Can Trust in Pharmacists Improve When They Have Complete Health Records?

Intro:

Pharmacists rank third amongst U.S. professionals for honesty and ethics. As one of the most accessible healthcare fields, we hypothesized that Since Ccommunity pharmacists with additional access to patient medical records would improve the pharmacist’s ability to conduct MTM and subsequently strengthen the patient-pharmacist relationship.

Methods:

This is a survey study administered as part of a randomized controlled trial (NCT03437694)e with the primary purpose of the impact of medication therapy management (MTM) on the health of persons living with Human Immunodeficiency Virus (HIV). As part of the larger clinical trial, participants were randomized 1:1 into the intervention arm (MTM with pharmacist access to patient health records) or the control arm (MTM without pharmacist access to patient health records). Patient health records were defined as updated labs, imaging results, and notes from their primary care provider. The inclusion criteria were African American, adults, and comorbid conditions including HIV on antiretrovirals, and the presence of hypertension and/or diabetes. The purpose of this survey study is to determine if there is a difference in the degree of participant trust based on the trial arms. Additional inclusion criteria for this study was completion of at least 5 out of the 9 scheduled visits. Participant surveys were excluded if they had unanswered responses.

The study was approved by the University of North Texas Health Science Center’s IRB (#1436643/2018-094) which included the administration of participant surveys. The survey was an unvalidated, contained 43-item questionnairesassessed on a 5-point Likert scale (1 = Strongly Agree to 5 = Strongly Disagree), and administered at every MTM visit. Four questions related to participant trust were extracted from the larger survey administered at the fifth study visit. Reverse coding was used given the structure of the Likert scale and applied so that higher values represented better outcomes. For each participant, an average of the responses to the four questions was calculated. All categorical data were analyzed with descriptive statistics. Since patients were not matched, an independent t-test was used to compare the survey scores between arms.

Results:

A total of 58 participants were included with an average age of 55 years. The majority of the surveys were from participants assigned to the control arm (57%). The average trust score for the intervention arm was 4.82 ± 0.39. The average trust score for the control arm was similar at 4.82 ± 0.41 (p = 0.99).

Conclusions:

The results demonstrated an overall strong degree of trust in pharmacists conducting MTM. There was no statistically significant difference in participant’s attitude or expression of trust towards the capability of the community pharmacist regardless of pharmacist access to additional medical records. The lack of statistical difference could be explained by the small sample size, unmatched participant characteristics, and the overall high agreement signifying an already trusting relationship between participant and pharmacist. This is in line with other data suggesting that the field of pharmacy is one of the most trusted fields in healthcare.