Measuring patient satisfaction with diabetes disease state management services in community pharmacy.

Background: Disease state management (DSM) programs for chronic conditions such as type 2 diabetes delivered by community pharmacists are a developing trend in health care service delivery. Although patient satisfaction with DSM services is an important indicator of service quality from the consumers' perspective, to date there is no valid and reliable instrument to enable its measurement in the context of a community pharmacy delivered service.

Objective: To develop and validate an instrument to measure patient satisfaction with diabetes disease state management (DDSM) services delivered by community pharmacists.

Methods: The DDSM questionnaire (DDSM-Q) was developed on the basis of 14 in-depth, semi-structured interviews with consumers who had received diabetes care services in community pharmacy. Thirty-one questionnaire items were developed from the qualitative interview findings and also incorporated 16 modified items from an existing instrument, the Diabetes Measurement and Evaluation Tool. The DDSM-Q was sent to 160 participants of pharmacy diabetes care projects. Higher-order factor analysis was performed to extract factors of patient satisfaction.

Results: One hundred and fourteen questionnaires were returned, thus yielding a 71.3% response rate. Data from 108 out of 114 questionnaires were used to validate the DDSM-Q. Respondents had a mean age of 62 years and 61% were male. The 3 factors of patient satisfaction were interpreted as (1) satisfaction with the pharmacist's service ("Service"), (2) satisfaction with self-management ("Self-management"), and (3) satisfaction with knowledge and understanding of diabetes ("Knowledge"). The model fitted the data at moderate level (relative chi2 = 1.58, n = 108, adjusted goodness-of-fit index = 0.77, comparative fit index = 0.89, root mean-square error of approximation = 0.07). The model was shown to have construct validity chi2(167) = 235.62, Bollen-Stine bootstrap P = .27). Reliabilities of the 3 factors were 0.92, 0.88, and 0.86, respectively.

Conclusion: The results support the validity and reliability of the DDSM-Q as an instrument to measure patient satisfaction with DDSM services in community pharmacy. Further research will be needed to validate the instrument in different populations.