• Michela Tinelli, Christine Bond, Alison Blenkinsopp, Mariesha Jaffray, Margaret Watson, Philip Hannaford, and Community Pharmacy Medicines Management Evaluation Team.
• Department of General Practice and Primary Care, and Health Economics Research Unit, University of Aberdeen, Aberdeen, Scotland. m.tinelli@abdn.ac.uk
• Ann Pharmacother. 2007 Dec 1; 41 (12): 1962-70.

BackgroundA patient-centered approach is increasingly recognized as an important component in the evaluation of healthcare services.ObjectiveTo 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.MethodsPostal 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.ResultsSurvey 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).ConclusionsPharmacist 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.

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