Review Article |
Corresponding author: Irma Melyani Puspitasari ( irma.melyani@unpad.ac.id ) Academic editor: Valentina Petkova
© 2022 Yuliandani Yuliandani, Sofa Dewi Alfian, Irma Melyani Puspitasari.
This is an open access article distributed under the terms of the Creative Commons Attribution License (CC BY 4.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
Citation:
Yuliandani Y, Alfian SD, Puspitasari IM (2022) Patient satisfaction with clinical pharmacy services and the affecting factors: a literature review. Pharmacia 69(1): 227-236. https://doi.org/10.3897/pharmacia.69.e80261
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Service quality is measured to assess the consistency of medical services provided to fulfill patient expectations. This article provides an overview of patient satisfaction with clinical pharmacy services and the influencing factors. A literature search from MEDLINE and EBSCO databases was performed with the keywords “patient satisfaction”, “pharmacy service”, “hospital pharmacy service”, and “clinical pharmacy service”. The inclusion criteria for articles are original articles, full papers, articles in English, and published in 2011–2021. A total of 25 articles from 1,118 articles discussed patient satisfaction with clinical pharmacy services such as counseling, drug therapy monitoring, patient support programs, and pharmaceutical care. Generally, patients are satisfied with clinical pharmacy services such as counseling, drug therapy monitoring, patient support programs, and pharmaceutical care. The most influencing factors with clinical pharmacy services are the quality, convenience, ease of information, and confidence in pharmacist competence. Pharmacists should equip themselves with the appropriate knowledge and competencies in clinical pharmacy services for benefits their patients.
counseling, drug therapy monitoring, pharmaceutical care, patient support program
Patient satisfaction measures the consistency of health services provided to fulfill patient expectations (
In experiencing health care, patients need professional health assistance that is easily accessible. Therefore, pharmacists are one health care professionals selected to accompany patients during the treatment period (
Clinical pharmacy service provides rational drug therapy that is safe, precise, and cost-effective (
Previous studies explained that patient satisfaction impacts pharmaceutical services, including patient compliance to the treatment provided, improving treatment outcomes and patient loyalty to healthcare providers (
The literature search on the MEDLINE and EBSCO databases was conducted in May–June 2021. The keywords used included “patient satisfaction”, “pharmacy service”, “hospital pharmacy service”, and “clinical pharmacy service”. The literature search report of flow diagram followed to the the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA).
The inclusion criteria for articles are original articles, full papers, article in English, and published in 2011–2021. Articles excluded have criteria that do not discuss clinical pharmacy service and do not contain the desired keywords.
The extracted data are references containing the main author’s name and year of publication, country, participants, the number of participants, place of service, type of clinical pharmacy service, study design, satisfaction measurement instrument, factors influencing patient satisfaction, results, and funding sources.
Fig.
Table
No | Authors, Country, Year | Participant | Number of participants | Service Place | Service Type | Study design | Instrument |
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1 | Alotaibi NH et al., Saudi Arabia, 2021 | Outpatient pharmacies of various public hospitals | n = 746 | Hospitals | Counseling | Cross-sectional study | A 23-items questionnaire that measure patient satisfaction related to pharmacy facilities and pharmacy services with 5-items Likert scale. |
2 | Al-Arifi MN, Saudi Arabia, 2012 | Patients attending community pharmacies. | n = 1,699 | Community pharmacies | Counseling | Cross-sectional study | The questionnaire composed of 8 items about patients’ views and satisfaction with the pharmacists’ role in the current community pharmacy practice |
3 | Alkhoshaiban A, Saudi Arabia, 2019 | Type II diabetic patients. | n = 102 | Hospitals | Counseling | The comparative study used Longitudinal method | Medication Adherence Scale-8 (MMAS-8) and Diabetes Medication Satisfaction (DiabMedSat) questionnaires |
4 | Hale A et al., Australia 2015 | Patients scheduled for elective surgery | n = 200 | A tertiary Hospital | Counseling | Cross-sectional study | Surveys containing 12 and 25 questions with a Likert scale responses that investigate patient satisfaction and views of collaborative doctor-pharmacist prescribing. |
5 | Iancu ME, et al. Romania, 2014 | Patients, relatives and caregivers who obtained counselling by pharmacists. | n = 3,303 | Pharmacies | Counseling | Prospective survey design | A 16 items questionnaire regarding the counseling provided by the pharmacist during the visit. |
