Impact of pharmacy care services on patients’ perceptions of health care quality for diabetes

Abstract

ObjectivesTo (1) construct and evaluate a measure of patients’ perceptions of the quality of diabetes care and (2) determine the impact of pharmacy care services (PCSs) on patients’ perceptions of the quality of their diabetes care while controlling for patient-related factors. DesignTwo-phased study using a single-group, pretest–posttest design. SettingCommunity pharmacies that provided PCSs to diabetic patients as part of the Patient Self-Management Program for Diabetes in North Carolina, Georgia, Ohio, and Wisconsin. Participants218 patients with diabetes covered by self-insured employers’ health plans. InterventionsPharmacist-provided care services using scheduled consultations, clinical goal setting, monitoring, and collaborative drug therapy management with physicians and referrals to diabetes educators. Main outcomes measuresChanges in patients’ perceptions of quality measured by a self-administered questionnaire that included a six-item scale of information quality, a five-item scale of provider quality, and a one-item overall rating of care. ResultsThe assessment of the baseline data (Phase I) demonstrated that the measures of perceived quality possessed acceptable psychometric properties. After PCSs were implemented (Phase II), the scores for the information scale improved significantly (paired t = 7.64, P < 0.01), as did the scores for the provider scale (paired t = 6.30, P < 0.01) and the overall rating (paired t = 5.54, P 7lt;0.01). In multivariate analyses, the improvement in perceived quality was not explained by the change in glycosylated hemoglobin when controlling for age, gender, race/ethnicity, and baseline quality perceptions. ConclusionPCSs enhanced patients’ perceived quality of their diabetes care. The improvement in perceived quality was not explained by the change in glycemic control, which suggests that nonclinical factors in care are important to patients’ evaluations of quality.