1 Pharmacy Survey on the Public's Perception of the Role and Responsibilities and Satisfaction on the Services Provided by Pharmacists
Andy Sie Ping Lau1, Tong Ding Lee1, Shirlie Chai1,2
1Pharmacy Department, Miri Hospital, Sarawak
2Clinical Research Centre Miri
Corresponding author name and email: Andy Sie Ping Lau (andylau@moh.gov.my)
ABSTRACT
Introduction: Pharmacist plays a vital role in helping the public in getting the best results
from their medications. Nevertheless, studies exploring the public's perception of the roles and responsibilities, as well as their satisfaction with the services provided by the pharmacist, are lacking.
Objective: The current study aimed to assess the public's perception of the roles and responsibilities, and their satisfaction on the services provided by the pharmacist.
Methods: This was a questionnaire-based, cross-sectional study conducted in Miri Hospital
from December 2019 to January 2020. We distributed the questionnaires to the public over the pharmacy counters. Convenience sampling method applied. The structured questionnaire consists of two sections which to: (1) evaluate the perception of the roles and responsibilities of pharmacists and (2) satisfaction on the services provided. Responses to the question rated on a 5-point Likert scale, and the mean perception and satisfaction scores calculated.
Results: We collected 150 responses with a mean perception score of 45.18 (SD=4.69) out of
a maximum score of 55. The mean score based on all satisfaction related questions was 37.31 (SD=4.41) out of a maximum score of 45. Almost half (48.7%) of the participants had moderate perception, whereas 50.7% of them had good perception on the role and responsibilities of
2 pharmacists. Most participants had moderate and good satisfaction, 58.0% and 41.3%, on the services provided respectively.
Conclusion: The public has a decent perception regarding the roles and responsibilities of the
pharmacist, and the public is satisfied with the services provided by the pharmacists in general.
However, there is space for further improvement. Future studies exploring the area qualitatively would be meaningful in providing a better picture regarding this vital aspect.
Keywords: Perception; role; responsibility; satisfaction; pharmacists; Malaysia
3 INTRODUCTION
Pharmacists play a vital role in healthcare delivery and helping people get the best results from their medications. The significant roles of pharmacists include providing correct and updated drug information to the public, ensure the prescribed medicine to the patient is suitable, educate the patients on their medications and encourage the patient to adhere to their medications (1).
The National Survey about the Use of Medicines (NUSM) in 2015 showed that 18.6% of the consumers partially understand the proper use of their medicines, 46.8% of the consumers were not familiar with the generic name of their medicines, and 29.7% of them were unaware of potential side effects (2). A study conducted by Jose et al. stated that the key factors to improve the pharmacy services in any country would know the public's need, expectation, and satisfaction (3).
On the contrary, the public needs to understand the roles, responsibilities, and services provided by the pharmacists so that the public can fully utilise the services available from the pharmacists (3). A cross-sectional pilot study conducted in Sabah, Malaysia, focusing on the public's perception of the role of pharmacists involving the public in the state. The study showed that half of the participants understand the primary role of the pharmacist is to educate them on their medications in terms of the correct way to take the medications and potential side effects of medication. However, half of the participants in the study agree that the sole role of the pharmacists' was to supply medications to them, and pharmacists' job was to follow doctors' instructions (4).
Patients' satisfaction is an essential indicator for measuring the quality of healthcare services.
Hence, several studies conducted to explore the patients' satisfaction toward services provided by pharmacists in order to identify the associated factors that might affect patients' satisfaction (5-7). Evidence showed that satisfied patients tend to have a good relationship with their health care providers, more adhere to their treatment, and consistent in using health care services and values, which would eventually lead to a better health outcome (6).
Due to the limited studies conducted in this region to assess the public's view on the pharmacist, we conducted this study to assess the public's perception of the roles and responsibilities and their satisfaction on the services provided by the pharmacist in our local setting.
