HARAMAYA UNIVERSITY

COLLEGE OF HEALTH AND MEDICAL SCIENCE

SCHOOL OF PHARMACY

ASSESSMENT OF PATIENT SATISFACTION

AND ASSOCIATED FACTORS AT SABIYAN
PRIMARY HOSPITAL

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Outline
 Background
 Statement of the problems
 Significance of the study
 Objectives
 Methodology
 Results
 Discussion
 Conclusion
 Recommendations
 Acknowledgements
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1.1 BACK GROUND
 The International Pharmaceutical Federation (FIP) in
1998, defined pharmaceutical care (PC) as the
“responsible provision of pharmacotherapy for the
purpose of achieving definite outcomes that improves
or maintains a patient’s quality of life”
 This is a collaboration process between the
pharmacist and the patient who is aimed at preventing
or identifying and resolving drug and health related
problems (FIP,1998)I

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 CONT..
 PC is key in pharmacy practice globally. This aims at providing a
better outcome for the patients And PC is one of those outcomes
 For pharmacies to have high patronage, their service must be
attractive for patient inflow.
 Patient satisfaction is likely to affect the image of the Pharmacist
and pharmacy profession
 The need to track patient satisfaction in pharmaceutical
services is vital because level of satisfaction reflects the reality
of care, as well as the preferences and expectations of the
patient.
 Therefore, it becomes important to evaluate the satisfaction
level of patients in face of the services offered by healthcare
professionals, once it can be used as an indicator of quality of
these services
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Cont..
 The observed satisfaction level becomes a useful
instrument; since by it, it might be possible to take
necessary corrective measures, aiming constant
improvement of the patient’s care.

 Generally Measurement of patient satisfaction plays

an important role in pushing health care providers
towards being accountable to their patients.

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 1.2 Statement of the problem
 Patient satisfaction with health services emerged to be
as an important indicator of quality of services
provided.

 Patient satisfaction may be considered to be one of

the desired outcomes of care, even an element in health
status itself.

 satisfaction information is important in assessing and

designing management of health care systems.
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Cont..
 Satisfaction with pharmaceutical care in medication therapy has
direct effects on the patient’s awareness and attitude toward the
effectiveness and safety of drugs as well as the health care service and
decreases patient’s acceptability of medication and in turn patient’s
adherence,

 one of the biggest duties of pharmacy professionals is to improve

patient adherence to medication. .

 There has been no study addressing patient satisfaction in

pharmaceutical care and its contributing factors in sabiyan
hospital and Dire Dawa Administration city

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Cont..

 The aim of the studyis to evaluate patients satisfaction

level in pharmaceutical care and contributing factors at
SH (Sabiyan hospital) and figure out if it is low, medium
or high, and identify the gaps and factors influencing it.

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 1.3 Significance of the study
 This study increase the awareness of pharmacists about patient’s
satisfaction value and how it could affect the pharmacotherapuetics
outcomes.

 The outcome of the study can be used to identify specific areas of

the service which need improvement in realizing high quality
pharmacy services in general and enhance the positive changes in
the current pharmaceutical services provision in SPH.

 As evident from the scarce documentation of the opinion of

patients towards pharmacy services in different parts of Ethiopia,
conducting studies answering this questions is important.

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Cont..
 The administrators of the Health Bureau may also utilize the
finding in taking administrative measure.

 the study might help as a stepping stone for those

experts who want to carry out further investigation in
similar area or for those who want to design and
implement intervention action.

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 3.objective
General Objective
 to assess Patients satisfaction in Pharmaceutical care and
associated factors at SABIYAN PRIMARY HOSPITAL (SPH)

Specific Objectives
 To assess the extent of involvement of pharmacy personnel in
pharmaceutical care
 To assess the level of patient satisfaction with pharmacy location,
the pharmacy premises and the interaction with the pharmacist
 To assess factors affecting patient satisfaction

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Conceptual frame work
pharmaceutical
care

patients Socio-
demographic
patronage characteristics
and status of e.g. (Age, sex,
payment Educational
level, work
status, income)
satisfaction
level
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 4.Methodology
 4.1Study Area and Period: The Study was conducted at OPD
pharmacy of SPH in Dire Dawa, Eastern Ethiopia, from August 1
up to September, 15 ,2018
 4.2 Study Design :A constitutional based cross-sectional study is
conducted using structured questionnaire was conducted
Population

 Source population:

 All patients who visited SPH for treatment

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Inclusion and exclusion criteria

Inclusion Criteria :
 All Patients who visited OPD Pharmacy for
medication

Exclusion Criteria

 Clients who are mentally and seriously ill

 clients under the age of 18 is excluded

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Sample size determination

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 Cont..

