title: How pharmacist-patient communication determines pharmacy loyalty? Modeling relevant factors.
abstract: BACKGROUND
  Portuguese community pharmacies provide pharmaceutical services, such as therapeutic outcomes follow-up, supplemented by relevant point-of-care testing that require continuity of provision to be effective.
  
  
  OBJECTIVE
  To identify factors of technical and communication nature that during a patient interview contribute to patients' loyalty.
  
  
  METHODS
  A cross-sectional descriptive study, with a purposive sample of community pharmacies providing pharmaceutical care, was conducted. Patient interviews were taped and transcribed verbatim. Duration, segments and utterances were identified and time stamped, using a previously validated coding scheme. To identify predictors of loyalty, logistic regression analyses were performed.
  
  
  RESULTS
  From 59 interviews, participants' average age was 65.7 years and 42 (71.2%) were female; 45 (76.3%) interviews were classified as outcomes measurements and 14 (23.7%) as pharmaceutical consultations, with 33.2% of the patients booking a following appointment. The significant items to explain loyalty were associated with lifestyle and psychosocial exchange, age of the patient, and the presence of all interview segments (i.e. a complete consultation).
  
  
  CONCLUSIONS
  Contrary to common professional beliefs and practice orientation it would appear that pharmacists' technical skills are not the essential factors that promote patients' loyalty needed for continuity of care, at least in the same extent as the social and lifestyle-related content of the exchange. Pharmaceutical care education should focus on relational skills as much as on medication-related competencies.
authors.affiliation: Faculty of Pharmacy, University of Lisbon, Av. Prof. Gama Pinto, 1649-003 Lisboa, Portugal.
authors.forename: Liliana
authors.initials: L
authors.lastname: Patrícia Antunes
authors.affiliation: Department of Statistics and Operational Research, Faculty of Sciences, University of Lisbon, Campo Grande, 1749-016 Lisboa, Portugal.
authors.forename: João José
authors.initials: JJ
authors.lastname: Gomes
authors.affiliation: Faculty of Pharmacy, University of Lisbon, Research Institute for Medicines (iMed.ULisboa), Av. Prof. Gama Pinto, 1649-003 Lisboa, Portugal. Electronic address: acavaco@ff.ul.pt.
authors.forename: Afonso Miguel
authors.initials: AM
authors.lastname: Cavaco
mesh_terms: D000328:Adult; D000368:Aged; D003142:Communication; D003157:Community Pharmacy Services / Q000592:standards; D003258:Consumer Behavior; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010595:Pharmacists / Q000592:standards; D011174:Portugal / Q000453:epidemiology; D011369:Professional-Patient Relations; D011795:Surveys and Questionnaires
keywords: Community pharmacy; Consumer satisfaction; Pharmacist counseling; Pharmacist–customer communication; Pharmacy loyalty; Portugal