International Journal of Clinical Pharmacy

, Volume 36, Issue 3, pp 636–647 | Cite as

Assessment of satisfaction with pharmaceutical services in patients receiving antiretroviral therapy in outpatient HIV treatment setting

  • Kenneth Anene AguEmail author
  • Dorothy Oqua
  • Peter Agada
  • Samuel I. Ohiaeri
  • Afusat Adesina
  • Mohammed Habeeb Abdulkareem
  • Rosalyn C. King
  • Anthony K. Wutoh
Research Article


Background The patient’s perception and satisfaction are increasingly considered as a useful factor in the assessment of competency of health care providers and quality of care. However, these patient focused assessments are largely ignored when assessing health care outcomes. Objective The study assessed the perception and satisfaction of patients receiving antiretroviral therapy (ART) with pharmaceutical services received in outpatient HIV treatment settings. Setting Seventeen HIV treatment centres in Nigeria. Methods This cross-sectional survey included 2,700 patients randomly selected from 26,319 HIV patients on ART, who received pharmaceutical services in the study setting. A study-specific Likert-type instrument was administered to the participants at point of exit from the pharmacy. Midpoint of the 5-point scale was computed and scores above it were regarded as positive while below as negative. Chi-square was used for inferential statistics. All reported p values were 2-sided at 95 % confidence interval (CI). Main outcome measure Patient satisfaction with pharmaceutical services. Results Of 2,700 patients sampled, data from 1,617 (59.9 %) were valid for analysis; 62.3 % were aged 26–40 years and 65.4 % were females. The participants had received pharmaceutical services for a mean duration of 25.2 (95 % CI 24.3–26.1) months. Perception of participants regarding the appearance of pharmacy was positive while that regarding the pharmacists’ efforts to solve patients’ medication related problems was negative. The participants’ rating of satisfaction with the waiting time to access pharmaceutical services was negative; the satisfaction decreases with increasing waiting time. However, the satisfaction with the overall quality of pharmaceutical services received was rated as positive; 90.0 % reported that they got the kind of pharmaceutical services they wanted; 98.2 % would come back to the pharmacy if they were to seek help again and would recommend services to others. The level of satisfaction was found to be associated with educational status of the participants (p = 0.006) unlike age, sex, marital and employment status. Conclusion The satisfaction with overall quality of pharmaceutical services received by participants was positive. Longer waiting times resulted in lower patient satisfaction. High patient load may be the cause of the long waiting time and the inadequate duration of interaction between pharmacist and the patient.


HIV/AIDS Nigeria Patients Perception Pharmaceutical care Satisfaction Services 



We wish to acknowledge all staff of HU PACE in Nigeria and USA who have supported in the implementation of the pharmacy component of the GHAIN Project. We also acknowledge the contribution of focal pharmacists who supported the direct provision of pharmaceutical care to patients in the health facilities.


Support for this paper was provided by Global HIV/AIDS Initiative in Nigeria (GHAIN) with funds from the US President’s Emergency Plan for AIDS Relief (PEP-FAR) through US Agency for International Development (USAID) Cooperative Agreement No. 620-A-00-04- 00122-00. The views expressed in this publication are that of the authors and do not necessarily reflect those of FHI360 and Howard University Pharmacists and Continuing Education (HU PACE) Center.

Conflicts of interest

The author(s) declare that they have no competing interests.


