Communication between pharmacists and patients: the role of place of residence in determining the expectations of older adults.

The relationship between the place of residence of elderly patients and their expectations about the content and style of their communication with pharmacists was studied. Using stratified random sampling of households, telephone interviews were completed in Spring 1994 with 200 rural and 200 urban persons age 65 or older currently taking a prescribed drug that they picked up at a pharmacy. Respondents were asked about their sociodemographic characteristics, health, and experiences with prescription drugs. Factor analysis of items measuring the elders' expectations yielded one factor with nine items. Multivariate analysis was used to examine the effect of residence while controlling for other variables. Subjects currently took 3.2 +/- 2.2 drugs (mean +/- SD). Fifty-two percent of rural elders used independent pharmacies, and 83% of urban elders used chain pharmacies. On six of the nine items in the expectation scale, rural elders held significantly different (higher) expectations for their pharmacists compared with urban elders. The most fully specified model contained five variables significantly associated with higher expectations: elders who took fewer drugs and who had a stroke, angina, osteoporosis, and no coronary heart disease. Although place of residence was a significant predictor of elders' expectations in the first three models, it was not when drug experiences were added in. Overall, older people in different places of residence have dissimilar personal and drug characteristics, and pharmacists practicing in different community contexts can anticipate encountering different patient expectations.