Strategies to improve patient loyalty and medication adherence in Syrian healthcare setting: The mediating role of patient satisfaction

The purpose of this study is to empirically examine the relationships between service quality, patient satisfaction, patient loyalty and medication adherence in the Syrian healthcare setting from a patient's perspective. Based on random sampling technique, data collection was conducted in six hospitals located in the Syrian capital Damascus. The reliability and validity of the theoretical model had been confirmed using quantitative analyses SmartPLS software. The study indicated that our proposed model can significantly explain (35) per cent of patient satisfaction, (55) per cent of patient loyalty and (46) per cent medication adherence in a statistically manner. Our results highlighted that patient satisfaction mediated the relationship between patient loyalty and service quality (assurance, reliability and financial aspect). Besides, patient satisfaction had mediation effect on the relationship between medication adherence and service quality (reliability and financial aspect). Financial aspect had the highest impact on patient satisfaction (β = 0.242) and medication adherence (β = 0.302). In addition, reliability was the only dimension of service quality that had a significant direct impact on patient satisfaction, patient loyalty and medication adherence. To increase patient loyalty in Syrian hospitals, healthcare professionals should place a greater emphasis on the reliability and responsiveness elements of service quality. To the author's knowledge, this is the first study conducted during the COVID pandemic to evaluate the mediating role of patient satisfaction in the relationship between service quality, patient loyalty and medication adherence in the Syrian healthcare sector.