Assessing patient satisfaction with community pharmacy in the UAE using a newly-validated tool

BackgroundPatient satisfaction has become an integral component of the quality of healthcare services. It has been used for the purpose of performance assessment, reimbursement, and quality management of health service delivery. It has been suggested that patient satisfaction could be a predictor of health-related behavior.ObjectivesTo develop and validate a tool for use within the Arabic context to assess patient satisfaction. To assess patient satisfaction with current community pharmacy services in the UAE using the validated tool.MethodsA systematic process was used to develop an assessment tool that could be used within the Arabic context and establish its validity and reliability. Survey participants assessed their satisfaction with the services based on a 5-point Likert-type scale: Poor = 1, Fair = 2, Good = 3, Very good = 4, Excellent = 5. The anonymous questionnaire was distributed over a 5-month period to eligible participants in public places such as malls and shopping markets, in various emirates across the UAE. Those who were 21 years or older, taking at least one scheduled (regular) medication and having adequate Arabic or English language proficiency were included.ResultsThe instrument comprised four dimensions: Information, Relationship, Accessibility and Availability. Participants required more information about medications and self-management (Mean = 2.49 ± 1.19). Measures of competence, i.e., care, interest, time, confidence and trust, could also be improved (Mean = 3.05 ± 1.07). Accessibility scores measuring physical, geographical and financial items were lowest (Mean = 2.80 ± 1.33). Overall scores on availability of medications indicated relative satisfaction with this dimension (Mean = 3.51 ± 0.7).ConclusionsThis study is the first to use a patient satisfaction tool specifically developed for the Arabic context. Patient satisfaction scores in all dimensions were significantly lower than published data, suggesting patients have unmet expectations of community pharmacy services in the UAE. Stakeholders could utilize this information to help in the design and delivery of improved services that could lead to increased demand.     

Pharmacy characteristics correlating to performance in a community pharmacy network

Objective

To assess the correlation between pharmacy characteristics and a broad set of performance measures used to support a community pharmacy network.

Teaching and Learning Health Literacy in a Doctor of Pharmacy Program

Objective. To evaluate the impact of health literacy (HL) activities incorporated into a required, first professional year (P1), patient-centered communication course on pharmacy students’ knowledge, abilities, confidence, and attitudes related to HL.Design. Integrated, active-learning HL activities were incorporated into the course. Students’ knowledge and abilities were assessed with course evaluations. Students’ knowledge, confidence levels, and attitudes were evaluated by a precourse and postcourse survey. Third professional year (P3) students who did not complete HL activities were also surveyed.Assessment. Almost all students “met” or “exceeded” expectations (the top 2 levels of achievement on the objective structured clinical examination (OSCE) grading rubrics) on HL course evaluations. Survey results showed significant improvement in P1 students’ knowledge, confidence, and attitudes related to HL after completing the course. First year students (postcourse) rated their confidence levels and attitudes higher than P3 students.Conclusion. The use of integrated, active-learning activities is effective at improving P1 pharmacy students’ knowledge, abilities, confidence levels, and attitudes related to HL.     

Perceptions of the incorporation of health literacy in pharmacy training programs

ObjectivesTo assess pharmacy residents’ perceptions regarding the incorporation of health literacy in pharmacy school and pharmacy residency training and to assess confidence while interacting with patients of limited health literacy.DesignProspective cross-sectional study.SettingUnited States from March to May 2012.ParticipantsPostgraduate year (PGY)1 and -2 pharmacy residents and pharmacy residency program directors.InterventionOnline survey.Main outcome measurePGY1 and -2 resident perceptions of health literacy incorporation into pharmacy school and residency training.Results939 surveys were completed. Residents agreed that their pharmacy school training encouraged the development of health literacy skills (P < 0.001) and made efforts to improve health literacy awareness (P < 0.001) significantly more than their PGY1 programs. In addition, they felt significantly more confident in their ability to communicate with patients with limited health literacy after their pharmacy school training compared with during or following PGY1 residency training (P < 0.001); however, no difference was found regarding confidence in identifying patients of limited health literacy.ConclusionPGY1 residency programs lag behind the efforts of schools of pharmacy to incorporate the health literacy training essential to encountering patients of limited health literacy. Future studies should assess whether these perceptions reflect true health literacy awareness and management among pharmacy residents.     

Pharmacy ownership in Canada: Implications for the authority and autonomy of community pharmacy managers

Background

In recent years, the number of independently owned pharmacies has declined even as the total number of pharmacies in Canada has increased. With increasing corporate ownership, there is concern that this trend will adversely affect the profession’s ability to influence pharmacy practice and practice change.

Objective

To examine the relationship between ownership type and community pharmacy managers in terms of professional and employer authority, managerial autonomy, decision making, and amount of control.

Methods

This study consisted of a cross-sectional survey of community pharmacy managers in Canada by means of a self-administered postal questionnaire sent to a stratified sample of community pharmacies. Statistical analysis consisted of exploratory factor analysis with reliability testing on identified constructs. Frequencies, 1-way analyses of variance, Scheffe post hoc tests, and general linear modeling were used to determine significant differences among groups based on ownership type.

