought it to the GP consultation. During the consultation, the GP and the patient reviewed the patient’s responses and discussed potential medication-related problems. For some patients, the increased reflection led to worries about the medications. Still, the pilot testing showed that, when using the PREPAIR tool, the patients arrived at the clinic well prepared and empowered to speak. From the PREPAIR-supported dialogue, the GPs obtained a better understanding of patients’ perspectives and provided a more patient-centred consultation. For the patients, the PREPAIR-supported dialogue ultimately promoted an increased sense of security, satisfaction and insight into their medication, despite initial worries for some patients.

Conclusions

We developed a brief tool to support active patient involvement in medication review in general practice. The PREPAIR-tool was well received by both patients and GPs and fitted well into the existing clinical practice. Our findings suggest that the PREPAIR-tool can support patient involvement during consultations and facilitate patient-centred care.

Nature and perceived benefits of patient-initiated consultations in community pharmacies: A population survey

Background

The role of community pharmacists in enhancing patient care has received increased attention. However, there is a paucity of literature on the nature, frequency, and perceived impacts of patient-initiated consultations in community pharmacies.

Objectives

We aim to describe the profile of patients seeking advice from community pharmacists as well as the nature and impact of those consultations.

Methods

A survey was conducted with Quebec adults who had consulted a pharmacist in the previous four weeks. Data was collected in 2017 and 1104 agreed to participate (25.3%). Of those, 93 were withdrawn due to incomplete data and 98 failed to meet the inclusion criteria. Sample representativeness was ensured by quota sampling (gender, age) after stratification by region.

Results

Among the 913 respondents, 46% had consulted a pharmacist more than once during the four weeks prior to the survey. Individuals with a university degree consulted less often than those without (1.97 vs. 2.17 times; t = 2.0; p < .05) and participants with one or several chronic diseases consulted more frequently than those having no chronic disease (2.18 vs. 1.94 times; t = 5.7; p < .05). Older adults (55+) consulted more often for themselves compared to younger (18–34) and middle-aged (35–54) adults (1.53 vs. 1.31 vs. 1.44 times; F = 4.0; p < .05). Concerning the consultations, 58% were related to medications and 33% to health problems. In terms of impacts, 81% of consultations were perceived to have prevented the use of other healthcare resources. Patient satisfaction with their consultations was high with an average score of 8.75 on a 10-point scale (SD = 1.63).

Conclusions

Findings reveal that the reasons for consulting a community pharmacist are diverse, most being related to medications or health issues. Patients reported that pharmacists were able to manage most consultations without referring them to other health care resources or professionals, and their satisfaction with their consultation was high.

MeSH terms

Community pharmacy; counselling; patient satisfaction; primary health care; surveys and questionnaires.

Patient Satisfaction of Ambulatory Care Pharmacy Services

The Ministry of Health (MOH) recently developed the Health Sector Transformation Program (HTSP) to focus on patient satisfaction, safety, and care. This study explored patient satisfaction with outpatient care services.

A semi-structured questionnaire was designed to collect the data of patient satisfaction with pharmacy care services through face-to face interviews of participants and over the internet using an electronic format of the same questionnaire (web-based survey).

A total of 508 participants responded of whom, 51.8% were male and 83% were below 46 years old. The average scores of domains 1, 2, 3, 4, 5, 6, 7, and 8 were 4.51, 4.11, 4.30, 3.70, 3.57, 3.82, 3.63, and 4.15, respectively. The general evaluation of pharmacy services demonstrated that respondents were very satisfied (245; 48.2%), satisfied (143; 28%), and willing to recommend the pharmacy to their families (380; 76.4%). There was no statistically significant difference in the overall satisfaction with pharmacy services among the 2 hospitals (P > .05).

Most respondents were satisfied with outpatient care pharmacy services. More efforts are needed to improve the service of following up on patients’ adherence by the pharmacists.

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.

Patient satisfaction with pharmaceutical services in Makkah: A cross-sectional study

Objective:

Patient satisfaction is considered an essential indicator of the treatment outcomes of pharmaceutical services. This study aimed to assess patient satisfaction with the pharmaceutical services at the Ministry of Health (MOH) hospitals in Makkah city in Saudi Arabia.