6 | Munro L, et al., Canada, 2020 | Patients at the oncology clinic | n = 35 | Hospital | Counseling | Cross-sectional study | Surveys and patient interviews with a total 20 items questions on their perceptions of the importance of the clinical pharmacy services and their satisfaction with the services provided. |
7 | Hall JJ, et al., Canada, 2016 | Rheumatology clinic patients | n = 62 | Hospital | Counseling | Cross-sectional study | The Leeds Satisfaction Questionnaire (LSQ) with a 5 points of Likert scale to measure patient satisfaction. |
8 | Fesharaki F, Iran, 2019 | Patients who waiting for their medicine | n = 326 | Pharmacies | Counseling | Cross-sectional study | A 36-items questionnaire with a 5-item Likert scale that ask the patient about the nonverbal communication of the pharmacist and their satisfaction. |
9 | Alshayban DM, et al., Saudi Arabia 2020 |
Chronic and acute disease patients | n = 531 | Hospitals | Counseling | Cross-sectional study | Arabic version of Patient Satisfaction Feedback (PSF) questionnaire that measured satisfaction as well as willingness-to-pay for a pharmacist counseling session. |
10 | Martin and Faber, United States of America 2016 | Patients receiving Hepatitis C Virus (HCV) treatment | n = 64 | Hospital | Drug therapy monitoring | Cross-sectional study | A patient satisfaction survey consists of 20 questions that assess the patient satisfaction with the health care provider(s) including clinical pharmacist during the management of HCV therapy. |
11 | Reich CM et al., United States of America, 2018 | Patients diagnosed with psychiatric disorders | n = 240 | Hospital | Drug therapy monitoring | Cross-sectional study | A 19-item questionnaire that measure patient satisfaction with a 5-point scale. |
12 | Crespo and Tyszka, Canada, 2016 | Patients receiving chemotherapy | n = 112 | Hospital | Drug therapy monitoring | Cross-sectional study | The 20-item survey with a Likert-scale questions that assessed satisfaction with clinical pharmacy services. |
13 | Beyene K et al., New Zealand, 2020 | Patients taking warfarin | n = 305 | Pharmacies | Drug therapy monitoring | Cross-sectional study | The 36-item questionnaire with a 5-item Likert scale to measure patient satisfaction with community pharmacist-led anticoagulation services. |
14 | Bezuidenhout et al., South Africa, 2014 | Patients with antiretrovirals treatment | n = 300 | Hospital | Drug therapy monitoring | Cross-sectional study | An interview with using a standardised structured questionnaire to assess patient satisfaction on general facility and healthcare provision, communication, and medicine management. |
15 | Chou YC et al., Taiwan, 2019 | Patients who received medical care | n = 741 | Hospital | Drug therapy monitoring | Cross-sectional study | The 5-item questionnaire to investigate patients’ perceptions about their trust, satisfaction, and cooperation with clinical pharmacists. |
16 | Sites BD et al., Lebanese 2018 | Patients with musculoskeletal conditions | n = 19,566 | Hospital | Drug therapy monitoring | Cross-sectional study | The Consumer Assessment of Health Plans Survey (CAHPS) from the the Medical Expenditure Panel Survey (MEPS) data. |
17 | Hatton J et al., United States of America 2017 | Patients who received care from the face-to-face or clinical video teleconferencing (CVT) pharmacy clinic. | n = 57 | Hospital | Patient support program | Cross-sectional study | The 10-item, patient self-reported questionnaire to evaluate patient satisfaction with pharmacist-provided consultations via CVT. |
18 | Mooney EV et al., United States of America, 2018 | Patients receiving LAIA (Long-Acting Injectable Antipsychotics) | n = 161 | Pharmacies | Patient support program | Prospective survey design | A survey consisted 4 sections that assessed patients’ satisfaction with pharmacist- administered LAIAs in the community pharmacy. |
19 | Bourdin A et al. Switzerland, 2020 | Patients who participated in Fingolimod Patient Support Program (F-PSP) | n = 17 | Hospital | Patient support program | Cross-sectional study |
A qualitative study with face-to-face semistructured interviews to explore the satisfaction, experiences and perceptions regarding the F-PSP. |
20 | Takaki H et al, Japan 2015 | Patients who visit the pharmacy and receive prescription medication | n = 407 | Pharmacies | Pharmaceutical care | Cross-sectional study |
A questionnaire package using four items and five response categories was used to measure overall satisfaction with pharmaceutical care services. |
21 | Soeiro OM et al., Brazil, 2017 | Patients in primary health care services | n = 8,803 | Primary health care services | Pharmaceutical care | Cross-sectional study | The Pesquisa Nacional sobre Acesso, Utilização e Promoção do Uso Racional de Medicamentos – Serviços (PNAUM – National Survey on Access, Use and Promotion of Rational Use of Medicines – Services) that measure patients satisfaction with pharmaceutical care services. |
