Exploring consumer understanding and preferences for pharmacy quality information
Objective: To describe consumer understanding of pharmacy quality measures and consumer preferences for pharmacy quality information.
Methods: Semi-structured focus group design was combined with survey methods. Adults who filled prescription medications for self-reported chronic illnesses at community pharmacies discussed their understanding of Pharmacy Quality Alliance approved quality measures. Questions examined preference of pharmacy quality information rating systems (e.g. stars versus percentages) and desired data display/formats. During the focus group, participants completed a survey examining their understanding of each pharmacy quality measure. All focus group discussions were transcribed verbatim. Data were analyzed using thematic analysis and descriptive statistics.
Results: Thirty-four individuals participated (mean age= 62.85; SD=16.05). Participants were unfamiliar with quality measures information and their level of understanding differed for each quality measure. Surveys indicated 94.1% understood “Drug-Drug Interactions” and “Helping Patients Get Needed Medications” better than other measures (e.g., 76.5% understood “Suboptimal Treatment of Hypertension in Patients with Diabetes”). Qualitative analysis indicated participants preferred an overall pharmacy rating for quick access and use. However, participants also wanted quality measures information displayed by health conditions. Participants favored comparison of their pharmacy to city data instead of state data. Most participants liked star ratings better than percentages, letter grades, or numerical ratings.
Conclusions: Individuals who have a chronic illness and regularly use community pharmacies are interested in pharmacy quality measures. However, specific quality measures were not understood by some participants. Participants had specific preferences for the display of pharmacy quality information which will be helpful in the design of appropriate quality report systems.
2 Mukamel DB, Mushlin AI, Weimer D, Zwanziger J, Partker T, Indirdason I. Do quality report cards play a role in HMO’s contracting practices? Evidence from the New York State. Health Serv Res. 2000;35(1 Pt 2):319-332.
3 Robinowitz DL, Dudley RA. Public reporting of provider performance: can its impact be made greater. Annu Rev Public Health. 2006;27:517-536.
4 Hibbard JH, Stockard J, Tusler M. Hospital performance reports: impact on quality, market share, and reputation. Health Aff (Millwood). 2005;24(4):1150-1160.
5 Lansky D. Improving quality through public disclosure of performance information. Health Aff (Millwood). 2002;21(4):52-62.
6 Marshall MN, Shekelle PG, Davies HT, Smith PC. Public reporting on quality in the United States and the United Kingdom. Health Aff (Millwood). 2003;22(3):134-148.
7 Marshall M, Davies H. Public release of information on quality of care: how are health services and the public expected to respond? J Health Serv Res Policy. 2001;6(3):158-162.
8 Schenider EC, Lieberman T. Publicly disclosed information about the quality of healthcare: response of the US public. Qual Health Care. 2001;10(2):96-103.
9 Hibbard JH, Mahoney ER, Stockard J, Tusler M. Development and testing of a short form of the patient activation measure. Health Serv Res. 2005;40(6 Pt 1):1918-1930.
10 Pharmacy Quality Alliance. PQA endorsed set of measures. Available at http://pqaalliance.org/measures/default.asp.pdf (accessed February 5, 2014).
11 Nau DP. Measuring pharmacy quality. J Am Pharm Assoc (2003). 2009;49(2):154-63. doi: 10.1331/JAPhA.2009.09019
12 Hibbard JH, Slovic P, Peters E, Finucane ML. Strategies for reporting health plan performance information to consumers: evidence from controlled studies Health Serv Res. 2002;37(2):291-313.
13 Marshall MN, Romano PS, Davies HT. How do we maximize the impact of the public reporting of quality of care? Int J Qual Health Care. 2004;16(Suppl 1):i57-i63.
14 Hibbard JH, Berkman N, McCormack LA, Jael E. The impact of a CAHPS report on employee knowledge, beliefs, and decisions. Med Care Res Rev. 2002;59(1):104-116.