4 METHODS
Study instrument
We adopted a validated, self-administered questionnaire from a study conducted in the Sultanate of Oman (3). Permission to use the questionnaire obtained from the original authors.
The questionnaire consisted of two sections, to assess the perception (Section A; 11 questions) and satisfaction (Section B; 9 questions) of study participants on the roles, responsibilities and services offered by the pharmacists. Response to each question was based on a 5-point Likert scale. The responses ranged from strongly agree to strongly disagree. We had also included several questions acquiring the demographics data of study participants and details on number of visits to the Miri Hospital in the last one year. The questionnaire was in English. The Cronbach's values for internal reliability of perception and satisfaction subscales were 0.770 and 0.758, respectively.
Study type and design
We conducted this cross-sectional study by using a non-probability sampling method, convenience sampling, and distributed the questionnaires to the public over the pharmacy counters during the period of 1 December 2019 – 31 January 2020. Researchers explained verbally to the participants on the objective of the study and written informed consent. The percentages of study participants answering the individual responses of strongly agree to strongly disagree, represented the response of the public to perception and satisfaction related questions. Therefore, the maximum score for perception and satisfaction subscales were 55 and 45, respectively (3).
Study population and criteria
Patients who visited pharmacy counters to collect medications, namely outpatient and satellite pharmacy counter in Miri Hospital were eligible to participate in our study. The inclusion criteria were those who were at least 18 years of age and were able to understand English.
However, we excluded those with non-functioning mental illness, healthcare professionals or studentsfrom any medical/health-related field.
Statistical analysis
We performed descriptive statistics to summarise the demographic characteristic, public perception and satisfaction score using SPSS version 23.
5 Ethical considerations
The present study received ethical approval from the Medical Research and Ethics Committee (MREC), Ministry of Health Malaysia and registered with the National Medical Research Register (NMRR-19-3194-51736).
RESULTS
Participant characteristics
A total of 150 participants returned the questionnaires to the pharmacy (response rate of 93.8%).
Table 1 shows the demographic characteristics of the study participants. There were more female than male. The age of study participants were between 18 to 89 years old. Most of the study participants had a secondary school (47.3%) or higher educational qualification (47.3%).
More than half of them were employed. Moreover, our study participants reported to have visited the pharmacy at Hospital Miri with a maximum of 20 times in the last year, whereas some of them never visit the pharmacy in the last year.
Table 1. Demographics characteristics of participants (n=150)
Demographics n (%) Min Max Mean (SD)
Gender Male Female
68 (45.3) 82 (54.7)
Age (years) 18 89 42.93 (16.67)
Educational qualification
No education or primary school Secondary School
Higher education
8 (5.4) 71 (47.3)
71(47.3) Employment
Unemployed Self-employed Employee Pensioner
28 (18.7) 18 (12.0) 85 (56.7) 19 (12.7) Number of visits to the pharmacy in
the last year
0 20 5.25 (4.60)
Perception
Overall, almost half (48.7%) of the respondents had moderate perception, whereas 50.7% of them had good perception on the role and responsibilities of pharmacists. Table 2 displays the public's response to perception related questions. The total perception score based on all
6 perception related questions was 45.18 (SD=4.69) out of a maximum score of 55. Although there are higher percentage (92.7%) of the study participants considered that pharmacist as an expert in matters related to drugs, approximately 65% of them considered them as a mere vendors or dispensers of drugs. Besides, most of the study participants (62.7%) reported that the pharmacists could offer health screening services likes blood pressure and blood sugar monitoring. Majority of the study participants (90.7%) was aware that pharmacist should check their prescriptions before dispensing the medications. Moreover, 79.4% of study participants trusted the information on the information use provided by pharmacists and most (82%) of them agreed pharmacist should advise patients on general health issues other than about drugs.