Methods:

A cross-sectional study was conducted via an interview-based questionnaire that involved patients who visited the outpatient pharmacy in five MOH hospitals from August 2018 to September 2018. The data were collected using a previously published, validated, and reliable questionnaire. The questionnaire was translated and piloted for the local context.

Findings:

Data of 295 respondents were analyzed. The overall mean score of satisfaction level with the pharmaceutical services was found to be 2.50 out of a maximum score of 3. The item that the patients were most satisfied with was, “The extent of cleanliness in the waiting area for the provision of pharmaceutical services” (mean = 2.80) whereas the item the patients were least satisfied with was, “The information the pharmacist gives you about the proper storage of your medication” (mean = 2.00). “Illiterate” patients and those who visited the pharmacy first time had significantly higher satisfaction levels compared to those with other educational categories and those who had visited the pharmacy before, respectively.

Conclusion:

Our study showed that the overall level of satisfaction of patients with pharmaceutical services was high.

Service design oriented multidisciplinary collaborative team care service model development for resolving drug related problems

Our goal was to help prevent drug-related morbidity and mortality by developing a collaborative multidisciplinary team care (MTC) service model using a service design framework that addressed the unmet needs and perspectives of diverse stakeholders. Our service model was based on a “4D” framework that included Discover, Define, Design, and Develop phases. In the “discover” phase, we conducted desk research and field research of stakeholders to identify the unmet needs in existing patient care services. We used service design tools, including service safaris, user shadowing, and customer journey maps to identify pain and opportunity points in the current services. We also performed focus group discussions and in-depth interviews with stakeholders to explore the needs for improved services. In the “define” phase, we generated the service concept by mind mapping and brainstorming about the needs of stakeholders. The service concept was defined to be a Patient-oriented, Collaborative, Advanced, Renovated, and Excellent (P-CARE) service. We named the service “DrugTEAM” (Drug Therapy Evaluation And Management). In the “design” phase, we designed and refined four prototypes based on results from validation tests for their application towards following services: 1) medication reconciliation, 2) medication evaluation and management, 3) evidence-based drug information, and 4) pharmaceutical care transition services. During the “develop” phase, we implemented four services in a longitudinal chronic care model, considering the time spent by patients for each inpatient and outpatient setting. In conclusion, this is a study to develop a collaborative MTC service model using service design framework, focused on managing the unmet needs of patients and healthcare providers. As a result of implementing this service model, we expect to strengthen the professional relationship between pharmacists and stakeholders to ultimately create better patient outcomes.

Consumer willingness to pay for pharmacy services: An updated review of the literature

BACKGROUND

Quantifying the value of pharmacy services is imperative for the profession as it works to establish an expanded role within evolving health care systems. The literature documents the work that many have contributed toward meeting this goal. To date, however, the preponderance of evidence evaluates the value of pharmacist services to third-party payers; few published studies address the value that consumers place on these services.

OBJECTIVES

In 1999, a review of studies that used the contingent valuation method to value pharmacy services was published. The objective of this manuscript is to provide an update of that review.

METHODS

Relevant studies published in the English language were identified searching MEDLINE, ECONLIT and International Pharmaceutical Abstracts databases from January 1999 to November 2017. Only studies that specifically elicited willingness to pay for a community pharmacist provided service from actual or potential consumers were included.

RESULTS

Thirty-one studies using the contingent valuation method to value pharmacy services were identified using the search strategy outlined. These studies included surveys in different demographic and geographic populations and valuing various pharmacy services.

CONCLUSIONS

Improving the quality of studies using contingent valuation to value pharmacy services will aid the profession in marketing pharmacy services to consumers, and may assist practitioners who wish to implement various pharmacy services in their practice settings. A limited number of studies have been conducted, but the quality of contingent valuation studies valuing pharmacist services is improving. Understanding the pharmacy services that consumers value, and understanding the level of their monetary willingness to pay for those services will be crucial as the profession continues to work toward establishing a sustainable and economically viable role within the evolving health care systems.