A cross-sectional assessment of patient satisfaction with community pharmacy services in Lebanon: The IMPHACT-LB study
DOI:
https://doi.org/10.46542/pe.2023.231.707722Keywords:
Access to care, Community pharmacy service, Patient satisfaction questionnaire, Pharmaceutical care, PSQ-18Abstract
Background: After the pharmacy profession has shifted from product-oriented practices to a more patient-centered approach, patient satisfaction has become an essential indicator of overall quality of care. This study aimed to assess the impact of pharmacy services and pharmacist-patient relationships on patient satisfaction in a crisis context, considering patient characteristics, economic factors, access to care, and health status.
Methods: A web-based cross-sectional study (April 11-April 27, 2023) assessed patient satisfaction using validated tools among 865 Lebanese adults.
Results: Satisfaction with pharmaceutical care was moderate (60%), varying between 58% and 63%. Notably, higher satisfaction was significantly and positively correlated with having private health insurance (Beta=0.583), taking more medications (Beta=0.166), and receiving advice from pharmacists about a healthy lifestyle (Beta=0.651), while lower satisfaction was associated with a university level of education (Beta=-0.505), older age (Beta=-0.022), and perceiving pharmacists as medication experts (Beta=-1.007).
Conclusion: Age, education, health coverage, and patient expectations, in addition to services offered by community pharmacists, significantly affected satisfaction in times of crisis. Stakeholders should address pharmaceutical care holistically, acting concomitantly on improving health coverage, access to care, reasonable expectations, and optimising community pharmacy services.
References
Alanazi, A. S., Shah, S., Abbas, G., Hussain, M., Saleem, A., Khurram, H., Chand, U. R., Mallhi, T. H., Khan, Y. H., Ilyas, K., Tariq, S., Jamil, A., Alzarea, A. I., & Alzarea, S. I. (2023). Assessing patient satisfaction with community pharmacy services: A large regional study at Punjab, Pakistan. Patient Preference and Adherence, 17, 13–22. https://doi.org/10.2147/PPA.S389053
Al-Arifi, M. N. (2012). Patients’ perception, views and satisfaction with pharmacists’ role as health care provider in community pharmacy setting at Riyadh, Saudi Arabia. Saudi Pharmaceutical Journal: The Official Publication of the Saudi Pharmaceutical Society, 20(4), 323–330. https://doi.org/10.1016/j.jsps.2012.05.007
Alghurair, S. A., Simpson, S. H., & Guirguis, L. M. (2012). What elements of the patient-pharmacist relationship are associated with patient satisfaction? Patient Preference and Adherence, 6, 663–676. https://doi.org/10.2147/PPA.S35688
Alssageer, M. A., Hassan, A. O., & Rajab, M. O. (2021). Consumers’ view, expectation and satisfaction with community pharmacy services. ConsumersMediterranean Journal of Pharmacy and Pharmaceutical Sciences, 1(4), 90–98. https://medjpps.com/mjpps/uploads/topics/16409139046107.pdf
Al-Tannir, M., Alharbi, A. I., Alfawaz, A. S., Zahran, R. I., & AlTannir, M. (2016). Saudi adults satisfaction with community pharmacy services. SpringerPlus, 5(1), 774. https://doi.org/10.1186/s40064-016-2442-8
Awad, A. I., Al-Rasheedi, A., & Lemay, J. (2017). Public Perceptions, expectations, and views of community pharmacy practice in Kuwait. Medical Principles and Practice, 26(5), 438–446. https://doi.org/10.1159/000481662
