Development and validation of a patient satisfaction survey for pharmaceutical service at primary care settings

Patient satisfaction is a key quality indicator of pharmacy service. However, there are few studies that develop and validate patient satisfaction surveys applied to pharmaceutical services in primary care settings. It is imperative to establish a well-validated multidimensional instrument for evaluating the viability and sustainability of pharmacy service across geographically diverse regions in low- and middle-income countries. To develop and validate a patient satisfaction instrument for community pharmaceutical services, we carried out a cross-sectional survey in seven provinces across China. The study was conducted in four phases: (i) literature review-based item generation, (ii) expert panel-endorsed questionnaire refinement, (iii) pilot questionnaire development, and (iv) psychometric validation. Survey respondents were standard patients recruited locally and trained to conduct unannounced visits to preselected primary care centers. Between December 2020 and November 2021, the pilot survey comprised a total of 166 unannounced standard patient visits from 125 health-care facilities. The final 24-item Likert-type instrument encompassed five domains: relationship, medication counseling, empathy, accessibility, and overall satisfaction. The satisfactory survey revealed excellent internal consistency. Factor analyses resulted in a 4-factor solution that accounted for 70.7% variance. The results suggest that the questionnaire is a valid and reliable instrument, which has been taken an important step to evaluate patient satisfaction with pharmaceutical services in Chinese primary care settings. Further research on its cross-culture adaptation and applicability in urban retail pharmacy settings is warranted.