Participants’ Baseline Characteristics
A total of 508 respondents agreed to participate in this study, of whom
492 (96.9%) were Saudi; 263 (51%) were males and 432 (83%) were below
46 years of age (Table 1). Age over sex distribution of the participants
is illustrated in Figure 1. There were no statistical differences in the
demographic characteristics of the respondents who attended either
hospitals (Table 1).
The average scores of domains medication availability, patient
counseling, pharmacist and patient relationship, medication
reconciliation, medication adherence, pharmacy location and waiting
area, pharmacy communications and waiting time, and overall patient
satisfaction of pharmacy services, were 4.51, 4.11, 4.30, 3.70, 3.57,
3.82, 3.63, and 4.15, respectively (Table 2). The general evaluation of
pharmacy services domain was reported excellent by 245 (48.2%)
respondents and very good (143; 28%), with 380 (76.4%) respondents
were willing to recommend the pharmacy to their family or friends.
The respondents’ satisfactions were compared in the two hospitals and
there was no significant difference (p>0.05) between them
concerning all the domains of outpatient services such as medication
availability, patient counseling, pharmacist and patient relationship,
medication reconciliation, medication aberrance, pharmacy location and
waiting area, pharmacy communications, waiting time, and overall patient
satisfaction of pharmacy services (Table 2).
Overall, more than one-half of respondents (265; 52.2%) were very
satisfied with pharmacy services and 233 (45.8%) were satisfied,
whereas very few respondents (10; 2%) were dissatisfied with pharmacy
services. There were no statistically significant differences between
the overall satisfaction among respondents attending the two hospitals
(p>0.05) (Table 3). The results showed no statistical
significant difference between the satisfactions of respondents scored
on paper questionnaire and web-based questionnaires (Table 4).
DISCUSSION
In this study, we explored the satisfaction with outpatient pharmacy
services among respondents attending two tertiary care hospitals with
variant medical specialties in the city of Tabuk, KSA. The study
assessed patients’ responses on eight domains of outpatient pharmacy
services. There was no statistical difference in all demographic
characteristics between the participants of the two hospitals. Most of
the respondents were Saudi nationals, which was expected because
healthcare services are provided through cooperative health insurance
regulations and insurance packages and only a small proportion of
non-Saudi residents are allowed to receive healthcare services from
governmental sectors17 . Most of
the respondents were young adults below 46 years old who agreed to
participate in the study, whereas a few number of respondents was
elderly. This may be due to the interest in participating the survey
through internet by the young adult population18 . Moreover,
the general health conditions of many elderly patients were sick and it
was not convenient for them to respond to the face-to-face interview.
We used mixed-mode survey in our study to improve the response rate as
the previous studies recommended to add paper-based questionnaire with
web-based questionnaire to increase the response rate. Though we used
mixed-mode survey in our study, it did not affect the self-reported
satisfaction of the respondents as previous studies in this regard have
already ruled out this phenomenon19-21 .
The respondents reported high satisfaction with medicines availability
domain and medication labeling and written instructions provided by the
hospital pharmacists. Our results were similar to that reported in a
recent study conducted in public, pediatric and emergency hospitals in
Riyadh city 12and to outpatient services of primary healthcare centers in Saudi Arabia11 . Since the
availability of medicines in hospitals remains the focus of the
government, and labeling of medicines is the traditional activity of
pharmacists, it might be a possible reason that respondents had higher
satisfaction scores in these domains. However, a recent study
demonstrated frequent drug shortages in ten largest Ministry of
Health-hospitals in Riyadh city, Saudi Arabia offers the potential
interest to conduct larger studies in order to enlighten the patient
satisfaction regarding the drug availability in the near future22 .
Respondents scored less but still very good in the level of satisfaction
with pharmacist counseling about the purpose of medications, explaining
the side effects and storage of the medications (3.93, 3.65 and 3.74) as
compared to medication labeling and providing written instructions. This
was also consistent with a recent study in Al-Jouf province in the
Northern Saudi Arabia which reported lower scores (3.08 and 3.11) in
medication counseling13 . Lack of
counseling areas in outpatient pharmacies along with inappropriate
location of such areas might be the cause of patients’ lower
satisfaction in this domain13 . However,
in the current study, the participants scored very good to the question
of whether counseling area was appropriate and respect the privacy. Our
results were higher than those scored to ambulatory service at tertiary
care hospitals in Riyadh city (2.2, 1.96 and 2.23) [4]. Low
satisfaction levels were also associated with poor counseling practices
provided by outpatient hospital pharmacies to diabetic patients23 . Whereas,
knowledge, skills and the quality of pharmaceutical care counseling were
determinants of willingness to pay for the service in Saudi Arabia7 . Older age,
high educated patients, comorbidities, illness type and longer duration
of treatment, few number of pharmacy staff in the hospitals, increased
workload, and lack of continuous education for pharmacy service
providers were reported as contributors to the low patients’
satisfaction with pharmacy services in the literature