Aziz, M. M., Ji, W., Masood, I., Farooq, M., Malik, M. Z., Chang, J., Jiang, M., Atif, N., & Fang, Y. (2018). Patient satisfaction with community pharmacies services: A cross-sectional survey from Punjab; Pakistan. International Journal of Environmental Research and Public Health, 15(12), 2914. https://doi.org/10.3390/ijerph15122914
Bawazir, S. A. (2004). Consumer attitudes towards community pharmacy services in Saudi Arabia. International Journal of Pharmacy Practice, 12(2), 83–89. https://doi.org/10.1211/0022357023718
Bou Raad, E., Hallit, S., Iskandar, K., Zeenny, R., & Salameh, P. (2017). Validation of a patient-pharmacist relationship measurement tool in Lebanon. Research & Reviews in Pharmacy and Pharmaceutical Sciences, 6(2), 1–10. https://www.rroij.com/peer-reviewed/validation-of-a-patientpharmacist-relationship-measurementrntool-in-lebanon-85917.html
Cavaco, A. M., Dias, J. P. S., & Bates, I. P. (2005). Consumers’ perceptions of community pharmacy in Portugal: A qualitative exploratory study. Pharmacy World & Science, 27, 54–60. https://doi.org/10.1007/s11096-004-2129-z
Cerulli, J. (2002). Patients’ perceptions of independent community pharmacists. Journal of the American Pharmaceutical Association, 42(2), 279–282. https://doi.org/10.1331/108658002763508551
Chhabra, M., Gudi, S. K., Rashid, M., Goyal, A., Tripathi, R. K., & Kashyap, A. (2019). Satisfaction towards the services provided by the community pharmacist in north-west India: A qualitative exploratory study. Clinical Epidemiology and Global Health, 7(4), 615–619. https://doi.org/10.1016/j.cegh.2019.02.001
Das, M. (2021). Lebanon faces critical shortage of drugs. The Lancet Oncology, 22(8), 1063. https://doi.org/10.1016/S1470-2045(21)00396-X
Druică, E., Ianole-Călin, R., Băicuș, C., & Dinescu, R. (2021). Determinants of satisfaction with services, and trust in the information received in community pharmacies: A comparative analysis to foster pharmaceutical care adoption. Healthcare, 9(5), Article 5. https://doi.org/10.3390/healthcare9050562
El Bizri, L., & Dimassi, A. (2019). Lebanese community pharmacy: The role of the pharmacist in the health care. European Journal of Pharmaceutical and Medical Research, 6(1), 149–158. https://www.ejpmr.com/home/abstract_id/4567
El Hajj, M. S., Salem, S., & Mansoor, H. (2011). Public’s attitudes towards community pharmacy in Qatar: A pilot study. Patient Preference and Adherence, 5, 405–422. https://doi.org/10.2147/PPA.S22117
El-Jardali, F., Masri, R., & Sleem, Z. (2023). LCPS - Rethinking Lebanon’s healthcare system amid the economic crisis. Lebanese Center for Policy Studies. https://www.lcps-lebanon.org/articles/details/4799/rethinking-lebanon’s-healthcare-system-amid-the-economic-crisis
El-Kholy, A. A., Abdelaal, K., Alqhtani, H., Abdel-Wahab, B. A., & Abdel-Latif, M. M. M. (2022). Publics’ perceptions of community pharmacists and satisfaction with pharmacy services in Al-Madinah City, Saudi Arabia: A cross sectional study. Medicina, 58(3), 432. https://doi.org/10.3390/medicina58030432
El‑Sharif, S. I., Abd Alrahman, N., Khaled, N., Sayah, N., Gamal, E., & Mohamed, A. (2017). Assessment of patient’s satisfaction with pharmaceutical care services in community pharmacies in the United Arab Emirates. Archives of Pharmacy Practice, 8(1), 22–30. https://archivepp.com/article/assessment-of-patients-satisfaction-with-pharmaceutical-care-services-in-community-pharmacies-in-the-united-arab-emirates
George, P. P., Molina, J. A. D., Cheah, J., Chan, S. C., & Lim, B. P. (2010). The evolving role of the community pharmacist in chronic disease management—A literature review. Annals of the Academy of Medicine, Singapore, 39(11), 861–867.