Since source population is less than 10,000, the correction

formula used as follows

 Where, nf= final sample size , N=source of population which is 3000

 By considering 5% non-response rate, then the total sample size

calculated is 340+17=357

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 Sampling technique
 Systematic sampling technique is employed to select study
participants in the study. After calculating the total sample size.
357 questionaries’ were used to OPD SPH pharmacy by
c o n s i d e r i n g number of prescription comes to pharmacy per day,
every 8th patient was interviewed

Study variables
Independent variables
 Socio-demographic (age, sex, marital status etc.)

Dependent variables
Patient satisfaction

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 Data Collection Method
Data Collection Instrument: A structured questionnaire was
used to collect data.

Data Collection Technique: Data was collected by face-to-

face interview. The respondents were interviewed after pharmacy
exit. Data was collected by researcher.

Data Quality Control

 Completeness, accuracy, and clarity of the collected data was
checked carefully before data analysis was made.
 Any erroneous, ambiguous, and incomplete data was excluded.
 Data Entry and Analysis
 Questionnaire items were coded entered into and analyzed using
statistical package for social sciences version 20 (SPSS - 20)
computer software package. Descriptive statistics was computed
(means, frequency, percentages). Figures and charts were used to
describe the study findings. Association between various socio-
demographic variables and the questionnaire items were explored
using logistic regression (95% confidence interval, p-value0.05). P-
value less than 0.05 was considered as statistically significant.
 4.9 Operational Definitions
 Patient waiting time: The interval between departure from the
Proceeding pharmacy station and receiving pharmacy service
 Satisfaction: Attaining one’s need or desire.
 Very satisfactory: Above one’s expectation.
 Satisfactory: Just one’s expectation.
 Dissatisfactory: Below one’s expectation.
 Very dissatisfactory: Fail to meet one’s expectation usually
 Leading to disappointment
 Service: any activity undertaken in the pharmacy to meet the
Rational use of medication
 4.9.1 Ethical Consideration

 Ethical clearance is obtained from Haramaya University, School

of Pharmacy. Verbal informed consent is obtained from each study
participant prior to the administration of questionnaire after the
purpose of the study is explained to respondents. Confidentiality is
maintained by omitting their personal identifications such as names
 5. results

 A total of 357 participants were interviewed with

response rate of 100%
 The overall mean score the respondents gave to
satisfaction with the pharmaceutical services was 2.7 out
of a maximum of 5.00 score

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 Socio-Demographic characteristics
 Among respondents (51%) were females and (49%) males. (62.2
%) of them were married and, (50.7 %) Orthodox Christians

 Those in the age group of 18 to 29 years old constituted the

highest proportion (44.3%). followed by those in the age group of
29-39 (26.6%)

 51.5% monthly incomes falls within 1,000-5000 ETB.

 The participants were asked about payment status 197

(73.6%) were cash, whereas (26.3%) were free.
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Cont..
 Majority of (88.5%) of participants Place of residence
were urban and the rest (11.5%) of participants were
from rural area
 As regards to the educational status of respondents
the most frequent had a status of higher education
(39.2%) followed by those who have elementary
education (28.6%).(table 1)

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Satisfaction level of clients with the services of
the pharmacy
 In the present study all of the 357 respondents
gave their responses to all the 18 parameters they
were asked to rate.
 Based on the five point Likert scale the mean
summary score for each variable satisfaction level
was done (table 2)

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 Cont..
 Among the mean scores the maximum scores were
given for parameters including “The location of the
pharmacy relative to other service areas” (3.51)
 the overall cleanliness and comfort of the waiting area”
(3.41).
 On the other hand, the parameters rated lowest
included “the information the pharmacist provided to
patients about the proper storage of your medication”
(1.89).
 “The amount of time the pharmacy professional spent
with w” (1.7759), and The information the pharmacy
professional gives to patients about the results you can
expect from your medication therapy (1.3669).
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Cont..

 The responses given on each activity on five

point scales: very low , low, medium, good, and
very good level the mean summary score was
2.7
 265(74.2%) of patients were found to be unsatisfied
 And only 92(25.8%) were found to be satisfied

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Level of satisfaction among the clients in SPH
OPD Pharmacy
 Difference in satisfaction level among respondents
 Bivariate logistic regression output to identify factors
associated with satisfaction level showed that age and level of
education were significantly associated with clients’
satisfaction.

 Accordingly, illiterate clients in comparison to college-

educated ones (P=0.020, COR =3) and the age groups 50 to
59 years of age (P= 0.002, COR =3.12) compared to other
age categories showed higher level of satisfaction.
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 Cont..
 On multivariable logistic regression, sex, occupation, patronage and
status of payment remained statistically significant.
 Males were found to be more satisfied than females (P= 0.001,
AOR=3.44) with the pharmaceutical care service.
 With regard to occupational status clients with no job (P=0.00, AOR
=19.0) and daily workers (P=0.002. AOR =6.12) were found to be more
satisfied with the services they received compared to government
employees and merchants.
 Clients served in the pharmacy with no payment required of them were
showed to have had (P=0.00, AOR=8) higher level of mean satisfaction
compared to clients who paid for the services received. Regarding
patronage it was found that new visitors (P=0.007, AOR=2.5) of the
outpatient pharmacies were more satisfied than those of who didn’t visited
the opd pharmacy for the first time(Table 3).

