title: Patient evaluation of a community pharmacy medications management service.
abstract: BACKGROUND
  A patient-centered approach is increasingly recognized as an important component in the evaluation of healthcare services.
  
  
  OBJECTIVE
  To assess patient satisfaction with, attitudes toward, and expectations of or experience with community pharmacy in general, and to evaluate the effect of the community pharmacy-led medications management service on these factors.
  
  
  METHODS
  Postal questionnaire surveys were completed at baseline and after 12 months (follow-up) as part of a randomized controlled trial of the service. The setting was 9 primary care organizations in England. Patients with coronary heart disease were recruited from general practice registers and randomly allocated to the intervention (pharmacy-led medications management service) or control group.
  
  
  RESULTS
  Survey response rates at baseline and follow-up were 88.4% (1232/1394) and 80.1% (1085/1355), respectively. The respondents indicated that they wanted pharmacists to provide dispensing, medications review, advice on medications and health, private consultation areas, and short visit times. At follow-up, intervention patients were more likely than control patients (p < 0.01) to rate the service provided by their pharmacist with a higher level of satisfaction, and most intervention patients stated a preference for seeing their physician to discuss their medications, although this was less marked than in control patients (76% vs 85%; p < 0.01). Intervention patients were also more willing than control patients to ask the pharmacist questions that they would be unable to ask a physician (20% vs 11%, respectively; p < 0.01), to ask the pharmacist questions about their medications (32% vs 18%, respectively; p < 0.01), and to recommend this practice to others (51% vs 40%, respectively; p < 0.01).
  
  
  CONCLUSIONS
  Pharmacist intervention was associated with significant and positive changes in patient satisfaction. While patients probably continue to prefer a physician-led service, they value aspects of a pharmacy service. Patients generally preferred discussing medications with the family physician, but experiencing the community pharmacy-led service resulted in an attitudinal shift toward the pharmacist. These findings suggest a benefit in developing the community pharmacist's role as a reviewer of, and adviser on, patients' medications.
authors.affiliation: Department of General Practice and Primary Care, and Health Economics Research Unit, University of Aberdeen, Aberdeen, Scotland. m.tinelli@abdn.ac.uk
authors.forename: Michela
authors.initials: M
authors.lastname: Tinelli
authors.forename: Christine
authors.initials: C
authors.lastname: Bond
authors.forename: Alison
authors.initials: A
authors.lastname: Blenkinsopp
authors.forename: Mariesha
authors.initials: M
authors.lastname: Jaffray
authors.forename: Margaret
authors.initials: M
authors.lastname: Watson
authors.forename: Philip
authors.initials: P
authors.lastname: Hannaford
mesh_terms: D000368:Aged; D003157:Community Pharmacy Services; D005260:Female; D006801:Humans; D008297:Male; D054539:Medication Therapy Management; D017060:Patient Satisfaction; D010595:Pharmacists; D010821:Physicians, Family; D024382:Professional Role; D011369:Professional-Patient Relations; D011795:Surveys and Questionnaires