Price versus service: the patient impact

tug of war

Patients who attend a discount pharmacy are more likely to have a poorer perception of its service standards and are less likely to adhere to their medicines, new research suggests

Researchers from the School of Pharmacy, University of Sydney, surveyed 319 patients recruited from eight Sydney pharmacies.

They found that “attending pharmacies with a price promotion business strategy” was predictive of lower “perceived service quality” (pSQ) – a patient’s judgement of, or impression about, the overall excellence of the service provided by the community pharmacy – when compared to regularly attending a pharmacy with a high service business strategy.

Attending these pharmacies was also linked to poor medication adherence, said the researchers, led by former NSW PSA president Stephen Carter.

They called for policy-makers to consider whether incentive/disincentive mechanisms could be built into remuneration systems for the supply of medicines.

“This study explored the impact of the regular day-to-day service that community pharmacies provide in supporting medication adherence,” the authors said.

“While it is clear that pharmacies aiming to provide high levels of service tend to have patients who report better patient experience and who are more adherent than patients attending discount stores, there was a high degree of variability in adherence both within and between pharmacy types.

Perhaps not surprisingly, patient experience (as reported by pSQ) was the best predictor of adherence and this should focus community pharmacy owners, managers and practitioners on the important role of communication and patient support,” they said.

Given the importance of improving medication adherence, and the negative impact on this when patients experience low service quality, community pharmacies need to be designed and managed to allow pharmacists to provide high levels of patient-centred care, the authors said.

“Each and every patient deserves the opportunity to have meaningful contact with their pharmacist, while obtaining their medicines. Regular ongoing support can allow for therapeutic relationships to develop and which allows for pharmacists to intervene to improve patient safety and provide adherence support,” they said.

“Designing and managing pharmacies without the specific intent of providing patient-centred care appears to be associated with poor adherence and this is likely to compromise therapeutic outcomes”.

There were more female (68.5%) participants in this study and approximately half (53.6%) of the participants were aged 35–54 years old.

Just over 84% of the patients lived within 5 km of the pharmacy. Most participants (91.8%) visited the pharmacy at least every month and used medicine at least once every day (92.1%), while 83.4% were
prescribed between 1 and 4 regular medicines and only 2.8% were prescribed more than 7.

The study was published in the journal Patient Education and Counselling.

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