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 Table 3. Test of statistical significance (logistic regression) of variation
in the mean satisfaction level of client’s by socio-demographic
characteristics, SPH, 2018
satisfaction Adjusted
OR p value
characteristics Satisfied Not satisfied [95% CI]

male 60 115 3.14 0.001

sex
female 150 32

unemployed 12 7 19.0 0.00

occupation
Daily 23 38 6.12 0.002
worker
Status of Pay 48 214
payment
free 43 51 8.0 0.00
 5.4. Discussion
 In this study overall mean satisfaction level was 2.7 lower compared to
findings from primary care centers at Ministry of Health in Saudi
Arabia which reported high level of satisfaction among clients average
of 4 out of maximum 5 (Yousef A,et al ,2016).
 This could be attributed to the difference in the development levels of
the countries generally and their pharmacy services particularly.

 In this study, information on side effects (1.93), Storage (1.89),

and Expected results from the medications (1.37). the amount of

time the pharmacy professional spends with you” (1.78)

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Cont..
 are the leading cause of dissatisfaction and is almost the same
to the finding from a study done in Addis Ababa, on
pharmacies of governmental hospitals (Eshetu E, 2010).

 Similarly lower than average level of satisfaction was reported

for medication counseling by to specific medications,
especially their availability, information on side effects,
storage, expected results from the medicationsThese areas of
pharmacy service are with problems. (Eshetu E, 2010)
 Cont..
 The construction of the pharmacy section did not provide a
suitable consultation area, and even windows used for dispensing
medications are only suitable for quick interaction and therefore
time and facility design were considered as important barriers.

 from 357 participants in this study 94% were satisfied with

overall comfort and cleanness of waiting area , and 87% were
satisfied with location of pharmacy from other service areas and
This is so high comparing with study done in gonder university
(Abdurrahman S,et al 2015)
Cont..
 which reported that cleints satisfaction level in overall
cleanness and comfort of waiting area was 68% , and only 13%
with the location of pharmacy from other service area.
 this might be because of sabiyann primary hospital was
established few years ago and it is building was intended to
facilitate good service for patients.
 Cont..
 In this study logistic regression output to identify factors
associated with satisfaction level showed that level of education
and group age associated with clients’ satisfaction. A similar
finding was reported in the study done in Mizan-Tepi University
(Adane T, et al,2016) this might be due to The higher level of
satisfaction reported among elderly clients compared to the young
ones and the higher level of satisfaction among illiterate clients
than in those having higher education were interrelated.

 The higher level of satisfaction among the illiterate and elderly

clients could be associated to lesser awareness on the importance
of details of the functions in the pharmacy and the services they
deserved to get
 limitation
 This study was limited in that a cross sectional study, which
might suffer from temporal relationship establishment with
some variables and could not provide much more substantial
evidence of causality .so it is difficult to see the prevailing
problems at a given point of time.
Study strength
 The findings of this study could be used for service
development/improvement by pharmacy commissioners,
pharmacy managers, educators and individual pharmacists. As
mentioned previously, this is one of the first studies in the city
of Dire Dawa to evaluate the quality of the Hospital pharmacy
service from a patient’s perspective.
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 Conclusions
 This study showed that the overall mean satisfaction level of
clients of the outpatient pharmacy was low. Patients were
dissatisfied with less counseling about their health condition and
the need for information about medication side effects and the
time pharmacy professionals spent with the patients. Mean
satisfaction level was found to be different in a statistically
significant manner between/among different groups including
age, educational status, occupationalstatus and payment status.

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 5.8 Recommendation
 The study recommends the following points which may help in
improving patients’ satisfaction in pharmaceutical care:

 Training on proper service should be given to staff working in the

hospital pharmacies to alleviate problems that encountered
patients’ satisfaction.

 Pharmacy staff(particularly clinical pharmacists) should be more

involved in patient counseling despite of the barriers for the
pharmacist role in counseling they should try their best to spend
more time with each patient.

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 Cont..

because The time that prescribers and dispensers spend with

each patient sets important limits on the potential quality of
diagnosis and treatment.

Future research should be focused in specific area of services

given in a pharmacy

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reference.
Acknowledgment
1.Almighty God for giving me the inspiration to start and
patience to finalize this research.
2.A great thanks to my advisor Mr. bisrat hagos (B-pharm,Msc )

3.Haramaya University,CMHS, School of Pharmacy

Thank you