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, 72 (4), 271-281

Developing Preliminary Steps in a Pharmacist Communication - Patient Outcome Pathway


Developing Preliminary Steps in a Pharmacist Communication - Patient Outcome Pathway

Bernadette Chevalier et al. Can J Hosp Pharm.


Background: Nonadherence to medication therapy has been associated with poor health outcomes and increased health care costs. The literature describes pharmacists as key health care professionals in identifying and addressing nonadherence issues but does not explain how and why effective pharmacist-patient communication affects patients' medication adherence. Previously published pathways used in linking effective physician-patient communication to patient outcomes are proposed for the context of pharmacist-patient communication.

Objectives: To develop preliminary steps in a pharmacist communication - patient outcome pathway, adapted from a physician-patient communication pathway.

Methods: This longitudinal descriptive study, which took place in a large quaternary hospital, involved hospital pharmacists and patients. Patients' assessment of pharmacist communication behaviours and reporting of patient satisfaction occurred after the pharmacist-patient consultation. Medication-taking behaviour questionnaires were administered before the consultation and again 4 weeks after discharge. Developing the preliminary pathway (based on previously established physician communication pathways) involved 2 steps, with investigation of the following associations: (1) between patient-reported effective communication by pharmacists, as per the Communication Accommodation Theory (CAT), and patient satisfaction; and (2) between patient-reported pharmacist communication and satisfaction and patients' medication-taking behaviour.

Results: Twelve pharmacists and 48 patients participated. For step 1, almost all patient-reported pharmacist communication behaviours were positively correlated with patient satisfaction statements. Strong associations between CAT-related pharmacist communication behaviours and patient satisfaction highlighted the pharmacists' behaviours that are important to patients and necessary for effective conversations to take place. In step 2, there were fewer correlations of medication-taking behaviour indices with pharmacist communication behaviours and patient satisfaction.

Conclusions: This study showed how a preliminary pharmacist communication - patient outcome pathway could be successfully adapted from existing physician communication pathways. Such pathways provide an initial platform upon which future pharmacist communication - patient outcome research can be built.

Keywords: Communication Accommodation Theory (CAT); communication-outcome pathway; hospital pharmacist communication; medication adherence; patient satisfaction.

Conflict of interest statement

Competing interests: None declared.


Figure 1
Figure 1
Pathways from pharmacist-patient communication to health outcomes. Potential areas for pharmacist-patient communication are shown in yellow. Adapted from Patient Education and Counseling, volume 75, no. 3, Street RL Jr, Makoul G, Arora NK, Epstein RM. “How does communication heal? Pathways linking clinician–patient communication to health outcomes”, pages 295–301, © 2009, with permission from Elsevier.
Figure 2
Figure 2
Relationships among effective communication, patient satisfaction, and medication-taking behaviour. CAT = Communication Accommodation Theory.
Figure 3
Figure 3
Patient enrolment and participation. BMQ = Beliefs about Medicines Questionnaire, MMAS = Morisky Medication Adherence Scale. Use of the ©MMAS is protected by US copyright laws. Permission for use is required and was obtained for the purpose of this study. A licence agreement for use of this questionnaire by other researchers is available from: Donald E. Morisky, ScD, ScM, MSPH, Professor, Department of Community Health Sciences, UCLA School of Public Health, 650 Charles E Young Drive South, Los Angeles, CA 90095-1772,

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