Introduction
Several reports show that communication with patients in community pharmacy is not satisfying. We have done research on patient/client satisfaction with the service they experience in the pharmacy. This research is part of the Counter Coach project that aims at improving the management process around patient communication in Dutch community pharmacies.

Methods
A 16-item questionnaire with closed questions was developed to collect information about patients' opinion regarding their pharmacy's service and some background variables. Fivehundred questionnaires were sent to every pharmacy in our project (n=30), totalling 15000. These questionnaires were distributed actively at the counter among clients visiting these pharmacies for a maximum duration of one month. The clients had to return the questionnaire to the university.

The returned questionnaires were analyzed with SPSS. Frequencies per question were calculated and differences between groups based on background variables were examined.

Results
The overall response to this questionnaire was 46% (n=6904). About 65% were women and 35% were men. Ninety-one percent of the respondents reported they had been visiting the pharmacy where they obtained the questionnaire for more than two years and more than half of the respondents visited the pharmacy more than seven times in the last year.

Waiting time is the service aspect that respondents are least satisfied with and willingness of employees to help them is the aspect they are most satisfied about.

When people are afraid of adverse effects and want to talk about that with someone, 85% report to talk to their physician, 60% with a pharmacy employee, 15.5% with family or friends.

Most important perceived barriers for asking drug-questions in the pharmacy were: not enough privacy, other patients have to wait longer and technicians are busy.

Reasons for being less satisfied with answers to drug questions are: too little information and problems with understanding the information.

Discussion and conclusion
Satisfaction of clients with drug related community pharmacy services is quite high in the pharmacies that were included in this study. Sixty percent of the respondents would ask the pharmacy personnel questions about side effects. This percentage is high enough to point out that a pharmacy is important in dealing with drug related questions from clients.

The high satisfaction rates can, firstly, be explained by the fact that the pharmacies in our study are, on average, very concerned with patient communication and actively involved in improving their services. These pharmacies are however not a good representation of the whole population of Dutch community pharmacies.

Secondly, a large proportion of the respondents visited the pharmacy very regularly.

Thirdly, more respondents from older age groups were present, who were on average more satisfied than younger people.

Lastly, as this study is a satisfaction study, social desirability might have increased the scores. Sending the questionnaires back, anonimously, to the university might have decreased the amount of socially desirable answers.

Future efforts to improve client satisfaction should focus on privacy, waiting time and the amount of information in answers to drug questions.