My Opinions Matter! How Perspectives, Knowledge and Expectations Matter in Moderating the Success of New Pharmaceutical Services Implementation in Malaysia

  The Malaysian Government through the National Health Policy aims to improve health outcomes through public pharmaceutical healthcare services. Pharmacy Value Added Services (PVAS) was introduced as a matter of public pharmaceutical health policy. PVAS is an important service to improve clinical outcomes by improving compliance, monitoring and even information dissemination. However, adoption rates are low and therefore hampering the achievement of national health policy goals. Our objective is to explore the key determinants and moderators of successful implementation of new public pharmaceutical services by investigating the cognitive perspectives of patients’ intentions to adopt with the Theory of Planned Behavior as the theoretical framework. A two-phase mixed methodology involving first a qualitative exploration and the second a quantitative phase was conducted in public health facilities in Negeri Sembilan, Malaysia. A cross-sectional survey (N = 410) was conducted using the Pharmacy Value Added Services Questionnaire (PVASQ). Multiple regression and robust moderation analysis were performed. Overall, perspectives were found to be significant predictors of intentions. In greater detail, subjective norms, perceived behavioural control, knowledge, expectations and ethnicity were found to be significant predictors of intentions to adopt PVAS. Perspectives and expectations are found to exert significant partial effects on intentions. We find that a significant self-reinforcing feedback loop exists between Expectations-Perspectives-Intentions. Positive perspectives and meeting the high expectations of the public can greatly improve the uptake of the new service. Ethnicity plays a crucial role in determining uptake of the new service and should be given greater focus. Our results are robust and suggests that a bottom-up approach should be key to successful implementation of health policies and services.