Results

In total, 646 of 1961 questionnaires from pharmacy managers were completed and returned (response rate 32.9%). Respondents rated their authority similarly across ownership types. Autonomy, decision-making capabilities, and control needed to carry out the professional role appear most limited among corporate respondents and, to a lesser extent, franchise managers.

Conclusions

Pharmacy managers currently perceive a high level of authority; but with limited autonomy among corporate managers, it is unclear whether this authority is sufficient to prevent the subordination of both patient and professional interests to financial interests.     

Assessment of the effects of a community pharmacy women's health education program on management of menopause survey scores

OBJECTIVE: This study examined the effect of a community pharmacy-based menopause education program on scores of the Management of Menopause (MoM) survey. The MoM survey is a tool administered to managed care organization members by the National Committee for Quality Assurance to determine the level of menopause-related education offered by their health care providers. The primary outcome was comparison of the median MoM survey scores of participants at baseline, 3 months, and 1 year posteducation. METHODS: Women aged 47 to 55 years who were able to provide informed consent were enrolled. Subjects completed a baseline MoM survey. Trained pharmacists working in 7 pharmacies conducted one-on-one education sessions regarding the consequences of menopause, treatment options, and the known risks and benefits of each option. Follow-up MoM surveys were administered by mail at 3 months and 1 year posteducation. The survey is scored on a 100-point scale for an overall composite score and includes 3 subsections: exposure, breadth, and personalization of counseling. RESULTS: A total of 31 subjects were enrolled, with 24 and 16 completing both baseline and 3-month or 1-year MoM follow-up surveys, respectively. Median 3-month composite MoM survey scores (86.1; 95% CI, 61.1-93.1) were significantly improved from baseline (54.2; 95% CI, 36.1-62.5; P<0.001). Scores on each subsection of the MoM survey also improved at 3 months, and median 1-year composite scores were significantly improved from baseline. (54.2 to 89, P = 0.001). Patient satisfaction with the education session was high, with a median satisfaction rating of 5 (a range of 4 to 5) on a 5-point satisfaction rating scale. CONCLUSION: A community pharmacy-based menopause education program significantly increased scores on the MoM survey, and subjects were satisfied with this program.     

Screening for social determinants of health in community pharmacy: Identifying best practices,barriers, and strategies for success

The social determinants of health (SDOH) play a key role in patients’ access to health care and medications. There exists an area of opportunity to leverage community pharmacists to make a large impact in identifying and incorporating an understanding of a patient’s SDOH into their treatment plan. Community pharmacies are accessible and trusted avenues for health care interventions. With the advancement of appointment-based models as well as the increased training of support personnel, community pharmacies may be well suited for this public health task. However, there are major challenges such as paradigm shifts in workflow, reimbursement, and training that must be addressed to make this endeavor successful. This commentary explores the sparse literature related to community pharmacists conducting screening for social risk factors to identify best practices and barriers to implementation and outlines how screening for social needs aligns with the Pharmacists’ Patient Care Process.     

Obtaining and providing health information in the community pharmacy setting

Community pharmacists are a valuable information resource for patients and other healthcare providers. The advent of new information technology, most notably the Internet, coupled with the rapid availability of new healthcare information, has fueled this demand. Pharmacy students must receive training that enables them to meet this need. Community advanced pharmacy practice experiences (APPEs) provide an excellent opportunity for students to develop and master drug information skills in a real-world setting. Preceptors must ensure that students are familiar with drug information resources and can efficiently identify the most useful resource for a given topic. Students must also be trained to assess the quality of resources and use this information to effectively respond to drug or health information inquiries. This article will discuss key aspects of providing drug information in the community pharmacy setting and can serve as a guide and resource for APPE preceptors.     

Integration of community pharmacy in primary health care: The challenge

Community pharmacies and pharmacists predominantly operate in a retail environment independently of other health care providers, and they are not often viewed as an integral member of the healthcare team. Thus, they remain overlooked or excluded during integration processes of health care systems. At the same time, there are calls by the profession at national and international levels for community pharmacy to be integrated within primary care systems. The COVID-19 pandemic appears to have further stimulated this desire. When pressing for integration, various terms, such as integration, integrated care, or interprofessional collaboration, are used in an interchangeable manner leading to lack of clarity, ambiguity and confusion for health care policy makers, planners, and other healthcare professionals. The literature was reviewed to identify critical components for community pharmacy to consider for integration. From the five selected articles describing integration of community pharmacies, four different constructs were identified: consensus, connectivity, communication and trust. The integration of community pharmacy into the health system may translate into better access for patients to primary care services, contribute to cost effectiveness, and promulgate the sustainability of the system. However significant political, economic, social, and practice change would be required by all stakeholders. Further research is needed to underpin a consensus for a definition, the type of integration, and the model optimally suited to integrate community pharmacy into primary care. These models, specific and adaptable to each national health care system and political environment, would need to be consensus-based by principal stakeholders to overcome a variety of barriers, including government resistance. Mere calls or demands by the pharmaceutical profession, although laudable, will not be sufficient to overcome the historical, cultural, and economic challenges.