Patient Experience and Satisfaction of Pharmaceutical Services in a Tertiary Care Hospital

Introduction

In a hospital, pharmacy is the service that is instrumental in maintaining and improving patient treatment and medication management to the highest standards.¹ Pharmacies are rapidly expanding their services beyond medicine distribution to become more patient-centred and caring. As per good pharmacy practice, it is required that pharmacist need to consider the welfare of patients and help patient to utilize the drug as their primary duty.² The pharmacist is expected to have a caring attitude and to use his or her pharmacological knowledge and skill to improve the health and well-being of patients.³ The key to enhancing the quality of patient services that impacts their satisfaction is increase in patient awareness about healthcare systems. There is a greater demand on the providers to enhance the level of care.⁴

There is ample evidence that a better patient experience leads to a higher level of adherence to recommended treatment, better clinical outcomes, greater patient safety in hospital and less utilization of medical care.⁵

Patients must be questioned about whether events that should have occurred in a healthcare setting did so to evaluate the patient experience. It will give a better insight into how happy a patient is with the service and the factors that lead to patient retention.⁶

Assessing patient satisfaction with medical services is clinically relevant because satisfied patients are more likely to comply with treatment, actively participate in their care to continue using pharmacy services and stay with the health provider in the specific system. It is found that survey is an effective, reliable, and useful method to assess patient satisfaction with pharmacy service.⁷ Studies show that punctuality of the service, attitude of the pharmacist, consultation of medicines, location of the pharmacy and the waiting area have a positive impact on patient satisfaction.^8,9 According to another study, participants’ perception of the waiting area and adequate number of pharmacists to provide services were important predictors of their satisfaction.¹⁰ The factors that determine the patient’s compliance with their treatment include complexity and frequency of dosage, convenience, and satisfaction.¹¹ A study conducted in Netherlands hospital showed that almost all patients considered it necessary to receive all information regarding the drug.¹² A positive association has been demonstrated between medication compliance and patient satisfaction with information received about their medication. Providing information about potential problems patients might face, can improve their medication experience.¹³ Regardless of the type of hospital, various findings highlight the critical need for managerial interventions such as hiring of trained professionals, onsite training of pharmacy staff, the implementation of clinical or patient centred pharmacy services, and appropriate controlling measures.¹⁴

Therefore, assessment of patient experience with pharmaceutical services is crucial. This in turn will give information to improve pharmacy services in a way that it can compel health care providers to guarantee clients health outcome by knowing their concerns and their needs. This study was conducted with the aim to assess patient experience and satisfaction in out-patient pharmacy of a selected hospital. Not many studies were found during the literature review showing the correlation between patient experience and satisfaction. This study will help health care providers to provide high quality services by identifying specific areas for improvement in pharmacy services and for enhancing positive experience in the current pharmaceutical service.

Materials and Methods

This study was descriptive cross sectional and was conducted in a tertiary care teaching hospital. A sample size of 95 was calculated using the formula n=Zα2 p(1-p)/e2. The study included patients visiting out-patient pharmacy. Random sampling technique was adopted to select the sample.

A structured questionnaire was developed from various relevant literature. Questionnaire included respondent’s demographic factors, questions related to experience and satisfaction. The satisfaction section of the questionnaire was divided into two - questions related to physical facility and those related to the pharmacist’s attitude. Patients were asked to rate their experience and satisfaction on a five-point Likert scale. The tool was created in English first, and then translated to Kannada. The tool was validated by experts and a pilot study was done on a sample of patients.

SPSS version 23 was used to analyze the data. The data was reported using descriptive statistical methods (frequency, percentages, mean). The patient experience and satisfaction was then evaluated using mean score. The 5-point rating was simplified into three categories for the purpose of drawing inference. If mean score was more than 4, it indicated ‘very good’, mean score between 3 & 4 was considered ‘good’ and if the mean score was less than 3, it was considered ‘poor’. The Karl Pearson correlation coefficient was used to calculate the correlation between patient experience and patient satisfaction.

Results

Demographic characteristics of respondents

A total of 95 study participants were included in the study. Most of the patients (34%) were between the age group 20-29 years, 62% of the patients were males, and 39% of the respondents were graduates. 55% patients had visited the pharmacy 1-3 times and for majority 52% of patients, the number drugs dispensed were between 1-3 (Table 1).

Overall patient experience in hospital pharmacy was found to be ‘very good’ with a mean of 4.49. Assessment of patient experience demonstrated that more than 70% patients strongly agreed with five out of nine aspects of patient’s experience in hospital pharmacy. More than 60% patients strongly agreed with adequate number of pharmacists (68%), privacy of patient’s conversation with the pharmacist (67%). Only 61% patients felt that they had to wait for a short time to receive the medication and 53% agreed pharmacist spent sufficient time with them to provide necessary service (Table 2).