Among all the perception statements, the public had the highest expectation on informing them how to use their medication and give warning of any possible side effects and how to prevent it (mean=4.47, SD=0.59); answering their drug related questions (mean=39, SD=0.64); and checking the prescriptions for accuracy in terms of drug name, dose, drug interaction, before dispensing the medication (mean=4.36, SD=0.69)
Satisfaction
Most respondents had moderate and good satisfaction, 58.0% and 41.3%, on the services provided respectively. Table 3 summarises the public's response to satisfaction related questions. The total satisfaction score based on all satisfaction related questions was 37.31 (SD=4.41) out of a maximum score of 45. 89.3% of the study participants were satisfied with the questions asked by pharmacist before dispensing medications like any history of previous drug allergy and disease details. Majority of study participants were satisfied with the privacy maintained (87.4%) as well as the time spent by the pharmacists for each patient (81.4%).
Moreover, 85.4% of study participants reported that they were satisfied with the relationship that pharmacists maintain with them. Majority of them satisfied with the kind of response pharmacist provide on questions related to drugs (86%) and language in discussing drug-related matters (88%). Furthermore, 84.7% of the participants were also satisfied with the kind of information the pharmacist provides on disease and other health issues, along with information on drugs.
In the aspect of satisfaction, the public had the highest satisfaction scores on the language used by the pharmacist in discussing drug-related matters (mean=4.20, SD=0.66); the questions asked by the pharmacist before dispensing medications like any history of previous drug allergy,
7 Table 2. Response to perception related questions
Questions
n (%) Mean
score (SD) Strongly
agree Agree Neutral Disagree Strongly disagree 1. I consider the pharmacists as an expert in matters
related to drugs
57 (38.0) 82 (54.7) 8 (5.3) 3 (2.0) 0 (0) 4.29 (0.66) 2. The pharmacist is an expert in suggesting
treatment for minor ailments
41 (27.3) 85 (56.7) 20 (13.3) 3 (2.0) 1 (0.7) 4.08 (0.74) 3. Pharmacists as a mere vendor/dispenser of drugs 28 (18.7) 69 (46.0) 38 (25.3) 8 (5.3) 7 (4.7) 3.69 (0.99) 4. Pharmacists as an integral part of the health care
system like physicians and nurses
48 (32.0) 80 (53.3) 20 (13.3) 1 (0.7) 1 (0.7) 4.15 (0.72) 5. Pharmacists could provide extended services like
health screening services; BP monitoring, Blood sugar monitoring mainly in the community pharmacies
28 (18.7) 66 (44.0) 49 (32.7) 6 (4.0) 1 (0.7) 3.76 (0.82)
6. I would seek advice from the pharmacist (community pharmacist) if the condition is not serious enough to visit a physician
39 (26.0) 69 (46.0) 22 (14.7) 7 (4.7) 13 (8.7) 3.76 (1.15)
7. Pharmacist should check my prescriptions for accuracy in terms of drug name, dose, any problem in taking the medications together, etc.
before dispensing the medication
70 (46.7) 66 (44.0) 12 (8.0) 2 (1.3) 0 (0) 4.36 (0.69)
8. Pharmacist should let me know how to use my medication and warn me of any possible side effects and how to prevent it
76 (50.7) 69 (46.0) 4 (2.7) 1 (0.7) 0 (0) 4.47 (0.59)
9. Pharmacist should answer my drug related questions
69 (46.0) 73 (48.7) 7 (4.7) 0 (0) 1 (0.7) 4.39 (0.64) 10. I trust the pharmacist for the information on the
use of medicines
54 (36.0) 65 (43.4) 25 (16.7) 4 (2.7) 2 (1.3) 4.10 (0.87) 11. Pharmacists should advice patients on general
health issues other than about drugs
56 (37.3) 67 (44.7) 21 (14.0) 3 (2.0) 3 (2.0) 4.13 (0.87)
8 Table 3. Response to satisfaction related questions
Questions
n (%) Mean
score (SD) Strongly
agree Agree Neutral Disagree Strongly disagree 1. I am satisfied with the type and amount of
information discussed by the pharmacist on drug related matters
36 (24.0) 93 (62.0) 19 (12.7) 2 (1.3) 0 (0) 4.09 (0.64)
2. I am satisfied with the questions asked by my pharmacist before dispensing medications like any history of previous drug allergy, disease details, etc.
