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Impact of pharmacy care services on patients' perceptions of health care quality for diabetes. [J Am Pharm Assoc (Wash DC)] Journal article

 
Nau DP, Pacholski AM 
Impact of pharmacy care services on patients' perceptions of health care quality for diabetes. [JOURNAL ARTICLE]
J Am Pharm Assoc (Wash DC) 2007 May-June 1; 47(3):358-365.


Objectives: To (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.
Design: Two-phased study using a single-group, pretest-posttest design.
Setting: Community pharmacies that provided PCSs to diabetic patients as part of the Patient Self-Management Program for Diabetes in North Carolina, Georgia, Ohio, and Wisconsin.
Participants: 218 patients with diabetes covered by self-insured employers' health plans.
Interventions: Pharmacist-provided care services using scheduled consultations, clinical goal setting, monitoring, and collaborative drug therapy management with physicians and referrals to diabetes educators.Main outcomes measures: Changes 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.
Results: The 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 < 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.
Conclusion: PCSs 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.



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