Testing a pharmacist-patient relationship quality model among older persons with diabetes.

Marcia M Worley
Author Information
  1. Marcia M Worley: University of Minnesota, College of Pharmacy, Duluth, MN 55812-3095, USA. wor10016@d.umn.edu

Abstract

BACKGROUND: Considering recent changes to the Medicare program, pharmacists will have unique opportunities to be reimbursed for providing Medication Therapy Management Services to older persons with diabetes. A high-quality pharmacist-patient relationship can lay the foundation for effective provision of Medication Therapy Management Services and improved care in this cohort.
OBJECTIVE: To test a pharmacist-patient relationship quality model in a group of older persons with diabetes from the patient's perspective. Antecedents to relationship quality were pharmacist participative behavior/patient-centeredness of relationship, patient participative behavior, and pharmacist-patient interpersonal communication. Pharmacist-patient relationship commitment was the outcome of relationship quality studied.
METHODS: Data were collected via mailed questionnaire from a random sample of 600 community-dwelling adults in the United States who (1) were 65 years of age and older, (2) had type 1 or type 2 diabetes, (3) used at least one prescription medication to treat their diabetes, and (4) used some type of nonmail order pharmacy as their primary source of obtaining prescription medications. Model relationships were tested using path analysis.
RESULTS: The adjusted response rate was 41.6% (221/531). The models explained 47% and 49% of the variance in relationship quality and relationship commitment, respectively. In the relationship quality model, pharmacist participative behavior/patient-centeredness of relationship (beta=.51, P<.001) and pharmacist-patient interpersonal communication (beta=.17, P=.008) had direct effects on relationship quality. In the relationship commitment model, relationship quality had a direct effect on relationship commitment (beta=.60, P<.001). Pharmacist participative behavior/patient-centeredness and pharmacist-patient interpersonal communication had indirect effects on relationship commitment through their effects on relationship quality, which is a mediator in the model.
CONCLUSIONS: Results affirm findings from previous research showing that patients' perceptions of pharmacist participative behavior/patient-centeredness of relationship and pharmacist-patient interpersonal communication are positively related to perceptions of relationship quality. Also, relationship quality is a strong mediator between pharmacist participative behavior/patient-centeredness of relationship and relationship commitment, as well as between pharmacist-patient interpersonal communication and relationship commitment.

MeSH Term

Age Factors
Aged
Aging
Attitude of Health Personnel
Communication
Community Pharmacy Services
Cross-Sectional Studies
Diabetes Mellitus, Type 1
Diabetes Mellitus, Type 2
Factor Analysis, Statistical
Female
Humans
Male
Models, Statistical
Patient Care Planning
Patient Participation
Patient Satisfaction
Pharmacists
Professional-Patient Relations
Quality of Health Care
Reproducibility of Results
Research Design
Surveys and Questionnaires
United States

Word Cloud

Created with Highcharts 10.0.0relationshipqualitypharmacist-patientcommitmentparticipativediabetesmodelbehavior/patient-centerednessinterpersonalcommunicationolderpharmacistpersonstypebeta=effectsMedicationTherapyManagementServices12usedprescriptionP<001directmediatorperceptionsBACKGROUND:ConsideringrecentchangesMedicareprogrampharmacistswilluniqueopportunitiesreimbursedprovidinghigh-qualitycanlayfoundationeffectiveprovisionimprovedcarecohortOBJECTIVE:testgrouppatient'sperspectiveAntecedentspatientbehaviorPharmacist-patientoutcomestudiedMETHODS:Datacollectedviamailedquestionnairerandomsample600community-dwellingadultsUnitedStates65yearsage3leastonemedicationtreat4nonmailorderpharmacyprimarysourceobtainingmedicationsModelrelationshipstestedusingpathanalysisRESULTS:adjustedresponserate416%221/531modelsexplained47%49%variancerespectively5117P=008effect60PharmacistindirectCONCLUSIONS:Resultsaffirmfindingspreviousresearchshowingpatients'positivelyrelatedAlsostrongwellTestingamong

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