Quality indicators for pharmaceutical care: a comprehensive set with national scores for Dutch community pharmacies

• Published in: International journal of clinical pharmacy Vol. 38; no. 4; pp. 870 - 879
• Main Authors: Teichert, Martina, Schoenmakers, Tim, Kylstra, Nico, Mosk, Berend, Bouvy, Marcel L., van de Vaart, Frans, De Smet, Peter A. G. M., Wensing, Michel
• Format: Journal Article
• Language: English
• Published: Cham Springer International Publishing 01-08-2016
• Subjects: Community Pharmacy Services - standards; Community Pharmacy Services - statistics & numerical data; Community Pharmacy Services - trends; Humans; Internal Medicine; Medicine; Medicine & Public Health; Netherlands; Pharmacy; Quality Indicators, Health Care - standards; Quality Indicators, Health Care - statistics & numerical data; Quality Indicators, Health Care - trends; Quality of Health Care - standards; Quality of Health Care - statistics & numerical data; Quality of Health Care - trends; Research Article; Retrospective Studies; The Netherlands; Quality indicators; Pharmaceutical care; Quality improvement; Community pharmacies
• ISSN: 2210-7703; 2210-7711
• DOI: 10.1007/s11096-016-0301-x

Background
The quality of pharmaceutical care in community pharmacies in the Netherlands has been assessed annually since 2008. The initial set has been further developed with pharmacists and patient organizations, the healthcare inspectorate, the government and health insurance companies. The set over 2012 was the first set of quality indicators for community pharmacies which was validated and supported by all major stakeholders. The aims of this study were to describe the validated set of quality indicators for community pharmacies and to report their scores over 2012. In subanalyses the score development over 5 years was described for those indicators, that have been surveyed before and remained unchanged.
Methods
Community pharmacists in the Netherlands were invited in 2013 to provide information for the set of 2012. Quality indicators were mapped by categories relevant for pharmaceutical care and defined for structures, processes and dispensing outcomes. Scores for categorically-measured quality indicators were presented as the percentage of pharmacies reporting the presence of a quality aspect. For numerical quality indicators, the mean of all reported scores was expressed. In subanalyses for those indicators that had been questioned previously, scores were collected from earlier measurements for pharmacies providing their scores in 2012. Multilevel analysis was used to assess the consistency of scores within one pharmacy over time by the intra-class correlation coefficient (ICC).
Results
For the set in 2012, 1739 Dutch community pharmacies (88 % of the total) provided information for 66 quality indicators in 10 categories. Indicator scores on the presence of quality structures showed relatively high quality levels. Scores for processes and dispensing outcomes were lower. Subanalyses showed that overall indicators scores improved within pharmacies, but this development differed between pharmacies.
Conclusions
A set of validated quality indicators provided insight into the quality of pharmaceutical care in the Netherlands. The quality of pharmaceutical care improved over time. As of 2012 quality structures were present in at least 80 % of the community pharmacies. Variation in scores on care processes and outcomes between individual pharmacies and over time can initiate future research to better understand and facilitate quality improvement in community pharmacies.