Ghattas, D., & Al-Abdallah, G. (2020). Factors affecting customers selection of community pharmacies: The mediating effect of branded pharmacies and the moderating effect of demographics. Management Science Letters, 10(8), 1813–1826. http://growingscience.com/beta/msl/3695-factors-affecting-customers-selection-of-community-pharmacies-the-mediating-effect-of-branded-pharmacies-and-the-moderating-effect-of-demographics.html
Gold, M., & Wooldridge, J. (1995). Surveying consumer satisfaction to assess managed-care quality: Current practices. Health Care Financing Review, 16(4), 155. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4193529/
Hajjar, M. S., Atallah, G. M., Faysal, H., Atiyeh, B., Bakhach, J., & Ibrahim, A. E. (2021). The 2020 Beirut explosion: A healthcare perspective. Annals of burns and fire disasters, 34(4), 293–300. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8717904
Hall, J. A., & Dornan, M. C. (1990). Patient sociodemographic characteristics as predictors of satisfaction with medical care: A meta-analysis. Social Science & Medicine, 30(7), 811–818. https://doi.org/10.1016/0277-9536(90)90205-7
Hallit, S., Zeenny, R. M., Sili, G., & Salameh, P. (2017). Situation analysis of community pharmacy owners in Lebanon. Pharmacy Practice, 15(1), 853–853. https://doi.org/10.18549/PharmPract.2017.01.853
Hamadeh, N., Van Rompaey, C., Metreau, E., & Eapen, S. G. (2022, July 1). New World Bank country classifications by income level: 2022-2023. https://blogs.worldbank.org/opendata/new-world-bank-country-classifications-income-level-2022-2023
Hasan, S., Sulieman, H., Stewart, K., Chapman, C. B., Hasan, M. Y., & Kong, D. C. M. (2013). Assessing patient satisfaction with community pharmacy in the UAE using a newly-validated tool. Research in Social & Administrative Pharmacy, 9(6), 841–850. https://doi.org/10.1016/j.sapharm.2012.10.002
Hermansen, C. J., & Wiederholt, J. B. (2001). Pharmacist-patient relationship development in an ambulatory clinic setting. Health Communication, 13(3), 307–325. https://doi.org/10.1207/S15327027HC1303_5
Iskandar, K., Hallit, S., Raad, E. B., Droubi, F., Layoun, N., & Salameh, P. (2017). Community pharmacy in Lebanon: A societal perspective. Pharmacy Practice, 15(2), 893. https://doi.org/10.18549/PharmPract.2017.02.893
Ismail, A., Gan, Y. N., & Ahmad, N. (2020). Factors associated with patient satisfaction towards pharmacy services among out-patients attending public health clinics: Questionnaire development and its application. PloS One, 15(11), e0241082. https://doi.org/10.1371/journal.pone.0241082
Kamei, M., Teshima, K., Fukushima, N., & Nakamura, T. (2001). Investigation of patients’ demand for community pharmacies: Relationship between pharmacy services and patient satisfaction. Yakugaku Zasshi: Journal of the Pharmaceutical Society of Japan, 121(3), 215–220. https://pubmed.ncbi.nlm.nih.gov/11265116/
Kamran, K., Iqbal, Q., Haider, S., Anwar, M., Ishaq, R., & Saleem, F. (2020). Public’ perception, awareness, expectations and experiences towards the role of community pharmacists in Quetta City, Pakistan. Journal of Pharmacy Practice and Community Medicine, 6(1). https://doi.org/10.5530/jppcm.2020.1.3
Kang, J., Rhew, K., Oh, J. M., Han, N., Lee, I.-H., Je, N. K., Ji, E., Lee, E., Yoon, J.-H., & Rhie, S. J. (2017). Satisfaction and expressed needs of pharmaceutical care services and challenges recognized by patients in South Korea. Patient Preference and Adherence, 11, 1381–1388. https://doi.org/10.2147/PPA.S141562
Karaca, A., & Durna, Z. (2019). Patient satisfaction with the quality of nursing care. Nursing Open, 6(2), 535–545. https://doi.org/10.1002/nop2.237
Kassam, R., Collins, J. B., & Berkowitz, J. (2009). Developing anchored measures of patient satisfaction with pharmaceutical care delivery: Experiences versus expectations. Patient Preference and Adherence, 3, 113–122. https://doi.org/10.2147/ppa.s5087
