The applicability of the tetraclass model to the management of the patient satisfaction in the pharmacies

  • Guenka Petrova
  • Fabrice Clerfeuille
  • Milena Vakrilova
  • Cvetomir Mitkov
  • Yannick Poubanne


The objective of this work is to study the possibilities of the tetraclass model for the evaluation of the changes in the consumer satisfaction from the provided pharmacy services during the time.

Methods: Within the same 4 months period in 2004 and 2006 were questioned at approximately 10 pharmacy consumers per working day. Every consumer evaluated the 34 service elements on a 5 points semantic-differential scale. The technique of the correspondence data analysis was used for the categorisation of the services.

Results: Most of the services have been categorized as basic ones. For the age group up to 40 years the access to pharmacy became a key element and external aspects became a secondary element in 2006 year. For the group of patients that are using the services of the pharmacy for more than 2 years, availability of phone connection, quality of answers and product prices move from plus to secondary element. The ratio quality/price moves from the group of basic to key services, visibility of the prices and hygiene became basic elements from secondary ones. During the two years period, all the service elements connected with the staff as availability, identification, good looking, confidence, dressing, advices, technical competence, explanation, and time spent with clients remain basic services. The confidentiality of the staff remains always a key element.

Conclusion: Our study shows that the tetraclass model allows taking more informed managerial decisions in the pharmacies, as well as, is providing information for the concrete area of services and possible measures. In case of a development of a simple statistical program for quick processing of the inquiry data, the method will became applicable and affordable even for small pharmacies.


Download data is not yet available.


1. Mobach MP. Consumer behaviour in the waiting area. Pharm World Sci. 2007;29:3-6.

2. Holsclaw SL, Olson KL, Hornak R, Denham AM. Assessment of patient satisfaction with telephone and mail interventions provided by a clinical pharmacy cardiac risk reduction service. J Manag Care Pharm. 2005;11:403-409.

3. Oparah AC, Kikanme LC. Consumer satisfaction with community pharmacies in Warri, Nigeria. Res Social Adm Pharm. 2006;2:499-511.

4. Chandra A, Finlay JB, Paul DP 3rd. Overall outpatient satisfaction and its components: perceived changes at the Huntington VA Medical Center over five years. Hosp Top. 2006;84:33-36.

5. Gastelurrutia MA, de San Vicente OG, Erauncetamurgil O, Odriozola I, Fernández-Llimós F. Customers' expectations and satisfaction with a pharmacy not providing advanced cognitive services. Pharm World Sci. 2006;28:374-376.

6. Emmett D, Paul DP, Chandra A, Barrett H. Pharmacy layout: What are consumers' perceptions?. J Hosp Mark Public Relations. 2006;17:67-77.

7. Hayashi S, Hayase T, Ikegami N, Kishino S, Takeuchi K. Comparison of viewpoints and awareness between patients with and without a "family pharmacy". Yakugaku Zasshi. 2006;126:123-131.

8. Guzmán MA, Ramos-Córdova LF, Castañeda-Sánchez O, del Castillo-Sánchez DL, Gómez-Alcalá AV. Satisfaction of users at a family medicine unit. Rev Med Inst Mex Seguro Soc. 2006;44:39-45.

9. Cadotte ER, Woodruff RB, Jenkins RL. Expectations and norms in models of consumer satisfaction, J Mark Res. 1987;24:305-314.

10. Cronin JJ, Taylor SA, Measuring service quality: a re-examination and extension, J Mark. 1992;56:55-68.

11. Audrain AF, Evrard Y. Satisfaction des consommateurs:précisions conceptuelles, Actes de la Conférence de l’Association Française du Marketing, Deauville, IAE de Caen-Basse Normandie;2001.

12. Rust RT, Zahoric AJ. Customer satisfaction, customer retention, and market share. J Retail. 1993;2:193-215.

13. Cheng CM. Simple additions to the pharmacy waiting area may increase patient satisfaction. J Am Pharm Assoc. 2004;44:630-632.

