Using Patient Expectations and Satisfaction Data to Design a New Pharmacy Service Model in a Primary Care Clinic

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Abstract
OBJECTIVE: To determine patient expectations for specific pharmacist-provided services and learn their present level of satisfaction with their current pharmacy services. Survey responses supported major decisions about the type of pharmacy practice model to implement in a local clinic. DESIGN: All patients who attended a primary care community-based clinic in June of 1995 completed a 72-item written survey while waiting for clinic care. Survey included items to determine patient's perceptions of current pharmacy services, level of satisfaction with these services; medication related education presently received in clinic, services the patient would desire from pharmacists if made available in clinic, and those factors that would influence use of pharmacy services. Responses provided by indicating the extent to which the respondent agreed with each specific survey item. Responses validated by incorporating comparable item response questions. Surveys analyzed by calculating frequencies in each response category and interpreting the practical significance. SETTING: Summit Plaza Clinic, a University of Nebraska Medical Center primary care community-based clinic in Bellevue. PATIENTS/PARTICIPANTS: The survey was administered to 475 clinic patients served by this clinic with 401 usable responses (response rate=84%). Most respondents were under captivated care (68%) and had a medication benefit as part of their health care plan (87%). INTERVENTIONS: Not applicable. MAIN OUTCOME MEASURES: Patient's expectations and satisfaction with specific pharmacy services expressed as "extent of agreement" statements. Patients stated intentions to use specific pharmacy services. RESULTS: Patients indicated general satisfaction with their traditional pharmacy services. However, 80% indicted they would switch to a dispensing pharmacy service provided within the primary care clinic if made available. Most patients also perceive that they receive basic medication counseling from their clinic physicians and other professionals. A majority of respondents indicated they would use advanced services from a pharmacist, such as advanced mediation monitoring services (60%), nonscheduled medication review sessions (40%), scheduled appointments (22%), and home visits (11 %), even though 1 %-6% indicated they used such services from pharmacists now. Patients also expressed a strong desire for pharmacists to interact with their physicians about medication-related needs. CONCLUSION: Survey results suggest that patients are interested in receiving advanced pharmacy-provided services, including education, telephone follow-up and refill reminders, physician-pharmacist interaction, and in-clinic dispensing services.

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