A pharmacist is advising a patient about his medication.Combatting Disparities in Rural Health Care through Community Pharmacy

If you are suffering from a headache, try this medicine! It’s about time you took back control of your day. Side effects may include fatigue, seizure, or death. Get started on your path to better health with the medicine that gives you your day back!

While most people tune out drug commercials like the one above, the infamous part of the commercial that includes a laundry list of side effects has become almost humorous. The idea of suffering from some of the symptoms listed may seem comical and exaggerated. However, such things are possible without proper supervision.

For populations in rural areas, over the counter medicine or even prescribed medicine is poorly administered. According to an article in American Journal of Health System Pharmacy, “rates of   overdose from prescription opioid misuse are highest in states with  large rural populations.” The laundry list of side effects isn’t that uncommon for populations with high rates of drug misuse.

In fact, a study in the American Journal of Health System Pharmacy mentioned that 1 in 4 Americans live in rural areas. The number of people subject to misuse of prescription medicine is quite high in rural settings due to geographic isolation. Rural areas are characterized as being far outside main cities with small populations and settlements.

Consequently, such areas have reduced access to health care providers. According  to  the  National  Rural   Health   Association, “access to healthcare services, including primary care, specialty care, psychiatry services,  and  hospital  care,  is  often  lacking  in  rural  areas.” Due to patient isolation from their health providers, rural areas have higher rates of health errors. So, what is the role of pharmacists in decreasing adverse effects and drug misuse?

Now, pharmacists are officially licensed as clinical specialists with the power to offer expansive services to patients. However, pharmacists couldn’t always offer such care.

Beginning in the 1920s to 1950, formal pharmacy practice centered around the compounding, the creation of prescription medicine by a pharmacist. In fact, in an article in the Pharmacy journal, this era of pharmacy practice was called the “Soda Fountain era.” Pharmacists just received and filled orders like a Soda Shop. Given only the most basic of tasks, pharmacists across the country were ready to do more!

From the 1950s to the 1970s, pharmacists began completing more tasks related to clinical patient care ,which is the observation and treatment of illnesses. With more time spent in doctoral training, pharmacists gained exposure to a multitude of different cases. For the first time, pharmacists were given the opportunity to demonstrate their potential to diagnose and treat patients, offering comprehensive care to the masses.

Beginning in the 1980s, the pharmacy practice underwent major changes: the degree program was lengthened to six years, pharmacy became an official clinical practice, and the first community pharmacy resident programs began. Pharmacists were officially given their rights to offer clinical care to patients in partnership with physicians. With the licensure of pharmacists as clinical specialists, pharmacists were encouraged to move to rural areas that were in need of primary care and fill the role as physicians. However, while pharmacists were allowed to practice as clinical specialists, they weren’t properly trained for rural practice.

Community pharmacy could help bridge the gap between patients residing in rural areas and pharmacists given the proper training. Therefore, pharmacy programs across the country are implementing comprehensive curriculum which includes residencies in rural sites. Specifically, the University of North Carolina at Chapel Hill’s Eshelman School of Pharmacy offers a rural pharmacy satellite program. As the number one pharmacy school in the country, the move to increase and improve rural pharmacy education demonstrates the future of rural health care.

Cohort studies conducted at other pharmacy school support the worth of working at rural sites. The time spent in an actual community pharmacy effectively exposes students to important practices, improving their confidence in their abilities.  According to the Eshelman School of Pharmacy, through comprehensive training, pharmacists leave school ready to accomplish their goal of improving population health in rural areas.

To improve population health, pharmacists are expected to be the leaders in their community. A community pharmacist is required to complete a multitude of task such as drug management, chronic illness management, and other drug counseling. They must proactively monitor patient’s care plans to ensure proper drug administration.

Telepharmacy is a new video conferencing tool created to improve drug administration and prevent drug misuse. Telepharmacy enables pharmacists and patients to conduct more frequent conversations. The tool can be used to discuss treatment plans and other drug counseling.

Accessibility is the main goal for health professionals as they seek to alleviate disparities in rural health care. With expanding fields such as community pharmacy with tools like telepharmacy at their disposal, community pharmacists are ready to meet the needs of populations without adequate health care.

The next time you are thinking of picking up a random patented headache imagine the laundry list of random symptoms you could develop. Take advantage of the services that your local pharmacist can offer. They won’t leave you astray and you can leave the pharmacy with less pain then you entered with.

By: K. Waite

References:

Hartley, David. “Rural health disparities, population health, and rural culture.” American journal of public health vol. 94,10 (2004),pp. 1675-1678. doi:10.2105/ajph.94.10.1675

Patterson, Brandon J., et al. “Rural Access to Clinical Pharmacy Services.” Journal of the American Pharmacists Association, vol. 54, no. 5, (2014), pp. 518–525.,doi:10.1331/japha.2014.13248.

Scott, Mollie, et al., “Creating a new rural pharmacy workforce: Development and implementation of the Rural Pharmacy Health Initiative”, American Journal of HealthSystem Pharmacy, Vol. 74, Iss. 23,(1 December 2017), pp. 2005–2012,doi.org/10.2146/ajhp160727

Urick, Benjamin Y., and Emily V. Meggs. “Towards a Greater Professional Standing: Evolution of Pharmacy Practice and Education, 1920–2020.” Pharmacy, vol. 7, no. 3, (2019), pp. 1-11. ProQuest, http://libproxy.lib.unc.edu/login?url=https://search.proquest.com/docview/2312274102?accountid=14244, doi:http://dx.doi.org/10.3390/pharmacy7030098.

 

Image Credits:

Baer, Rhoda,”Man Consults with Pharmacist”, National Cancer Institute Visuals Online, https://visualsonline.cancer.gov/details.cfm?imageid=7517

 

 

 

 

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