44 (29.3) 90 (60.0) 16 (10.7) 0 (0) 0 (0) 4.19 (0.61)
3. I am satisfied with the privacy maintained by pharmacist while discussing with patients and dispensing medications
43 (28.7) 88 (58.7) 19 (12.7) 0 (0) 0 (0) 4.16 (0.62)
4. I am satisfied with the level of knowledge that pharmacists demonstrate in drug related issues
47 (31.3) 87 (58.0) 13 (8.7) 3 (2.0) 0 (0) 4.19 (0.67) 5. I am satisfied with the kind of response
pharmacist provide on questions related to drugs
47 (31.3) 82 (54.7) 20 (13.3) 1 (0.7) 0 (0) 4.17 (0.67) 6. I am satisfied with the language used by the
pharmacist in discussing drug related matters
49 (32.7) 83 (55.3) 17 (11.3) 1 (0.7) 0 (0) 4.20 (0.66) 7. I am satisfied by the amount of time spend by my
pharmacist with each patient
40 (26.7) 82 (54.7) 24 (16.0) 2 (1.3) 2 (1.3) 4.04 (0.78) 8. I am satisfied with the relationship that the
pharmacist tries to maintain with the patients
43 (28.7) 85 (56.7) 32 (14.0) 1 (0.7) 0 (0) 4.13 (0.66) 9. I am satisfied with the kind of information the
pharmacist provides on disease and other health issues along with information on drugs
46 (30.7) 81 (54.0) 22 (14.7) 1 (0.7) 0 (0) 4.15 (0.68)
9 disease details, (mean=4.19, SD=0.67); and the level of knowledge that pharmacists demonstrate in drug-related issues (mean=4.19, SD=0.61).
DISCUSSION
We assessed the perception and satisfaction regarding the roles and responsibilities of the pharmacists in Hospital Miri. We observed that participants had a high level of understanding regarding the roles and responsibilities of a pharmacist. Besides, their satisfaction level on the services provided by the pharmacist was good. Most of the participants agreed that pharmacists as an expert in matters related to drugs. A study conducted by Eades et al. has shown similar results which the customers considered pharmacist as a drug expert (8). Other than that, majority of participants considered pharmacist as an expert in the treatment of minor ailments and this results were similar to the findings from the study conducted by Wirth et al. in Malta as the peoples in Malta often consult pharmacists regarding minor ailments (9).More than half of participants in this study had shown they considered pharmacist as a mere vendor/dispenser, which contradicts to the fact that pharmacist has other roles other than serves as a dispenser.
Nevertheless, a high number of participants considered pharmacists as an integral part of a health care system in which similar results were found in the studies conducted by Al-Arifi and Perepelkin in Saudi Arabia and Canada, respectively (10, 11).
Similar to findings from a study conducted by Peterson et al., most of the participants in this study prefer that pharmacists should provide extended services such as health screening, blood pressure monitoring and blood glucose monitoring (12). Almost all of the participants agreed that a pharmacist should check the prescription for accuracy before dispensing the medication.
It is quite evident that participants have a good understanding of the primary responsibilities of pharmacists, and they anticipate pharmacists to fulfill their responsibility perfectly.
Furthermore, most of the participants anticipated that pharmacists should counsel them on their medication in terms of the way of using it, side effects of the medications, and how to prevent it. The response of participants in this study is similar to the results obtained in a study conducted by Al-Arifi (10).
As a pharmacist, besides focusing on drug-related issues, most of the participants believed that it would be nice that pharmacist provide advice on general health issues due to pharmacy often has a private consultation area which would protect their privacy (8).Most of the participants indicated satisfaction with the kind of response pharmacist-provided on questions related to
10 drugs. Additionally, 89% of the participants indicated that they were satisfied with the level of knowledge that pharmacist demonstrated related to drugs. Most of them were satisfied with the language used by the pharmacist in discussing drug-related matters, and this results considered acceptable as only minority of them might facing language barrier when communicating with the pharmacists since Malaysia is a multiracial country.
