Determining factors influencing the intention to adopt Value Added Services (VAS) for refill prescriptions among patients at Hospital Universiti Sains Malaysia (HUSM) / Mohamad Amir Ashraf Shamsuddin and Wan Iskandar Firdaus Shahariman

Patients’ perception on the pharmacy service quality were profoundly affected by the long waiting time, which later will have impact on patients’ treatment outcome and satisfaction. The HUSM Outpatient Pharmacy had introduced a new service of pharmacy Value Added Service (VAS) in response to cope with the issue of increasing number of patients and long waiting time at the pharmacy, which also affected the key performance index (KPI) achievement of outpatient pharmacy. These VAS users mainly consist of patients with refill prescriptions. However, the adoption rate is low with total of 7.70% adoption for the first 12 months of implementation, and therefore hampering the goals for the department to achieve which is at least 80% of patients with refill prescriptions used VAS. The main objective of this study is to assess and identify the factors that influence the intention to adopt VAS among the patients in HUSM with the Theory of Planned Behavior (TPB) as the theoretical framework. A single-centered through self-administered, face-to-face survey was conducted in the outpatient pharmacy department of HUSM, Kelantan, Malaysia. This cross sectional survey (N=324) was conducted using the adopted and adapted questionnaires from Pharmacy Value Added Services Questionnaire (PVASQ). Intention (INT) to adopt pharmacy VAS was predicted by knowledge, attitudes (ATT), subjective norms (SN), perceived behavioral control (PBC) and expectation. Internal consistency was measured by Cronbach’s Alpha where all the scales for the three main domains of questionnaire, knowledge, perspective and expectation had value of α 0.748, 0.926 and 0.871 respectively. Meanwhile Cronbach’s Alpha values for each TPB construct for ATT, SN, PBC and INT were 0.773, 0.844, 0.768 and 0.896 respectively. Data were analyzed using Pearson’s correlation and multiple regression analysis. Overall, using Pearson’s correlation, all the five predicted factors showed significant association with the patients’ intention to adopt pharmacy VAS (p<0.05). Using multiple regression, the significant predictors for patients’ intention to adopt VAS were SN, PBC and ATT which demonstrated statistically significant (p<0.05). The strongest predictor factor with respect to intention was SN, followed by PBC and subsequently ATT. Even though knowledge and expectation factor were shown as not statistically significant for this study, these two factors still could be considered as the key predictors for the intention of the patients to adopt VAS. The intention to adopt pharmacy VAS, perspectives moderate both expectations and knowledge relationships, whereas expectations moderate the perspective-intention relationship. To increase the intention to use pharmacy VAS, it was recommended that patients' knowledge be improved through appropriate media, and that extra effort be done to improve their perspectives on pharmacy VAS. Individuals who had a positive perspective were more likely to use PVAS if they had more knowledge and their service quality expectations are met.