Impact of pharmacy care services on patients' perceptions of health care quality for diabetes.
OBJECTIVE
To (1) construct and evaluate a measure of patients' perceptions of the quality of diabetes care and (2) determine the impact of pharmacy care services (PCSs) on patients' perceptions of the quality of their diabetes care while controlling for patient-related factors.


METHODS
Two-phased study using a single-group, pretest-posttest design.


METHODS
Community pharmacies that provided PCSs to diabetic patients as part of the Patient Self-Management Program for Diabetes in North Carolina, Georgia, Ohio, and Wisconsin.


METHODS
218 patients with diabetes covered by self-insured employers' health plans.


METHODS
Pharmacist-provided care services using scheduled consultations, clinical goal setting, monitoring, and collaborative drug therapy management with physicians and referrals to diabetes educators.


METHODS
Changes in patients' perceptions of quality measured by a self-administered questionnaire that included a six-item scale of information quality, a five-item scale of provider quality, and a one-item overall rating of care.


RESULTS
The assessment of the baseline data (Phase I) demonstrated that the measures of perceived quality possessed acceptable psychometric properties. After PCSs were implemented (Phase II), the scores for the information scale improved significantly (paired t = 7.64, P < 0.01), as did the scores for the provider scale (paired t = 6.30, P < 0.01) and the overall rating (paired t = 5.54, P < 0.01). In multivariate analyses, the improvement in perceived quality was not explained by the change in glycosylated hemoglobin when controlling for age, gender, race/ethnicity, and baseline quality perceptions.


CONCLUSIONS
PCSs enhanced patients' perceived quality of their diabetes care. The improvement in perceived quality was not explained by the change in glycemic control, which suggests that nonclinical factors in care are important to patients' evaluations of quality.
Nau
David P
DP
College of Pharmacy, University of Kentucky, Lexington, KY 40536-0082, USA. dnau2@email.uky.edu
Pacholski
Angela M
AM
D003920:Diabetes Mellitus / Q000188:drug therapy / Q000523:psychology*; D005260:Female; D006442:Glycated Hemoglobin; D006801:Humans; D007004:Hypoglycemic Agents / Q000627:therapeutic use; D008297:Male; D008875:Middle Aged; D010353:Patient Education as Topic; D017060:Patient Satisfaction; D010465:Perception; D010593:Pharmaceutical Services; D011369:Professional-Patient Relations; D011787:Quality of Health Care; D011795:Surveys and Questionnaires
D006442:Glycated Hemoglobin; D007004:Hypoglycemic Agents