Testing a pharmacist-patient relationship quality model among older persons with diabetes.
BACKGROUND
Considering recent changes to the Medicare program, pharmacists will have unique opportunities to be reimbursed for providing Medication Therapy Management Services to older persons with diabetes. A high-quality pharmacist-patient relationship can lay the foundation for effective provision of Medication Therapy Management Services and improved care in this cohort.


OBJECTIVE
To test a pharmacist-patient relationship quality model in a group of older persons with diabetes from the patient's perspective. Antecedents to relationship quality were pharmacist participative behavior/patient-centeredness of relationship, patient participative behavior, and pharmacist-patient interpersonal communication. Pharmacist-patient relationship commitment was the outcome of relationship quality studied.


METHODS
Data were collected via mailed questionnaire from a random sample of 600 community-dwelling adults in the United States who (1) were 65 years of age and older, (2) had type 1 or type 2 diabetes, (3) used at least one prescription medication to treat their diabetes, and (4) used some type of nonmail order pharmacy as their primary source of obtaining prescription medications. Model relationships were tested using path analysis.


RESULTS
The adjusted response rate was 41.6% (221/531). The models explained 47% and 49% of the variance in relationship quality and relationship commitment, respectively. In the relationship quality model, pharmacist participative behavior/patient-centeredness of relationship (beta=.51, P<.001) and pharmacist-patient interpersonal communication (beta=.17, P=.008) had direct effects on relationship quality. In the relationship commitment model, relationship quality had a direct effect on relationship commitment (beta=.60, P<.001). Pharmacist participative behavior/patient-centeredness and pharmacist-patient interpersonal communication had indirect effects on relationship commitment through their effects on relationship quality, which is a mediator in the model.


CONCLUSIONS
Results affirm findings from previous research showing that patients' perceptions of pharmacist participative behavior/patient-centeredness of relationship and pharmacist-patient interpersonal communication are positively related to perceptions of relationship quality. Also, relationship quality is a strong mediator between pharmacist participative behavior/patient-centeredness of relationship and relationship commitment, as well as between pharmacist-patient interpersonal communication and relationship commitment.
Worley
Marcia M
MM
University of Minnesota, College of Pharmacy, Duluth, MN 55812-3095, USA. wor10016@d.umn.edu
D000367:Age Factors; D000368:Aged; D000375:Aging; D001291:Attitude of Health Personnel; D003142:Communication; D003157:Community Pharmacy Services; D003430:Cross-Sectional Studies; D003922:Diabetes Mellitus, Type 1 / Q000188:drug therapy*; D003924:Diabetes Mellitus, Type 2 / Q000188:drug therapy*; D005163:Factor Analysis, Statistical; D005260:Female; D006801:Humans; D008297:Male; D015233:Models, Statistical; D010347:Patient Care Planning; D010358:Patient Participation; D017060:Patient Satisfaction; D010595:Pharmacists; D011369:Professional-Patient Relations; D011787:Quality of Health Care; D015203:Reproducibility of Results; D012107:Research Design; D011795:Surveys and Questionnaires; D014481:United States