22 | El-Sharif SI et al., Uni Emirat Arab, 2017 | Patients with medical and non-medical educational background | n = 375 | Pharmacy | Pharmaceutical care | Cross-sectional study | Modified questionnaire from the Community Pharmacy Patient Questionnaire (PSNC), United Kingdom and surveys of patient satisfaction with pharmaceutical services in rural areas, Ministry of Health in Saudi Arabia that measure patients satisfaction with pharmaceutical care services. |
23 | Abebe TB et al., Ethiopia 2016 | HIV/AIDS patients | n = 291 | Hospital | Pharmaceutical care | Cross-sectional study | Data were collected using structured questionnaires measuring patients expectation and satisfaction of pharmaceutical care using a Likert scale of 1–5 through face-to-face interviews. |
24 | Ali HS et al, Uni Emirat Arab, 2019 | All patients who come to the pharmacy | n = 210 | Community pharmacies | Pharmaceutical care | Cross-sectional study | A 20-item questionnaire regarding the patients’ perception towards pharmacist ‘performance and satisfaction with the pharmaceutical services provided. |
25 | Mináriková et al., Slovakia, 2016 | Patients aged 40 years and over | n = 2844 | Community pharmacies | Pharmaceutical care | Cross-sectional study | A 29-item questionnaire with a 5-item Likert scale to measure the extent of patient satisfaction with the pharmaceutical care provided in community pharmacies. |
Total n=41.494 |
Table
Authors | Country | Participants | Factors that affect satisfaction | Result | Funding |
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Alotaibi NH et al. 2021 | Saudi Arabia | 746 patients | Quality of pharmacy services, pharmacy facilities | Approximately one-half of the patients were not satisfied with outpatient pharmacy services. The overall satisfaction score was 2.97 ± 0.65 out of 5 scale. | Not applicable |
Al-Arifi MN, 2012 | Saudi Arabia | 1,699 patients | The role of pharmacists in counseling patient compliance and providing drug information | The patients showed better satisfaction, perception and appreciation of the pharmacists’ role in the health care team. | Not applicable |
Alkhoshaiban A et al. 2019 | Saudi Arabia | 102 type II diabetic patients (T2DM) | Treatment adherence and satisfaction of elderly patients, the impact of adherence to HbA1c | The intervention program has improved medication adherence, satisfaction, and HbA1c level among elderly patients with T2DM. | Not applicable |
Alshayban DM et al. 2020 | Saudi Arabia | 531 patients with chronic and acute disease | Quality of service, duration of counseling, pharmacist knowledge | Most patients (43.9%) were satisfied with pharmacist counseling and average satisfaction rating was 7.87 ± 1.99/10. |
Not applicable |
Hale A et al. 2015 | Australia | 200 patients scheduled for elective surgery | Consultation satisfaction from doctor collaboration and patient satisfaction with prescribing pharmacists | Most of the patients had a high satisfaction with pharmacist prescriber consultations. | Not applicable |
Iancu ME et al. 2014 | Romania | Patients, relatives and caregivers who obtained counselling by pharmacists. | Patient education and counseling satisfaction, counseling on expired drug information | A great proportion of the respondents received all the information they needed from the pharmacist and were satisfied in the highest degree by the interview with the pharmacist. |
Not applicable |
Munro L et al. 2020 | Canada | 35 patients at the oncology clinic at | Convenience and easiness, medication information, communication between patients and clinical pharmacists | Patients are very satisfied with the average satisfaction score from 5.97 to 6.70, out of 7 possibilities. | Not applicable |
Hall JJ et al. 2016 | Canada | 62 patients at rheumatology clinic | General satisfaction, providing information, empathy for patients, Service techniques as well as competencies, ethics, and communication | Patient satisfaction in the collaborative care group was consistently higher across all dimensions. | Not applicable |
Fesharaki F, 2019 | Iran | 326 patients | Counseling using nonverbal communication (pharmacist tone of voice, body language), waiting time, Pharmacy atmosphere | In community pharmacies, nonverbal communication are significantly related to patient satisfaction. | Not applicable |
Another study from Saudi Arabia reported that the level of is low patient satisfaction with score was 2.97 ± 0.65 out of 5 scale (
In addition, the study conducted by Alkhoshaiban A et al. (2019) on 102 patients with type II diabetes showed that the intervention program has improved medication adherence, satisfaction, and HbA1c level among patients with type II diabetes. Medication adherence, satisfaction, and HbA1c level were all associated with gender. The improvement in medication adherence, satisfaction, and HbA1c level demonstrates the pharmacist’s critical role in the patient’s overall health management (
