A conceptual framework of patient satisfaction with a pharmacy adherence service
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Background Patients do not adhere to their medicines for a host of reasons which can include their underlying beliefs as well as the quality of their interactions with healthcare professionals. One way of measuring the outcome of pharmacy adherence services is to assess patient satisfaction but no questionnaire exists that truly captures patients’ experiences with these relatively new services. Objective Our objective was to develop a conceptual framework specific to patient satisfaction with a community pharmacy adherence service based on criteria used by patients themselves. Setting The study was based in community pharmacies in one large geographical area of the UK (Surrey). All the work was conducted between October 2008 and September 2010. Methods This study involved qualitative non-participant observation and semi-structured interviewing. We observed the recruitment of patients to the medicines use review (MUR) service and also actual MUR consultations (7). We also interviewed patients (15). Data collection continued until no new themes were identified during analysis. We analysed interviews to firstly create a comprehensive account of themes which had significance within the transcripts, then created sub-themes within super-ordinate categories. We used a structure-process-outcome approach to develop a conceptual framework relating to patient satisfaction with the MUR. Favourable ethical opinion for this study was received from the NHS Surrey Research Ethics Committee on 2nd June 2008. Results Five super-ordinate themes linked to patient satisfaction with the MUR service were identified, including relationships with healthcare providers; attitudes towards healthcare providers; patients’ experience of health, healthcare and medicines; patients’ views of the MUR service; the logistics of the MUR service. In the conceptual framework, structure was conceptualised as existing relationships, environment, and time; process was conceptualised as related to recruitment and consultation stages; and outcome as two concepts of immediate patient outcomes and satisfaction on reflection. Conclusion We identified and highlighted factors that can influence patient satisfaction with the MUR service and this led to the development of a conceptual framework of patient satisfaction with the MUR service. This can form the basis for developing a questionnaire for measuring patient satisfaction with this and similar pharmacy adherence services.
KeywordsCommunity pharmacy Conceptual framework Medication adherence Medicines use Patient satisfaction Review
The authors are grateful to Kingston University, Boots UK, the Harold and Marjorie Moss Charitable Trust Fund and Morecon Ltd for their support. The authors would like to thank the patients and pharmacists who took part in the study.
Funding was received from the Harold and Marjorie Moss Charitable Trust Fund for patient interviews and additionally from Morecon Ltd for purchasing software and equipment used in the transcribing of the interviews. Kingston University and Boots UK jointly funded the PhD of one of the authors (MvdB).
Conflicts of interest
The observations and interviews took place in a community pharmacy chain which employs one of the authors (MvdB) as a teacher practitioner.
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