15 Faber M, Bosch M, Wollersheim H, Leatherman S, Grol R. Public reporting in healthcare: how do consumers use quality of care information? A systematic review. Med Care. 2009;47(1):1-8. doi: 10.1097/MLR.0b013e3181808bb5
16 Shiyanbola OO, Mort JR, Lyons K. Advancing the utility of community pharmacy quality measures: a qualitative study. J Am Pharm Assoc (2003). 2013;53(4):400-407. doi: 10.1331/JAPhA.2013.12160
17 Huston SA, Hobson EH. Using focus groups to inform pharmacy research. Res Social Adm Pharm. 2008;4(3):186-205. doi: 10.1016/j.sapharm.2007.09.001
18 Fereday J, Muir-Cochrane E. Demonstrating rigor using thematic analysis: a hybrid approach of inductive and deductive coding and theme development. Int J Qual Methods. 2006;5:1-11.
19 The public health researcher: A methodological approach. Melbourne: Oxford University Press, 1997.
20 Peters E, Dieckmann N, Dixon A, Hibbard JH, Mertz CK. Less is more in presenting quality information to consumers. Med Care Res Rev. 2007;64(2):169-190.
21 Hibbard JH, Greene J, Daniel D. What is quality anyway? Performance reports that clearly communicate to consumers the meaning of quality of care. Med Care Res Rev. 2010;67(3):275-293. doi: 10.1177/1077558709356300
22 Werner RM, Asch DA. The unintended consequences of publicly reporting quality information. JAMA. 2005;293(10):1239-1244.
23 Kaiser Family Foundation. 2008 update of consumers’ views on patient safety and quality Menlo Park, CA. Available at http://www.kff.org/kaiserpolls/posr101508pkg.cfm (accessed August 13, 2014).
24 Kaiser Family Foundation, a national survey on consumers experiences with patient safety and quality information. Available at http://www.kff.org/kaiserpolls/7209.cfm (accessed August 13, 2014).
25 Building the Science of Public Reporting, Research Grants. Available at http://www.ahrq.gov/legacy/qual/value/sciencepubreport.htm (accessed August 13, 2014).
26 Massachusetts Health Quality Partners. Available at www.mhpq.org (accessed August 13, 2014).
27 Longo DR, Everet KD. Health care consumer reports: an evaluation of consumer perspectives. J Health Care Finance. 2003;30(1):65-71.
28 Boscarino JA, Adams RE. Public perceptions of quality care and provider profiling in New York: implications for improving quality care and public health. J Public Health Manag Pract. 2004;10(3):241-250.
29 Robinson S, Brodie M. Understanding the quality challenge for health consumers: the Kaiser/AHCPR Survey. Jt Comm J Qual Improv. 1997;23(5):239-244.
30 Arnold SD. Improving quality health care: the role of consumer engagement. Robert Wood Johnson Foundation Issue Brief. Page 1-6. Available at http://www.academyhealth.org/files/issues/ConsumerEngagement.pdf (accessed February 7, 2014).
31 Caiaazza A, Shaw A. The Status of Women in South Dakota. Institute for Women’s Policy Research. Washington DC, October 2004.
The authors hereby transfer, assign, or otherwise convey to Pharmacy Practice: (1) the right to grant permission to republish or reprint the stated material, in whole or in part, without a fee; (2) the right to print pr epublish copies for free distribution or sale; and (3) the right to republish the stated material in any format (electronic or printed). In addition, the undersigned affirms that the article described above has not previously been published, in whole or part, is not subject to copyright or other rights except by the author(s), and has not been submitted for publication elsewhere, except as communicated in writing to Pharmacy Practice with this document.
Authors retain copyright and grant the journal right of first publication with the work simultaneously licensed under a Creative Commons Attribution License (CC-BY-NC-ND) that allows others to share the work with an acknowledgement of the work's authorship and initial publication in this journal.
Author Self-Archiving Policy
Pharmacy Practice permits and encourages authors to post and archive the final pdf of the articles submitted to the journal on personal websites or institutional repositories after publication, while providing bibliographic details that credit its publication in this journal.