Pittsburgh, PA—Most pharmacy locations in the United States are part of large chains and provide convenient service to more urban areas. People living in rural areas, however, are more likely to depend on community pharmacies (both franchised and independent), according to an analysis.

The report in Journal of the American Pharmacists Association pointed out that, as a result, pharmacies are conveniently located for the vast majority of Americans. "Pharmacy accessibility is key for the emerging role of community pharmacists as providers of patient-centered, medication management services in addition to traditional dispensing roles," the University of Pittsburgh School of Pharmacy–led researchers wrote.

The study team sought to quantify population access to community pharmacies across the U.S. To accomplish that, researchers obtained and geocoded addresses for pharmacy locations in the U.S. from the National Council for Prescription Drug Programs. Using a 1% sample of a U.S. synthetic population, they calculated the driving distance to the closest pharmacy using mapping software (ArcGIS), estimating the proportion of the population living within 1, 2, 5, and 10 miles of a community pharmacy.

The analysis identified 61,715 pharmacies, including 37,954 (61.5%) chains, 23,521 (38.1%) regional franchises or independently owned pharmacies, and 240 (0.4%) government pharmacies.

"In large metropolitan areas, 62.8% of the pharmacies were chains; however, in rural areas, 76.5% of pharmacies were franchises or independent pharmacies," the authors reported.

The results indicated that:

• 48.1% of U.S. residents lived within 1 mile of any pharmacy
• 73.1% lived within 2 miles
• 88.9% lived within 5 miles
• 96.5% lived within 10 miles.

A special note was made for the 8.3% of counties that had at least 50% of residents with a distance greater than 10 miles; those were concentrated in Alaska, South Dakota, North Dakota, and Montana.

"The nature of patient-pharmacist encounters has recently evolved from its traditional focus on medication dispensing to the provision of patient-centered, medication management services, including vaccinations, point-of-care testing, and chronic disease state management," the researchers suggested, adding, "Most recently, community pharmacies have become vital for the success of COVID-19 testing and vaccination."

Those changes have underscored the importance of pharmacy locations. "With drive-up windows, extended hours of operation, and flexible scheduling, the accessibility and convenience of pharmacies have been critical in the expansion of services offered by community pharmacists," according to the study. "Recent research has demonstrated that patients visit community pharmacies almost twice as often as primary care providers and that community pharmacies are particularly successful at reaching rural residents and patients who otherwise would not be reached by other health care providers."

Arguing for an expanded role for pharmacists, the authors pointed out that key organizations have often claimed that more than 90% of Americans live within 5 miles of a community pharmacy, "though this statistic is not peer-reviewed, limiting credibility and impact."

The report advised that access to community pharmacies is critical to public health delivery because of:

• The expected shortage of physicians in the next decade
• The recent trends of pharmacy closures, which have disproportionately affected independent pharmacies
• The essential role of pharmacy locations in the administration of COVID-19 vaccines.

The authors wrote that their analysis confirms that community pharmacies remain highly accessible healthcare locations for the majority of the U.S. population.

"Because of the accessibility to community pharmacies, pharmacists are well positioned to become providers of patient-centered, medication-related clinical services," the authors added. "These include the provision of vaccinations, point-of-care testing, and chronic disease state management. The expanded role of the pharmacist beyond medication dispensing is of relevance for achieving equitable and timely health care access in light of the expected shortage of physicians in the next decade and the evidence suggesting that community pharmacists are particularly successful at reaching patients who otherwise would not be reached by other health care providers."

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