This study aimed to validate a Malay version of the drive-thru community pharmacy service questionnaire and to obtain a better understanding of the Malaysian public’s awareness, attitudes, and perceptions of drive-thru community pharmacy service during COVID-19. The content and face validity for the drive-thru community pharmacy service Malay version questionnaire were deemed to be satisfactory by the expert panel. In addition, the Malay version questionnaire was accepted during the pilot test among participants in terms of being free of difficulty or ambiguity with no suggested changes. The drive-thru community pharmacy service questionnaire was found to be reliable as most of the statements had very good agreement coefficient values, with strong internal consistency for the whole tool with a strong Cronbach’s alpha of 0.833 [36].

Participants in the current study had a limited level of awareness about the existence of drive-thru pharmacies in a community context, which accounts for the low rate at which they used this service. This is due to the fact that the service was only recently launched in Malaysia in February 2022 [23]. Same findings were shown in previous studies, and most customers in Jordan and Saudi Arabia had little awareness of drive-thru pharmacy services in a community setting [21, 22].

Friends or colleagues, the internet, and pharmacy personnel were the most common sources that made participants aware of the availability of drive-thru community pharmacy service. Jordanian pharmacy consumers using the drive-thru service revealed comparable outcomes, as the main sources that made them aware about this service were friends, the internet, and pharmacy staff [21]. Surprisingly, only 12.9% of the participants in the current survey cited doctors as the source who made them aware of the existence of community pharmacies with drive-thru services. It points out the necessity for doctors to increase public awareness of this service.

Most study participants had favorable attitudes toward the need for drive-thru community pharmacy services; as 49.1% of them were strongly in favor of establishing such services during COVID-19 time or at later stage, 49.9% were strongly in favor of establishing such services throughout Malaysia, and 75.9% thought that such services would be beneficial to the whole population. These results were consistent with a prior study conducted in Saudi Arabia, where the majority of respondents who used the drive-thru community pharmacy service believed that this service would reduce the likelihood of the COVID-19 pandemic and benefit everyone [22]. Furthermore, about 45% of the present participants strongly believed this service will benefit patients who are ill, the elderly, or individuals with disabilities during COVID-19. The same findings, indicating drive-thru pharmacy services are beneficial for a particular population, including geriatrics, the disabled, and sick, were published prior to the emergence of COVID-19 [12, 21].

The drive-thru window was the preferred method among the current participants for placing an order at a community pharmacy using drive-thru services, and for receiving short counselling when using this service. This could be explained by the opinion previously expressed in Taiwan that the drive-thru area had less disturbance and noise while being used [12].

About 21.8% of the participants strongly agreed that community pharmacists will be able to manage their work well between the business side of things and the health of their patients. Similar to this, 20.9% of Jordanians who used a drive-thru pharmacy service thought that local pharmacists would strike a good balance between patient health and the business side of their jobs [21]. This is justified by the dramatic change in pharmacy practice focusing mainly on patients’ care [41, 42].

The perceived differences between drive-thru and in-store drug refills among the study participants were mainly that the prescription might be filled more quickly in drive-thru compared to in-store pharmacy services. Same results were documented previously [12, 21, 22]. Prior to the drive-thru service being implemented in Taiwan, it took at least 40 min to pick up in-store refill prescriptions; compared with only 3 min using drive-thru refill [12]. Community pharmacies’ consumers in Jordan and Saudi Arabia believed that prescriptions might be filled more quickly using drive-thru compared to traditional pharmacy services [21, 22]. On the other hand, participants in this study believed that, in contrast to in-store pharmacy services, those pharmacists providing drive-thru services were less readily available to answer their queries, provided less written information, and were unable to clarify crucial points of prescriptions. These results are supported by earlier research, which showed that interactions between patients and pharmacists were better when prescriptions were filled in-store [43], and that drive-thru service might shorten interactions between customers and pharmacists [21, 44].

According to the current study, participants had favorable perceptions of this service during COVID-19, because they thought it had several advantages. The two most highly agreed advantages of this service during COVID-19 were to encourage social isolation and stop the virus from spreading. Only one study discussed this service during COVID-19 in Saudi Arabia [22]. All previously conducted studies were in line with our findings that drive-thru service is an accessible and convenient service that that facilitates receiving prescriptions promptly and with minimal waiting time [10, 20,21,22].

This study supported what was documented in the literature about the disadvantages toward this service while using it [20, 21, 43,44,45]. The participants believed that it may mainly contribute to restricting the opportunity for interaction with the pharmacist, and difficulty in providing drug information/counselling to customers (especially written information) [20, 21, 43,44,45]. In addition, it was believed among the study participants that drive-thru community pharmacy service is suitable for refilling prescriptions and for getting OTC products. This result is consistent with a previous study in which Jordanian consumers thought that drive-thru pharmacies were only appropriate for OTC purchases and prescription refills [21].

This research provides the validation and reliability tests to the Malay version of the drive-thru community pharmacy service questionnaire including the accessibility, pharmacist–patient interaction, and the perceived advantages and concerns depicted by the Malaysian public in the Malay language; thus, to better inform future pandemic preparation efforts, including drive-thru pharmacies in Malaysia. It is crucial to acknowledge certain limitations that may influence the direct translation of our findings into broader policy and practice. First, to avoid the spread of COVID-19, the instrument was distributed online, and participants completed it using Google Forms; as a result, replies from regions without access to the internet may not have been recorded. Second, the scope of our research, focused on Malaysian population only and it may has limited the generalizability of the results to diverse settings. Besides, the reliance on self-reported data in this study may introduce a response bias. Third, the test–retest reliability had a small sample size. As a result, the dependability test results should be interpreted with caution. This was mostly, because it was challenging to obtain second sets of responses, because they were provided voluntarily and without financial benefits; therefore, we relied only on participants’ cooperation. Fourth, there was no other validated instrument for comparison to do criterion and construct validity. Finally, the drive-thru community pharmacy service has not been the subject of many previous studies, and those that have been conducted have solely focused on Malaysian governmental hospitals, such as Queen Elizabeth Hospital and Hospital Raja Perempuan Zainab II [19, 20]. Nevertheless, this research provides an insight to the drive-thru pharmacies in Malaysia, thus, it is important to interpret the findings within the context of these acknowledged limitations.

Further studies are needed to assess the test–retest reliability of the translated drive-thru community pharmacy service questionnaire on a larger sample size. In addition, future studies discussing the economic side by analyzing the full cost of implementing drive-thru community pharmacy service are recommended.