CONCLUSION
To conclude, this study provided a comprehensive representation regarding the Mirian's perception of the role and satisfaction on the services provided by the pharmacists in Hospital Miri. In this study, it indicated that the public had a decent perception regarding the roles and responsibilities of the pharmacist and the public are satisfied with the services provided by the pharmacists in general. However, there is space for further improvement. It is crucial to have a plan in order to improve the quality of services provided, the relationship between patients and pharmacists and this would further improve the patient's satisfaction level. Future qualitative study exploring the area would be meaningful in providing a better picture regarding this vital aspect.
11 REFERENCES
1. Kefale AT, Atsebah GH, Mega TA. Clients' perception and satisfaction toward service provided by pharmacy professionals at a teaching hospital in Ethiopia. Integrated pharmacy research & practice. 2016;5:85.
2. Pharmaceutical Services Division, Ministry of Health Malaysia. A National Survey on the Use of Medicines (NSUM) by Malaysian Consumers 2015. [cited 2 January 2020].
Available from: https://www.pharmacy.gov.my/v2/sites/default/files/document- upload/national-surveyuse-medicine-iii-nsum-iii.pdf
3. Jose J, Al Shukili MN, Jimmy B. Public's perception and satisfaction on the roles and services provided by pharmacists – Cross-sectional survey in Sultanate of Oman. Saudi Pharmaceutical Journal. 2015 Nov 1;23(6):635-41.
4. Cheah MF. Public Perception of the Role of Pharmacists and Willingness to Pay for Pharmacist-provided Dispensing Services: A Cross-sectional Pilot Study in the State of Sabah, Malaysia. Malaysian Journal of Pharmaceutical Sciences. 2018;16(1):1-21.
5. Kefale AT, Atsebah GH, Mega TA. Clients' perception and satisfaction toward service provided by pharmacy professionals at a teaching hospital in Ethiopia. Integrated pharmacy research & practice. 2016;5:85.
6. Aziz M, Ji W, Masood I, Farooq M, Malik M, Chang J, Jiang M, Atif N, Fang Y. Patient Satisfaction with Community Pharmacies Services: A Cross-Sectional Survey from Punjab;
Pakistan. International journal of environmental research and public health. 2018 Dec;15(12):2914.
7. Ayalew MB, Taye K, Asfaw D, Lemma B, Dadi F, Solomon H, Tazeze H, Tsega B.
Patients'/clients' expectation toward and satisfaction from pharmacy services. Journal of research in pharmacy practice. 2017 Jan;6(1):21.
8. Eades C, Ferguson J, O'Carroll R. Public health in community pharmacy: A systematic review of pharmacist and consumer views. BMC Public Health. 2011;11(1).
9. Wirth F, Tabone F, Azzopardi L, Gauci M, Zarb-Adami M, Serracino-Inglott A. Consumer perception of the community pharmacist and community pharmacy services in Malta.
Journal of Pharmaceutical Health Services Research. 2010;1(4):189-194.
10. Al-Arifi M. Patients' perception, views and satisfaction with pharmacists' role as health care provider in community pharmacy setting at Riyadh, Saudi Arabia. Saudi Pharmaceutical Journal. 2012;20(4):323-330.
11. Perepelkin J. Public Opinion of Pharmacists and Pharmacist Prescribing. Canadian Pharmacists Journal / Revue des Pharmaciens du Canada. 2011;144(2):86-93.
12 12. Peterson G, Jackson S, Hughes J, Fitzmaurice K, Murphy L. Public perceptions of the role of Australian pharmacists in cardiovascular disease. Journal of Clinical Pharmacy and Therapeutics. 2010;35(6):671-677.