  1. 1.
    Erah PO, Chuks-Eboka NA. Patients’ perception of the benefits of pharmaceutical care services in the management of hypertension in a tertiary health care facility in Benin City. Trop J Pharm Res. 2008;7(1):897–905.CrossRefGoogle Scholar
  2. 2.
    Donabedian A. The role of outcomes in quality assessment and assurance. Qual Rev Bull. 1992;18:356–60.Google Scholar
  3. 3.
    Ford RC, Bach SA, Fottler MD. Methods of measuring patient satisfaction in health care organizations. Health Care Manage Rev. 1997;22:74–89.PubMedCrossRefGoogle Scholar
  4. 4.
    Rosenthal GE, Shannon SE. The use of patient perceptions in the evaluation of health-care delivery systems. Med Care. 1997;35(11 Suppl):NS58–68.PubMedGoogle Scholar
  5. 5.
    Rossiter L, Langwell K, Wan T, Rivnyak M. Patient satisfaction among elderly enrollees and disenrollees in Medicare health maintenance organizations. Results from the National Medicare Competition Evaluation. JAMA. 1989;262:57–63.PubMedCrossRefGoogle Scholar
  6. 6.
    Ware JE, Snyder MK, Wright WR, et al. Defining and measuring patient satisfaction with medical care. Eval Prog Plan. 1983;6:247–63.CrossRefGoogle Scholar
  7. 7.
    Larson LN, Rovers JP, MacKeigan LD. Patient satisfaction with pharmaceutical care: update of a validated instrument. J Am Pharm Assoc. 2002;42:44–50.CrossRefGoogle Scholar
  8. 8.
    Sitzia J, Wood N. Patient satisfaction: a review of issues and concepts. Soc Sci Med. 1997;45:1829–43.PubMedCrossRefGoogle Scholar
  9. 9.
    Schommer JC, Kucukarslan SN. Measuring patient satisfaction with pharmaceutical services. Am J Health Syst Pharm. 1997;54:2721–32.PubMedGoogle Scholar
  10. 10.
    Hepler C, Strand L. Opportunities and responsibilities in pharmaceutical care. Am J Hosp Pharm. 1990;47:533–43.PubMedGoogle Scholar
  11. 11.
    King RC, Fomundam HN. Remodeling pharmaceutical care in Sub-Saharan Africa (SSA) amidst human resources challenges and the HIV/AIDS pandemic. Int J Health Plann Manage. 2010;25:30–48.PubMedCrossRefGoogle Scholar
  12. 12.
    Oparah AC. Pharmaceutical care concept, philosophy, competency and benefits. In: Oparah AC, editor. Essentials of pharmaceutical care. Lagos, Nigeria: ACybex publication; 2010. p. 21–39. ISBN: 9789783840195.Google Scholar
  13. 13.
    Volume CI, Farris KB, Kassam R, Cox CE, Cave A. Pharmaceutical care research and education project: patient outcomes. J Am Pharm Assoc. 2001;41(3):411–20.Google Scholar
  14. 14.
    Erah PO, Nwazuoke JC. Identification of standards for pharmaceutical care in Benin City. Trop J Pharm Res. 2002;1(2):55–66.Google Scholar
  15. 15.
    Farris KB, Llimos FF, Benrimoj S. Pharmaceutical care in community pharmacies: practice and research from around the world. Ann Pharmacother. 2005;39(9):1539–41.PubMedCrossRefGoogle Scholar
  16. 16.
    Swift BG. Barriers to pharmaceutical care in the home care setting. Am J Hosp Pharm. 1993;50:1611–4.Google Scholar
  17. 17.
    Oparah AC, Eferakeya AE. Attitudes of Nigerian pharmacists towards pharmaceutical care. Pharm World Sci. 2005;27(3):208–14.PubMedCrossRefGoogle Scholar
  18. 18.
    Andaleeb SS. Service quality perceptions and patient satisfaction: a study of hospitals in a developing country. Soc Sci Med. 2001;52(9):1359–70.PubMedCrossRefGoogle Scholar
  19. 19.
    Oparah AC. Enato EFO and Akoria OA. Assessment of patient satisfaction with pharmaceutical services in a Nigerian teaching hospital. Int J Pharm Pract. 2004;12:7–12. doi: 10.1211/0022357023204.CrossRefGoogle Scholar
  20. 20.
    Hanan M, Karp P. Customer satisfaction: how to maximize, measure, and market your company’s “ultimate product”. New York, NY: American Management Association; 1989. p. 7. ISBN-10: 0814477720.Google Scholar
  21. 21.