Overall patient satisfaction was ‘very good’ with a mean of 4.49 which included satisfaction regarding physical facility and pharmacist attitude. Assessment of patients’ satisfaction regarding physical facility demonstrated that >70% patients were highly satisfied regarding four areas of physical facility i.e enough number of seats in waiting area, comfortable waiting area, cleanliness of pharmacy, comfortable pharmacy counter. Around 68% of patients were highly satisfied regarding convenience of pharmacy’s location and appropriate signage’s to locate the pharmacy. Assessment of satisfaction regarding pharmacist attitude revealed that patients were highly satisfied about three aspects i.e courtesy and friendliness of pharmacist, pharmacist paying attention to patients, providing medication with an explanation and a clear drug label. About 65% patients were highly satisfied with pharmacist giving information regarding how to take medication, 62% patients were highly satisfied with pharmacist giving proper information regarding how to store the medication and 34% patients were dissatisfied regarding pharmacist explaining the medication side effects.

Correlation between patient experience and patient satisfaction

The correlation between patient experience and patient satisfaction was significantly positive with r=0.755, P=0.000 (<0.05).

Discussion

The tool used in this study had relevant factors to assess patient experience and satisfaction. This study revealed that overall patients' experience in outpatient pharmacy was very good with a mean 4.49 ± 0.50; this could be because the pharmacy was newly built with good infrastructure. Although patient experience in OP pharmacy was very good, patient experience regarding waiting time and pharmacist spending adequate time was not so good. Few factors related to patient experience in the study were similar to previous studies.^9,15 Respectful pharmacist, privacy of patient and waiting time appear to be the factors that are common in these studies. The findings are comparable to that of Oparah and Enato et al., where nearly half of the patients were dissatisfied with the amount of time the pharmacist offered to spend with them and only half of the patients were satisfied with the pharmaceutical services.¹⁶

Patient satisfaction is a person’s experience of joy or disappointment as a result of a service’s perceived performance or outcome in accordance with his or her expectation. Assessing patient satisfaction with medical services is clinically relevant because satisfied patients are more likely to comply with treatment, actively participate in their care, continue using pharmacy services and stay with the health provider in the specific system.^4,17 In the current study, overall patient satisfaction regarding hospital pharmacy was very good with a mean of 4.49 ± 0.48. Here more than 70% patients were highly satisfied about four areas of physical facility i.e, enough number of seats in waiting area (71.6%), comfortability of waiting area (72.6%), cleanliness of pharmacy (73.7%), comfortability of pharmacy counter (74.7%). Around 68.4% of patients were highly satisfied regarding convenience of pharmacy’s location and appropriate signage’s to locate the pharmacy. The findings are consistent with Kebede and Tsehay’s study in which more than half of the respondents agreed that the pharmacy location was appropriate/convenient, waiting area was comfortable, and the dispensary was clean.¹⁸ Ambelie and Demssie et al., however reported that 70.8% of participants were dissatisfied with the availability of sign and direction indicators to help them find their way around the hospital with 93.2% patients satisfied with the cleanliness of service delivery rooms.¹⁹ In line with current study, majority of participants were satisfied with drug labelling, but were less satisfied with the medication guidance received. Less than half of the study participants were pleased with the emphasis placed on medications they received and the storage conditions for the medications. Furthermore, only about a quarter of the participants were satisfied with the medication side effects and drug interactions precautions.^{7,16, 20,}

The attention of hospital management is required in few areas of hospital pharmacy, improvement of which will result in increased satisfaction. Designing separate counter for dispensing less than three medicines can reduce waiting time. Providing proper and sufficient medication guidance to needy clients and regular training programmes regarding patient education can improve patient experience. The limitation of the study was that it was conducted in a single setting and cannot be generalized to other settings.

Conclusion

In this study, most participants expressed satisfaction regarding their hospital pharmacy experience. The satisfaction of respondents with the physical facility and the pharmacist's attitude was highly encouraging. Participants' satisfaction was negatively related to their perception of information about medication side effects. It is recommended that hospital pharmacist provide proper and sufficient medication guidance to patients as they play an important role in providing complete information that ensures best results of the medications, while reducing occurrence of the untoward effects. Improving pharmacists' interpersonal skills is likely to increase patient satisfaction with pharmacy services. These are few areas which require attention to improve quality of service in the pharmacy.

Conflict of interest

None