<p>The Rural Pharmacy Practice Landscape: Challenges and Motivators</p>

Abstract

Background: Health outcome delivery for rural and remote Australian communities is challenged by the maldistribution of the pharmacy workforce. High staff turnover rates, reduced pharmacist numbers, and reliance on temporary staff have placed great strain on both state health services and rural community pharmacies. However, recent changes to the demographic profile of the rural pharmacist including a lower average age and increased time spent in rural practice highlights a more positive future for the delivery of better health outcomes for rural communities. The aim of this study was to investigate the factors that motivate and challenge pharmacists' choice to practice rurally. Methods: Rural pharmacists were invited to participate in semi-structured interviews using purposive non-probability sampling. Twelve pharmacists were interviewed with early-, middle-and late-career pharmacists represented. Participants described their experiences of working and living in rural and remote locations. Three themes emerged: workforce, practice environment and social factors, which were examined to determine the underlying challenges and motivators impacting rural and remote pharmacy practice. Results: Lack of staff presented a workforce challenge, while motivators included potential for expanded scope of practice and working as part of a multidisciplinary team. While social isolation has often been presented as a challenge, an emerging theme highlighted that this may no longer be true, and that notions of "rural and remote communities as socially isolated was a stigma that needed to be stopped". Conclusion: This study highlights that despite the challenges rural pharmacists face, there is a shift happening that could deliver better health outcomes for isolated communities. However, for this to gain momentum, it is important to examine both the challenges and motivators of rural pharmacy practice to provide a platform for the development and implementation of appropriate frameworks and programs to better support the rural pharmacy workforce.

Factors contributing to the recruitment and retention of rural pharmacist workforce: a systematic review

“…Of the included 13 studies (Table 4 ), eight (62 %) focused on pharmacists only or reported on recruitment and retention factors associated with practicing rurally among health professionals generally. The latter studies, which provided separate data specifically for pharmacists, included one study from Canada [ 33 ] and seven studies from Australia [ 6 , 15 , 35 – 37 , 39 , 40 ]. There were two studies reporting factors for final year pharmacy students and recent graduates, with one from New Zealand [ 34 ] and the other from Canada [ 32 ].…”

“…Thus, financial support may act as an incentive among those students who are seeking to work rurally. In addition, in the Australian study by Hays et al [ 15 ], a lack of available resources, such as stock control, access to services, logistical delays, was identified as a disincentive to practice rurally amongst qualified pharmacists.…”

“…Further, a negative image of rural health care (e.g., underestimation of the practice facilities, logistics pertaining to running a pharmacy, and that rural communities are somehow not as progressive as metropolitan areas) was also identified as a barrier to rural pharmacist practice by Harding et al [ 37 ]. Conversely, some study participants [ 15 ] felt that the negative perceptions should be mitigated or at least the views concerning rural practice improved.…”

“…Although there remain some similarities with factors associated with nurse recruitment and retention in rural settings, such as having a positive work environment [ 3 ], many key elements were exclusive to the pharmacist workforce. These included the need for good inter- and intra-disciplinary relationships and communication as well as higher levels of job security that employment in rural settings offered [ 15 , 31 , 37 ].…”

Role Theory: A Framework to Explore Health Professional Perceptions of Expanding Rural Community Pharmacists’ Role

“…Rural community pharmacists have been identified as highly skilled health professionals who are ideally placed to address these shortcomings by providing a variety of expanded services, including disease screening and management, vaccinations and health promotion [ 6 ]. For rural pharmacists working in this challenging environment, their role is often poorly defined with ambiguous boundaries to their recognised scope of practice [ 7 ].…”