Validation of a patient satisfaction questionnaire for services provided in Spanish community pharmacies.

BACKGROUND: The concept of Pharmaceutical Care (PC) is being gradually developed, and it's impact in health care should be measured using a quality tool. OBJECTIVE: The aim of this study was to describe and assess the psychometric properties of a patient satisfaction questionnaire (PSQ) for PC services in community pharmacies in Seville, Spain. It was based on a previous questionnaire in Spanish. METHODS: The face and content validity were assessed using the items of a validated questionnaire developed by Traverso et al. and adapted to the Seville pharmacy patient population. The PSQ was designed for use in the community pharmacy setting by a panel of seven pharmacists with expertise in both PC and questionnaire design. The result, was a 'draft PSQ' which comprised of 27 multidimensional items, with responses recorded on a five-point 'Likert-type scale'. The validity and reliability of the 'final PSQ' was carried out using a cross-sectional and analytical study. Eighteen community pharmacies agreed to participate in the study. The draft PSQ was a self completion questionnaire distributed to patients by pharmacists following selection criteria. The survey response rate was assessed. The validity was determined by establishing the distribution of the PSQ's items and dimensions of the PSQ through factor analysis, and the reliability was evaluated with Cronbach's alpha coefficient (α). RESULTS: Two-hundred and twenty-three patients took part in the study.The factor analysis with varimax rotation established a 'final PSQ' with 24 items over two dimensions: Medication Therapy Management (MTM) and General satisfaction with the pharmacy/staff and services (GSP/SS) which extracted 63.5% of the variance. The internal consistency by α was 0.964 for the PSQ and 0.959 and 0.916 for the two dimensions, respectively. The median (mode) score for GSP/SS was 5.0 (5.0) and 4.0 (5.0) for MTM. The Wilcoxon-test indicated that the difference between these scores was statistically significant (P < 0.001). CONCLUSION: Our results suggest that the PSQ is a two dimensional instrument with psychometric properties able to assess patient satisfaction in community pharmacies. However, its validity and reliability need to be further confirmed in different PC settings and its sensitivity to measure changes in satisfaction over time also needs to be established.

Gastric damage induced by subchronic administration of preferential cyclooxygenase-1 and cyclooxygenase-2 inhibitors in rats.

Nonsteroidal anti-inflammatory drugs (NSAIDs) are well known to induce gastrointestinal damage including bleeding, ulceration and perforation in humans and animals. The aim of this study was to compare the effects of two oxicams, preferential cyclooxygenase (COX)-1 or COX-2 inhibitors, on both gastric mucosa and some biological parameters (hematological, hepatic and renal) after subchronic administration (14 and 28 days) in rats. Neutrophil infiltration was also assessed. Equipotent doses of meloxicam (3.75 and 7.5 mg/kg) and piroxicam (5 and 10 mg/kg) were administered. Both drugs dose-dependently caused multiple gastric erosions and hemorrhage in rats after 14 and 28 days of administration. Treatment with meloxicam led to a higher gastric damage than with piroxicam on day 14 although these results were not significant. The levels of myeloperoxidase activity (as an index of neutrophil infiltration) were not changed compared with control after drug treatment. All the hematological parameters obtained after drugs administration for 14 and 28 days were in the range of normal values, and a significant increase in platelet levels could be observed in the group treated with 5 mg/kg of piroxicam for 14 days. Aspartate aminotransferase (AST or GOT) increased significantly after 14 days, but after 28 days the values returned to normality. Creatinine and urea did not undergo significant changes except for the piroxicam 14-day 5 mg/kg group, in which uremia increased significantly over normal values. In conclusion, our results show that meloxicam, a preferential COX-2 inhibitor, causes rates of gastric lesion comparable to those seen with traditional NSAIDs, without inducing important changes in biological parameters.