14. Tootelian DH, Rolston LW, Negrete MJ. Consumer receptiveness to non-traditional roles for community pharmacists. Health Mark Q. 2005;23:43-56.

15. Villako P, Raal A. A survey of Estonian consumer expectations from the pharmacy service and a comparison with the opinions of pharmacists. Pharm World Sci. 2007;29:546-550.

16. Bolton RN, Drew JH. A longitudinal analysis of the impact of service changes on customer attitudes, J Mark. 1991;55:1-9.

17. Cadotte E.R., Turgeon N., Dissatisfiers and Satisfiers: Suggestions for consumer complaints and compliments. J Cons Satisf Dissatisf Compl Behav. 1988;1:74-79.

18. Clerfeuille F, Poubanne Y. Differences in the contributions of elements of service to satisfaction, commitment and consumer’s share of purchase: a study from the tetraclass model, Journal of Targeting, Measurement and Analysis for Marketing. 2003;1:66-81.

19. Clerfeuille F, Poubanne Y, Vakrilova M, Petrova G. Evaluation of the consumer’s satisfaction using the tetra-class model. Res Social Adm Pharm. 2008;4(3):258-271.

20. Kucukarslan S, Schommer JC. Patients’ expectations and their satisfaction with pharmacy services. J Am Pharm Assoc. 2002;8:489-496.

21. McGee JE, Festervand TA. Competitive advantage and the independent retail pharmacy:the role of distinctive competencies. J Pharm Mark Manage. 2000;13:31-46.

22. Garbarino E, Johnson MS. The different roles of satisfaction, trust, and commitment in customer relationships. J Mark. 1999;63:70-87.

23. Llosa S. Contributions à l’étude de la satisfaction dans les services, Thèse de Doctorat en Sciences de Gestion, I.A.E. Aix-Marseille, 1996.

24. Bartikowski B, Llosa S. De la théorie du poids fluctuant des éléments dans la satisfaction à la mesure. Comparaison empirique de quatre méthodes, Actes de la Conférence de l’Association Française du Marketing, Deauville, IAE de Caen-Basse Normandie, 2001.

25. Llosa S. L’analyse de la contribution des éléments du service à la satisfaction : un modèle tétra-classe. Décisions Marketing 1997;10:81-88.

26. Lichtlé MC, Plichon V, Llosa S. La contribution des éléments d'une grande surface alimentaire à la satisfaction du client, Actes de la Conférence de l’Association Française du Marketing, Deauville, IAE de Caen-Basse Normandie, 2001.

27. El-Awady MY. Satisfaction of clients attending out-patient clinics at Ain Shams University Hospitals. J Egypt Public Health Assoc. 1999;74:263-274.

28. Hayashi S, Hayase T, Mochizuki M, Hashiguchi M, Takeuchi K. Classification of pharmaceutical services from the viewpoint of patient satisfaction/dissatisfaction. Yakugaku Zasshi 2005;125:159-168.

29. FIP. Standards for quality of pharmacy services approved by the FIP Congress in September 1997. (Assessed: 23 January 2008).

30. Bitner MJ. Evaluating service encounters: the effects of physical surroundings and employee responses, J. Mark. 1990;54:69-82.

31. Swan J, Combs J. Product Performance and consumer satisfaction: a new concept”, J Mark. 1976;40:25-33.

32. Mobach MP. The transformation of pharmacy concepts into building and organization. Pharm World Sci. 2005; 27: 329-338.

33. Breiman L., Friedman J.H., Olshen R.A., Stone C.J. Classification and regression trees, Belmont California, Wadsworth, 1984
How to Cite
PETROVA, Guenka et al. The applicability of the tetraclass model to the management of the patient satisfaction in the pharmacies. Pharmacy Practice, [S.l.], v. 7, n. 1, p. 19-28, mar. 2009. ISSN 1886-3655. Available at: <>. Date accessed: 25 nov. 2017.
Original Research


Consumer Satisfaction; Community Pharmacy Services

Most read articles by the same author(s)