Assessment of chronic non-communicable diseases patients’ Satisfaction with pharmaceutical care in Public hospitals at Addis Ababa

Abstract

By applying pharmaceutical care, Pharmacists working in public hospitals have potential of preventing complications of diabetes and CVD. But this is not the case. Most pharmacy professionals are engaged merely in traditional dispensing of drugs and management of drug inventory. This traditional practice affects patient satisfaction and potential role of pharmacists in improving the patients’ health. Objectives: The main objective of this study was to assess the level of chronic noncommunicable diseases patients’ satisfaction with pharmaceutical care in public health facilities and examine possible factors which affect their satisfaction. Methods: A cross-sectional survey with both quantitative and qualitative components was used to assess chronic non-communicable diseases patients’ satisfaction with pharmaceutical care in four public hospitals, under the Addis Ababa City Administration Health Bureau from December 2010-February 2011. Results: A total of 417 diabetic and CVD patients were participated in this study. 220(52.8%) of study participants were found to have satisfaction level below the mean satisfaction score. Sex, type of disease and frequency of visit had significant association with patient satisfaction. No statistically significant association was found for other sociodemographic characteristics like age, education level, occupation, marital status and type of payment. Conclusion and recommendations: Findings of this study showed that more than half of (52.8%) of diabetic and CVD patients were not satisfied with the pharmaceutical service they received from the hospitals. Technical aspects of the pharmaceutical care practice received lower satisfaction rate by study participants as compared to the interpersonal skill. Emphasis should be given on the technical aspects of the pharmaceutical care. 2 1. Introduction 1.1. Background Currently 80% of deaths from chronic disease occur in low- and middle-income countries, where people develop these diseases at younger ages, suffer longer, and die sooner(1). It is estimated that between 1990 and 2020, mortality due to heart disease in developing countries will increase by 120% in women and 137% in men(2). Between 2007 and 2025, the number of people living with diabetes globally will increase from 246 to 380 million, and the majority will live in developing countries (3, 4). In Ethiopia, nationally representative prevalence rate for CVD and diabetes is not available. Pharmacists working in public hospitals have potential of preventing complications of diabetes and CVD by applying the new practice: Pharmaceutical care. Pharmaceutical care activities include counseling patients about their medications, monitoring patients' symptoms, helping resolve drug-related problems, facilitating communication with physicians, and performing condition- and patient-specific interventions when appropriate(5, 6). Clients' evaluation of health care services is an important element in assessing accessibility of care and the quality of care delivered(7, 8). Patient satisfaction defined as "multiple evaluation of distinct aspects of health care which are determined in some ways by the individual’s expectations, attitudes and comparison process"(9). Patient satisfaction with delivery of health care services has become recognized as an increasingly important indicator of the quality of health services (10). It also reflects the provider's ability to successfully deliver care that meets patients' needs(11). 3 As compared to unsatisfied patients, satisfied patients are more likely to continue using health services, maintain relationships with specific providers, and comply with care regimens(12). Many factors affect patient satisfaction in pharmaceutical service including waiting time, health status, and the patient’s own expectations (13-16). 1.2. Problem statement Even if Pharmacists working in public hospitals have potential of preventing complications of diabetes and CVD by applying concepts of pharmaceutical care, this is not the case in our country. Most hospital pharmacy professionals are engaged merely in traditional dispensing of drugs and management of drug inventory. This traditional practice affects patient satisfaction and potential role of pharmacists in improving the patients’ health. Many studies have been conducted to assess patient satisfaction with medical services, but only few of them have specifically investigated pharmacy and even fewer have addressed different pharmacy settings (17-21). The same is true in Ethiopia. In the past some researches were done to assess patient satisfaction in medical services. Little is known about the level and expectation of patients in Pharmaceutical care provided by public hospitals in Ethiopia and particularly in Addis Ababa. This study aimed at filling the void in information about patient satisfaction and expectation in Pharmaceutical care provided by public hospitals in Addis Ababa.