    Marquis M, Davies A, Ware J. Patient satisfaction and change in medical care provider: a longitudinal study. Med Care. 1983;21:821–9.PubMedCrossRefGoogle Scholar
  22. 22.
    Ware J, Wright W, Snyder M, et al. Consumer perceptions of health care services: implications for academic medicine. J Med Educ. 1975;50:839–48.PubMedGoogle Scholar
  23. 23.
    Ross C, Frommelt G, Hazelwood L. The role of expectations in patient satisfaction with medical care. J Health Care Mark. 1987;7:16–26.PubMedGoogle Scholar
  24. 24.
    Bartlett E, Grayson M, Barker R. The effects of physician communication skills on patient satisfaction, recall and adherence. J Chronic Dis. 1984;37:755–64.PubMedCrossRefGoogle Scholar
  25. 25.
    Karunamoorthi K, Rajalakshmi M, Makesh Babu S, Yohannes A. HIV/AIDS patient’s satisfactory and their expectations with pharmacy service at specialist antiretroviral therapy (ART) units. Eur Rev Med Pharmacol Sci. 2009;13:331–9.PubMedGoogle Scholar
  26. 26.
    Nunnally JC. Psychometric theory. New York: McGraw-Hill; 1978. ISBN: 0070474656, 9780070474659.Google Scholar
  27. 27.
    Field A. Discovering statistics using SPSS for windows. London–Thousand Oaks–New Delhi: Sage; 2000. p. 446. ISBN: 0761957545.Google Scholar
  28. 28.
    Stewart DW. The application and misapplication of factor analysis in marketing research. J Mark Res. 1981;18:51–62.CrossRefGoogle Scholar
  29. 29.
    Hair JF, Anderson RE, Tatham RL. Multivariate data analysis. 2nd ed. New York: Macmillan; 1987. p. 149.Google Scholar
  30. 30.
    Probst JC, Greenhouse DL, Selassie AW. Patient and physician satisfaction with an outpatient care visit. J Fam Pract. 1997;45:418–25.PubMedGoogle Scholar
  31. 31.
    Abdosh B. The quality of hospital services in eastern Ethiopia: patient’s perspective. Ethiop J Health Dev. 2006;20:199–200.Google Scholar
  32. 32.
    American Pharmacists Association (APhA). Principles of practice for pharmaceutical care. 2005. Accessed 20 May 2013.
  33. 33.
    American Society of Hospital Pharmacists. ASHP statement on pharmaceutical care. Am J Hosp Pharm. 1993;50:1720–3.Google Scholar
  34. 34.
    American Society of Health-System Pharmacists. ASHP guidelines on the provision of medication information by pharmacists. Am J Health-Syst Pharm. 1996;53:1843–5.Google Scholar
  35. 35.
    Troutman WG. Consensus-derived objectives for drug information education. Drug Inf J. 1994;28:791–6.Google Scholar
  36. 36.
    George D, Mallery P. SPSS for windows step by step: a simple guide and reference. 11.0 update. 4th ed. Boston: Allyn and Bacon; 2003. p. 231. ISBN: 0205375529, 9780205375523.Google Scholar
  37. 37.
    Streiner DL, Norman GR. Health measurement scales: a practical guide to their development and use. Oxford: Oxford University Press, 2008. ISBN: 0199231885, 9780199231881.Google Scholar
  38. 38.
    Portney LG, Watkins MP. Foundations of clinical research applications to practice. New Jersey: Prentice Hall; 2000. p. 560–7. ISBN: 0838526950, 9780838526958.Google Scholar
  39. 39.
    Streiner DL. Starting at the beginning: an introduction to coefficient alpha and internal consistency. J Pers Assess. 2003;80:99–103.PubMedCrossRefGoogle Scholar

Copyright information

© Koninklijke Nederlandse Maatschappij ter bevordering der Pharmacie 2014

Authors and Affiliations

  • Kenneth Anene Agu
    • 1
    Email author
  • Dorothy Oqua
    • 1
  • Peter Agada
    • 1
  • Samuel I. Ohiaeri
    • 1
  • Afusat Adesina
    • 1
  • Mohammed Habeeb Abdulkareem
    • 1
  • Rosalyn C. King
    • 2
  • Anthony K. Wutoh
    • 2
  1. 1.Pharmacist and Continuing Education (PACE) CenterHoward UniversityGarki AbujaNigeria
  2. 2.College of Pharmacy, Pharmacist and Continuing Education (PACE) CenterHoward UniversityWashingtonUSA

Personalised recommendations