Development and validation of the Attitudes to Pharmacist Services for Diabetes Scale (APSDS)

Community pharmacists are uniquely placed to deliver a range of services to support clients with type 2 diabetes (T2D). However successful uptake of new services depends on consumers' willingness to access these. An understanding of consumer perspectives is thus pivotal to designing appropriate services and to developing strategies to promote uptake.

To develop and validate a new measure the "Attitudes to Pharmacist Services for Diabetes Scale" (APSDS) and to assess consumers' interest in receiving diabetes services from community pharmacy.

The APSDS, based on Donabedian's model of service quality, comprised 14 items on a five-point scale from strongly disagree to strongly agree. A cross-sectional online and postal survey was conducted among T2D members of the Australian Diabetes Council between April and June 2013. The sample was randomly split into two groups. Construct validity was first examined with principal components analysis (PCA) and Rasch analysis on the first sample and confirmed with confirmatory factor analysis (CFA) and Rasch analysis on the second sample. Criterion validity was examined through correlation of APSDS scores with variables predicted a priori to correlate with consumer attitudes. Internal consistency was examined with Cronbach's alpha.

540 consumers completed the survey (57.6% male). PCA produced a two-component solution. The two sub-scales were labeled "Attitudes to pharmacy diabetes services" (6 items; α = 0.92) and "Attitudes to pharmacist competency in diabetes care" (4 items; α = 0.89). Fit of the data to the Rasch model was generally good. APSDS sub-scale scores were positively correlated with likelihood of using pharmacy service for diabetes (Spearman's rho = 0.30, 0.32). The CFA confirmed the two-component solution.

The APSDS scales represent a valid and reliable tool which may serve to identify attitudes to pharmacists' diabetes services in different regions and communities as well as measure the impact of pharmacy diabetes interventions on consumer perspectives.