The study conducted by Hale A et al. (2016) in Australia on 200 patients scheduled for surgery reported that most of the patients had a high satisfaction with pharmacist prescriber consultations. This is because more than 97% patients were satisfied with counseling services in consultations with pharmacists. These are all key components in forming an effective partnership with a patient and adherence with treatment plans. (
In Romania,
Study conducted in Canada in 2021 on 35 patients experiencing anticancer therapy showed very high patient satisfaction with counseling services, where the average satisfaction score was 5.90–6.70 out of 7 possibilities (
In Iran, study conducted on 326 patients showed high patient satisfaction (
Table
Authors | Country | Participants | Factors that affect satisfaction | Result | Funding |
---|---|---|---|---|---|
Martin MT and Faber D M, 2016 | United States of America | A total of 64 patients received Hepatitis C Virus (HCV) treatment | HCV infection treatment as well as compliance education | Patients expressed high levels of satisfaction with the clinical pharmacist who assisted them with HCV treatment. | Not Applicable |
Reich CM et al. 2018 | United States of America | A total of 240 patients with psychiatric disorders | Satisfaction with antipsychotic drug monitoring | Conversations between prescribers and psychiatric patients in which the prescriber controls the conversational floor are a symptom of low patients satisfaction. | Not Applicable |
|
Canada | A total of 112 respondents were chemotherapy patients | Clinical pharmacy services and follow-up care for chemotherapy patients | 95.5% of respondents indicated that the time spent with the pharmacist at the first chemotherapy treatment was worthwhile (n=112). | Not Applicable |
Beyene K et al. 2020 | New Zealand | A total of 305 respondents who use Warfarin and are registered with the Community pharmacist-led Anticoagulation Management Service (CPAMS) | Patient satisfaction with CPAMS, communication, patient confidence in pharmacist competence, patient and pharmacist relationship | The mean overall satisfaction score was 94.5% ± 13.1 (range 3%–100%). | Not Applicable |
|
South Africa | A total of 300 patients used antiretrovirals | Antiretroviral treatment (ART) management satisfaction | The majority of patients (n = 297; 98%) were satisfied with the care they received at the ART locations. | Not Applicable |
Chou YC et al.,2019 | Taiwan | A total of 741 patients who received medical care | Patient confidence in doctors and pharmacists, patient satisfaction | Patient satisfaction and cooperation between patients and clinical pharmacists are both positively related to patient trust. | Taiwan National Science Council |
Sites BD et al, 2018 | Lebanese | A total of 19,566 patients with musculoskeletal disease | Satisfaction with prescription opioids use | Patients who take prescribed opioids for musculoskeletal pain are satisfied with their treatment. | Not Applicable |
Patient satisfaction with drug therapy monitoring services in the United States is reported to have different levels. According to
According to
Study of satisfaction with drug therapy monitoring services in South Africa on 300 patients with antiretroviral drug therapy monitoring for four months or more showed a high satisfaction level but patients expressed some dissatisfaction with certain dimensions of the quality of care, including an inability to talk to health workers about their treatment and problems, time spent in queues waiting to be examined and facility cleanliness (
Based on another study, patients in Taiwan with a history of more than one disease and monitored for therapy with more than one prescription had high satisfaction, as evidenced by a high level of confidence in pharmacists. Patient trust is positively related to patient satisfaction and cooperation between patients and clinical pharmacists. Thus, pharmacists should spend more time on each patient for can provide detailed information (
Table
Authors | Country | Participants | Factors that affect satisfaction | Results | Funding |
---|---|---|---|---|---|
Hatton J et al. 2017 | United States of America | 57 patients who received care from the face-to-face or clinical video teleconferencing (CVT) pharmacy clinic. | Patient convenience level, patient satisfaction with communication made with the clinical pharmacistcompetence and skills | Patients are satisfied with clinical pharmacists’ use of patient-centered communication via both CVT and face-to-face consultations. | Not Applicable |
Mooney EV et al. 2018 | United States of America | 161 patients received LAIA (Long-Acting Injectable Antipsychotics). | The level of privacy, the ease of making consultation appointments, convenience to pharmacy services, location convenience, the level of confidence in the pharmacist | Patients are satisfied with the LAIA services provided by pharmacists in community pharmacies. | Not applicable |
