Patient preferences for objective quality metrics during community pharmacy selection: A discrete choice experiment

Background: Patients select healthcare providers and facilities based on a complex array of factors. Pharmacy-level quality metrics have been discussed as a way to help direct patients towards high-quality pharmacies. Limited research has been conducted on the potential impact of quality metrics on the pharmacy selection process. Objectives: This study aimed to measure the relative strength of patient preferences for community pharmacy attributes and to describe associations between patient sociodemographic and health characteristics and pharmacy preferences. Methods: This study elicited preferences for pharmacy attributes using a discrete choice experiment presenting a scenario in which participants had moved to a new location and needed to select a pharmacy. Six attributes were selected based on published literature, expert opinion, and pilot testing feedback. Attributes were relationship-based (hours of operation, staff friendliness/courtesy, pharmacist communication, pharmacist willingness to establish a personal relationship) or competence-based (overall quality and a drug-drug interaction (DDI) specific quality metric). Participants responded to blocks of 10 random and 2 fixed choice tasks assigned by Sawtooth v9.2. Data were analyzed using conditional logit, and Hierarchical Bayes estimates of individual-level utilities were used to compare preferences across demographic subgroups. Results: Study participants expressed the strongest preferences for competence-based pharmacy attributes, including DDI-specific and overall quality measures (Attribute Importance Values: 40.3% and 31.3%, respectively). Women ascribed higher utility to 5-star DDI and overall quality ratings than men. Rural respondents and those with inadequate health literacy expressed stronger preferences for patient-pharmacist relationships than those in suburban areas and with adequate health literacy, respectively. Conclusions: Respondents exhibited strong preferences for pharmacies with higher competence-based quality ratings, suggesting that they may perceive medication safety to be a key role of community pharmacists. Future research on patient expectations of and preferences for community pharmacies can inform ways to effectively encourage patient engagement with pharmacists to improve health outcomes.