Multidimensional service quality and its associations on customer satisfaction, loyalty, and word-of-mouth intention in community pharmacies: a structural equation modeling study

Abstract Background Service quality is an important aspect of customers’ experiences and behavioral intentions in community pharmacies. This study aimed to provide initial psychometric validation of a multidimensional service quality scale and examine its associations with customer satisfaction, loyalty, and word-of-mouth (WOM) intention in Da Nang, Vietnam. Methods A cross-sectional survey was conducted from January to March 2024 with the participation of 409 customers. Service quality (six dimensions, 23 items), satisfaction (single item), loyalty (3 items), and WOM intention (2 items) were assessed using five-point Likert scales. Exploratory Factor Analysis and Confirmatory Factor Analysis were performed to evaluate the measurement model. Covariance-based Structural Equation Modeling was applied to test the hypothesized relationships. Additional regression and moderation analyses examined the associations of customer characteristics and pharmacy type with the three outcomes. Results The measurement model demonstrated good reliability and validity, with satisfactory factor loadings (> 0.65), composite reliability (> 0.78), and average variance extracted (> 0.53). The robust fit indices indicated adequate model fit (χ²/df = 1.722, CFI = 0.960, TLI = 0.952, RMSEA = 0.046, SRMR = 0.041). Customer satisfaction, loyalty, and WOM intention were generally favorable, with mean scores of 3.91 ± 0.75, 3.74 ± 0.77, and 3.63 ± 0.78, respectively; 80.2%, 76.3%, and 67.5% of respondents scored above the midpoint for these outcomes. Three dimensions of service quality, including Pharmacist-Customer Interpersonal Communication and Responsiveness (β = 0.316, 95%CI: 0.193–0.429), Pharmaceutical Counseling and Clinical Information Provision (β = 0.247, 95%CI: 0.132–0.359), and Perceived Price Fairness (β = 0.181, 95%CI: 0.056–0.296), were significantly and positively associated with customer satisfaction. In contrast, Pharmacy Physical Environment (β = 0.086, 95%CI: -0.035-0.196), Medicine Availability and Quality (β = 0.028, 95%CI: -0.097-0.156), and Service Accessibility and Convenience (β = 0.107, 95%CI: -0.016-0.240) were not significantly associated with customer satisfaction. Customer satisfaction was positively associated with loyalty (β = 0.794, 95%CI: 0.737–0.840) and with WOM intention (β = 0.183, 95%CI: 0.042–0.310). Customer loyalty was also positively associated with WOM intention (β = 0.712, 95%CI: 0.583–0.837). Demographic characteristics showed limited associations with three outcomes, and no significant moderating effects of pharmacy type were observed. Conclusions Pharmacist-customer interpersonal communication and pharmaceutical counseling showed the strongest positive associations with customer satisfaction, underscoring the importance of customer-centered pharmaceutical services and providing evidence to guide service quality improvement in community pharmacies in urban Vietnam.