Kassam, R., Collins, J. B., & Berkowitz, J. (2012). Patient satisfaction with pharmaceutical care delivery in community pharmacies. Patient Preference and Adherence, 6, 337–348. https://doi.org/10.2147/PPA.S29606
Khalife, J., Ekman, B., Ammar, W., El-Jardali, F., Al Halabi, A., Barakat, E., & Emmelin, M. (2023). Exploring patient perspectives: A qualitative inquiry into healthcare perceptions, experiences and satisfaction in Lebanon. PLOS ONE, 18(8), e0280665. https://doi.org/10.1371/journal.pone.0280665
Khayyat, S., Walters, P., Whittlesea, C., & Nazar, H. (2021). Patient and public perception and experience of community pharmacy services post-discharge in the UK: A rapid review and qualitative study. BMJ Open, 11(3), e043344. https://doi.org/10.1136/bmjopen-2020-043344
Khojah, H. M. J. (2019). Privacy level in private community pharmacies in Saudi Arabia: A simulated client survey. Pharmacology & Pharmacy, 10(10), Article 10. https://doi.org/10.4236/pp.2019.1010036
Kristina, S. A., Lienaningrum, A. S., & Aditama, H. (2021). Assessing patient satisfaction with community pharmacy services in Yogyakarta, Indonesia. International Journal of Pharmaceutical Research, 13(01). https://doi.org/10.31838/ijpr/2021.13.01.652
Larson, L. N., Rovers, J. P., & MacKeigan, L. D. (2002). Patient satisfaction with pharmaceutical care: Update of a validated instrument. Journal of the American Pharmaceutical Association, 42(1), 44–50. https://doi.org/10.1331/108658002763538062
Lea, T., Sheridan, J., & Winstock, A. (2008). Consumer satisfaction with opioid treatment services at community pharmacies in Australia. Pharmacy World & Science, 30(6), 940–946. https://doi.org/10.1007/s11096-008-9257-9
Malewski, D. F., Ream, A., & Gaither, C. A. (2015). Patient satisfaction with community pharmacy: Comparing urban and suburban chain-pharmacy populations. Research in Social & Administrative Pharmacy, 11(1), 121–128. https://doi.org/10.1016/j.sapharm.2014.05.001
Márquez-Peiró, J. F., & Pérez-Peiró, C. (2008). Evaluación de la satisfacción y de la insatisfacción de pacientes atendidos en la unidad de atención farmacéutica a pacientes externos. Farmacia Hospitalaria, 32(2), 71–76. https://doi.org/10.1016/S1130-6343(08)72817-4
Marshall, G. N., & Hays, R. D. (1994). The patient satisfaction questionnaire short form (PSQ-18). RAND Corporation. https://www.rand.org/pubs/papers/P7865.html
Matar, M. S., Eljanzoury, A. M., Musa, S. I., Abdulwahaab, M. A., Mustafa, A. A., Yousef, B. A., & Badi, S. (2021). Evaluation of counseling services provided by community pharmacists and patients’ satisfaction toward their services: A cross-sectional survey from Sudan. Current Medical Issues, 19(1), 24. https://doi.org/10.4103/cmi.cmi_138_20
Mera, J. A. (2002). A review of the “welfare state” and alternative ways of delivering health care. International Journal for Quality in Health Care, 14(2), 87–90. https://doi.org/10.1093/oxfordjournals.intqhc.a002605
Mináriková, D., Malovecka, I., & Foltan, V. (2016a). Patient choice of pharmacy and satisfaction with pharmaceutical care – Slovak regional comparison. Farmacia, 64(3), 473–480. https://farmaciajournal.com/wp-content/uploads/2016-03-art-24-Minarikova_473-480.pdf
Mináriková, D., Malovecká, I., Lehocká, Ľ., Snopková, M., & Foltán, V. (2016b). The Assessment of patient satisfaction and attendance of community pharmacies in Slovakia. European Pharmaceutical Journal, 63(2), 23–29. https://doi.org/10.1515/afpuc-2016-0002
Mohamud, A. I., Shire, F. A., Hussain, K. S., Mahmoud, A. N., & Taha, L. O. (2021). Assessing Patient satisfaction with the service quality provided in community pharmacies: Khartoum locality, Sudan. Journal of Young Pharmacists, 13(4), 405–410. https://doi.org/10.5530/jyp.2021.13.98
Naik Panvelkar, P., Saini, B., & Armour, C. (2009). Measurement of patient satisfaction with community pharmacy services: A review. Pharmacy World & Science, 31(5), 525–537. https://doi.org/10.1007/s11096-009-9311-2
Naser, A. Y., & Abu Sbeat, B. S. (2022). Satisfaction with community pharmacies services in Jordan: A cross-sectional study. Saudi Pharmaceutical Journal, 30(11), 1646–1651. https://doi.org/10.1016/j.jsps.2022.09.007
