Building intentions with the theory of planned behaviour: a qualitative assessment of salient beliefs about pharmacy value added services in Malaysia

Abstract

ObjectiveTo improve pharmaceutical care delivery in Malaysia, the Ministry of Health (MOH) had introduced the concept of value added services (VAS). Despite its reported convenience and advantages, VAS utilization rate is low in the country. The study aims to explore patients’ understanding, beliefs and expectations towards VAS in Malaysia using the theory of planned behaviour (TPB) as the theoretical model.MethodsA qualitative methodology was used whereby face‐to‐face interviews were conducted with 12 patients who collected partial medicine supplies from government pharmacies. Participants were recruited using purposive and snowball sampling method in the state of Negeri Sembilan, Malaysia. Interviews were audio‐recorded. Verbatim transcription and thematic content analysis were performed on the data.ResultsThematic content analysis yielded five major themes: (i) attitudes towards using VAS, (ii) subjective norms, (iii) perceived behavioural control, (iv) lack of knowledge and understanding of VAS and (v) expectations towards VAS.ConclusionThe interviews explored and informed new information about salient beliefs towards pharmacy VAS. The findings suggest that VAS is still in its infancy and a more robust and effective advertising and marketing campaign is needed to boost the adoption rate. Behavioural attitudes, subjective norms and perceived control elements were discussed and serve as important variables of interest in future study. Expectations towards VAS serve as an important guideline to further improve patient‐oriented services.

Building Intentions with the Theory of Planned Behaviour: The Mediating Role of Knowledge and Expectations in Implementing New Pharmaceutical Services in Malaysia

“…The conclusions from Phase 1 will assist the formation and formulation of research questions. 14 The qualitative study completed by Tan et al 15 showed clearly that five main themes emerged as significant predictors of intention which were attitudes, subjective norms, perceived behavioural control, knowledge and expectations in agreement with the TPB. This provides a strong impetus to proceed to Phase 2 of the study.…”

“…Earlier work by Tan and colleagues' qualitative study suggests that knowledge and expectations also play a larger role than just predictors of intention but somehow indirectly affect the patient's perspectives through the TPB domains. 15 Thus, it is reasonable to posit that knowledge and expectations act as multiple mediators of each TPB construct of attitudes, subjective norms and perceived behavioural control. From Figure 1A, the total effect of X on Y is the c path for a relationship with no mediators.…”

Pharmacy Value Added Services: Early Begininings, Current Implementation, And Challenges From The Malaysian Experience

“…42 These studies by Tan and colleagues provide the policy maker with important conclusion regarding the implementation challenges of PVAS in Malaysia. [38][39][40][41] In particular, the results suggest that the influence of peers, friends and family plus the ease of which patients can use the services are the main predictors of adoption intentions. Generally, patient knowledge and their expectations can strengthen the relationship between intentions and cognitive perspectives.…”

“…The first is a series of interviews that aims to solicit and generate themes for analysis. 38 This is followed by the questionnaire development stage where a survey instrument is designed based on the thematic analysis gained from the qualitative stage as mentioned earlier. 39 Finally, the authors perform a final stage quantitative studies to capture the mediating effects of knowledge and expectations on intentions 40 and also to study how total cognitive perspectives (made up of subjective norms, perceived behavioural control and attitudes) can moderate the patient's intentions to adopt PVAS.…”

“…This encourages their families to favour PVAS over traditional services and promotes compliance in the long term especially for those on chronic medications. 38 In simpler terms, a mediating variable strengthens the relationship between the dependent and the independent variables. On the other hand, a moderation occurs when the relationship between the dependent and the independent variable depends on a third variable.…”