Bourdin A et al. 2020 | Switzerland | 17 patients participated in F-PSP (The Fingolimod Patient Support Program). | The level of patient safety and medication compliance with the F-PSP (Fingolimod Patient Support Program) method | Patients satisfied with F-PSP (The Fingolimod Patient Support Program) | The development of the F-PSP is supported by an unlimited grant from Novartis Pharma Schweiz AG. |
According to
In addition, a study in the United States was conducted by Mooney EV et al. (2018) on patients receiving aripiprazole, paliperidone, palmitate, and risperidone treatment. These patients were reported to have high satisfaction with the LAIA program with factors such as privacy, ease of making consultation appointments, convenience to pharmacy services, location convenience, and level of confidence in pharmacists (
Another study concerning the patient support program conducted in Switzerland by Bourdin, A. et al. (2020) on 17 patients who participated in The Fingolimod Patient Support Program (F-PSP) program showed high satisfaction assessed based on safety and compliance with treatment using the F-PSP method. The pharmacist-led consultations with medication-related and holistic support were well received by the patients. Patients’ involvement in their health is boosted by consultations based on motivational technique and the use of provided tools. Furthermore, pharmacists tend to contribute significantly to patient management from the perspective of patients (
Table
Authors | Country | Number of samples | Factors that affect satisfaction | Results | Funding |
---|---|---|---|---|---|
El-Sharif SI et al. 2017 | United Arab Emirates | A total of 375 patients with medical and non-medical educational backgrounds | Satisfaction with pharmaceutical care services | 77.1% of patients are satisfied with the pharmacist’s assistance. | Not Applicable |
Ali HS et al. 2019 | United Arab Emirates | A total of 210 respondents who came to pharmacy | The convenience of pharmacists in providing pharmaceutical care services | 39% patients were highly satisfied with the professional pharmacists’ counselling profile and 72.8% satisfied with the simple, understandable language used by the pharmacists. | Not Applicable |
Soeiro OM et al. 2017 | Brazil | A total of 8,803 patients present in the five geopolitical regions of Brazil | Convenience, availability of pharmaceutical care services | 58.4% patients satisfied with the pharmaceutical care services | Department for Pharmaceutical Services and Strategic |
Takaki H et al. 2015 | Japan | A total of 407 patients in Fukuoka Prefecture, Japan | Pharmaceutical care service information satisfaction | Patient satisfaction with pharmaceutical care was linked to pharmacist and patient views of information provision. | Not Applicable |
Abebe TB et al. 2016 | Ethiopia | A total of 291 patients living with HIV/AIDS | The level of privacy, the ease of making consultation appointments, the convenience of pharmaceutical care services | Patient satisfaction is relatively low with an average satisfaction of 2.86, 2.88, and 2.99 from 5-point Likert-type scale | Not applicable |
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Slovakia | A total of 2844 respondents aged 40 years and over | Location of pharmacy services, patient experience with qualified pharmacists and staff convenience, health checks, and self-service areas. | The results show high patient satisfaction with pharmaceutical services, specifically interpersonal relationships. | Not Applicable |
In the United Arab Emirates (UAE), a study conducted by
In a study conducted by
The study conducted by Soeiro, O.M., et al. (2017) on 8,803 patients in five geopolitical regions of Brazil stated that 58.4% were satisfied with the services received. This is influenced by the patients’ comfort feeling when communicating with pharmacists (
Another study was also conducted by
This literature review has several limitations. First, because of insufficient information about the health care system in countries where studies were conducted, this review does not discuss the difference in the health care system that could lead to different satisfaction levels. Second, the level of satisfaction could not be generalized, because the different cultures could influence the level of satisfaction of patients. However, this article could give an overview of patient satisfaction with clinical pharmacy services and the affecting factors.
In general, most patients are satisfied with clinical pharmacy services such as counseling, drug therapy monitoring, patient support programs, and pharmaceutical care. In addition, pharmaceutical service quality, convenience, information easiness, and patient confidence in pharmacist competence primarily influence patient satisfaction with clinical pharmacy services. Therefore, in the future, community pharmacists should equip themselves with the appropriate knowledge and competencies in clinical pharmacy services for benefit their patients.
There is no funding for this study.
This study has no conflict of interest.