Nkansah, N., Mostovetsky, O., Yu, C., Chheng, T., Beney, J., Bond, C. M., & Bero, L. (2010). Effect of outpatient pharmacists’ non-dispensing roles on patient outcomes and prescribing patterns. The Cochrane Database of Systematic Reviews, 2010(7), CD000336. https://doi.org/10.1002/14651858.CD000336.pub2
Pinto, A. R., Machado, A., Gonçalves, E., Salsas, L., Vicente, T., Ribeiro, M. I. B., & Pinto, I. C. J. F. (2014). Users satisfaction regarding the service provided in community pharmacies. Advances in Pharmacology and Pharmacy, 2(2), 18–29. https://doi.org/10.13189/app.2014.020202
Prawitz, A. D., Garman, E. T., Sorhaindo, B., O’Neill, B., Kim, J., & Drentea, P. (2006). Incharge financial distress/financial well-being scale: Development, administration, and score interpretation. Financial Counseling and Planning, 17, 34–50. https://doi.org/10.1037/t60365-000
Rasheed, M. K., Alqasoumi, A., Hasan, S. S., & Babar, Z.-U.-D. (2020). The community pharmacy practice change towards patient-centered care in Saudi Arabia: A qualitative perspective. Journal of Pharmaceutical Policy and Practice, 13, 59. https://doi.org/10.1186/s40545-020-00267-7
Sacre, H., Hajj, A., Badro, D. A., Abou Selwan, C., Haddad, C., Aoun, R., & Salameh, P. (2022). The combined outcomes of the COVID-19 pandemic and a collapsing economy on mental well-being: A cross-sectional study. Psychological reports, 332941221110545. https://doi.org/10.1177/00332941221110545
Sacre, H., Haddad, C., Hajj, A., Zeenny, R. M., Akel, M., & Salameh, P. (2023). Development and validation of the socioeconomic status composite scale (SES-C). BMC Public Health, 23(1), 1619. https://doi.org/10.1186/s12889-023-16531-9
Sakr, F., Akel, M., Sacre, H., Haddad, C., Tawil, S., Safwan, J., Hajj, A., Zeenny, R. M., Iskandar, K., & Salameh, P. (2023). The specialized competency framework for community pharmacists (SCF-CP) in Lebanon: Validation and evaluation of the revised version. Journal of Pharmaceutical Policy and Practice, 16(1), 77. https://doi.org/10.1186/s40545-023-00585-6
Sanmartin, C., Berthelot, J.-M., & McIntosh, C. N. (2007). Determinants of unacceptable waiting times for specialized services in Canada. Healthcare Policy = Politiques De Sante, 2(3), e140-154.
Stergachis, A., Maine, L. L., & Brown, L. (2002). The 2001 national pharmacy consumer survey. Journal of the American Pharmaceutical Association, 42(4), 568–576. https://doi.org/10.1331/108658002763029535
Tawil, S., Sacre, H., Sili, G., & Salameh, P. (2020). Patients’ perceptions regarding pharmacists’ healthcare services: The case of Lebanon. Journal of Pharmacy Practice and Research, 50(2), 137–143. https://doi.org/10.1002/jppr.1615
United Nations. (2023). Sustainable development goal 3 (SDG3): Good health and well-being. Sustainable Development Goals (SDGs). https://unstats.un.org/sdgs/report/2023/Goal-03/
Verbeek, J. (2004). Patient satisfaction: Is it a measure for the outcome of care or the process of care? Journal of Clinical Epidemiology, 57(2), 217. https://doi.org/10.1016/j.jclinepi.2003.07.006
Wazaify, M., Al-Bsoul-Younes, A., Abu-Gharbieh, E., & Tahaineh, L. (2008). Societal perspectives on the role of community pharmacists and over-the-counter drugs in Jordan. Pharmacy World & Science, 30(6), 884–891. https://doi.org/10.1007/s11096-008-9244-1
Wiedenmayer, K., Summers, R. S., Mackie, C. A., Gous, A. G. S., Everard, M., Tromp, D., Organization, W. H., & Federation, I. P. (2006). Developing pharmacy practice: A focus on patient care - handbook (WHO/PSM/PAR/2006.5). World Health Organization. https://apps.who.int/iris/handle/10665/69399
Wirth, F., Tabone, F., Azzopardi, L. M., Gauci, M., Zarb-Adami, M., & Serracino-Inglott, A. (2010). Consumer perception of the community pharmacist and community pharmacy services in Malta. Journal of Pharmaceutical Health Services Research, 1(4), 189–194. https://doi.org/10.1111/j.1759-8893.2010.00034.x
