Trends in Community Pharmacy Counts and Closures Before and After the Implementation of Medicare Part D

Klepser, Donald G.; Xu, Liyan; Ullrich, Fred; Mueller, Keith J.

doi:10.1111/j.1748-0361.2010.00342.x

Cited by 12 publications

(18 citation statements)

References 7 publications

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“…In fact, in numerous areas in the country, particularly in the Southwest and Plain states, independents dominate market share and are frequently the only pharmacy serving the local population. Ensuring pharmacies are available and accessible in these populations should be a public health priority considering independents are the most at-risk for pharmacy closures [ 24 ].…”

Section: Discussionmentioning

confidence: 99%

The availability of pharmacies in the United States: 2007–2015

et al. 2017

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ImportanceDespite their increasingly important role in health care delivery, little is known about the availability, and characteristics, of community pharmacies in the United States.Objectives(1) To examine trends in the availability of community pharmacies and pharmacy characteristics (24-hour, drive-up, home delivery, e-prescribing, and multilingual staffing) associated with access to prescription medications in the U.S. between 2007 and 2015; and (2) to determine whether and how these patterns varied by pharmacy type (retail chains, independents, mass retailers, food stores, government and clinic-based) and across counties.MethodsRetrospective analysis using annual data from the National Council for Prescription Drug Programs. Pharmacy locations were mapped and linked to the several publically-available data to derive information on county-level population demographics, including annual estimates of total population, percent of population that is non-English speaking, percent with an ambulatory disability and percent aged ≥65 years. The key outcomes were availability of pharmacies (total number and per-capita) and pharmacy characteristics overall, by pharmacy type, and across counties.ResultsThe number of community pharmacies increased by 6.3% from 63,752 (2007) to 67,753 (2015). Retail chain and independent pharmacies persistently accounted for 40% and 35% of all pharmacies, respectively, while the remainder were comprised of mass retailer (12%), food store, (10%), clinic-based (3%) or government (<1%) pharmacies. With the exception of e-prescribing, there was no substantial change in pharmacy characteristics over time. While the number of pharmacies per 10,000 people (2.11) did not change between 2007 and 2015 at the national-level, it varied substantially across counties ranging from 0 to 13.6 per-capita in 2015. We also found that the majority of pharmacies do not offer accommodations that facilitate access to prescription medications, including home-delivery, with considerable variation by pharmacy type and across counties. For example, the provision of home-delivery services ranged from less than <1% of mass retailers to 67% of independent stores and was not associated with county demographics, including ambulatory disability population and percent of the population aged ≥65 years.ConclusionsDespite modest growth of pharmacies in the U.S., the availability of pharmacies, and pharmacy characteristics associated with access to prescription medications, vary substantially across local areas. Policy efforts aimed at improving access to prescription medications should ensure the availability of pharmacies and their accommodations align with local population needs.

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Section: Discussionmentioning

confidence: 99%

The availability of pharmacies in the United States: 2007–2015

et al. 2017

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“…11 With the availability of over 70,000 pharmacies in the United States, pharmacists are among the most accessible health care professionals who may prevent medication errors and provide counseling for pediatric patients with acute or chronic conditions and their parents or caregivers. 12 Despite having great potential to assume a role as a health and medication educator to children, studies have shown that these patients receive less attention from pharmacists because communications regarding medication use are often geared toward the children's parents or caregivers. 13 As medication experts, pharmacists play a vital role in counseling children in adhering to their medication regimens through direct collaboration and communication about safe and effective use of medicines.…”

Section: Introductionmentioning

confidence: 99%

Identifying Barriers and Facilitators at Affect Community Pharmacists' Ability to Engage Children in Medication Counseling: A Pilot Study

Abraham

Alexander

Schleiden

et al. 2017

The Journal of Pediatric Pharmacology and Therapeutics

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OBJECTIVESThis study aimed to describe the barriers and facilitators that influence community pharmacists' ability to provide medication counseling to pediatric patients.METHODS Semistructured interviews (n = 16) were conducted with pharmacy staff at 3 community pharmacies in 2 Eastern states. The interview guide elicited pharmacy staff experiences interacting with children and their perceived barriers and facilitators to providing medication counseling. Transcripts were reviewed for accuracy and a codebook was developed for data analysis. NVivo 10 was used for content analysis and identifying relevant themes.RESULTS Ten pharmacists and 6 pharmacy technicians were interviewed. Most participants were female (69%), aged 30 to 49 years (56%), with ≥5 years of pharmacy practice experience. Eight themes emerged as barriers to pharmacists' engaging children in medication counseling, the most prevalent being the child's absence during medication pickup, the child appearing to be distracted or uninterested, and having an unconducive pharmacy environment. Pharmacy staff noted 7 common facilitators to engaging children, most importantly, availability of demonstrative and interactive devices/technology, pharmacist demeanor and communication approach, and having child-friendly educational materials.CONCLUSIONS Findings suggest that pharmacy personnel are rarely able to engage children in medication counseling because of the patient's absence during medication pickup; however, having child-friendly materials could facilitate interactions when the child is present. These findings can inform programs and interventions aimed at addressing the barriers pharmacists encounter while educating children about safe and appropriate use of medicines.

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“…However, rural residents report several barriers to accessing healthcare including transportation difficulties and distance to care, social isolation, financial constraints, limited health care facilities (hospitals and pharmacies), physician shortages, and lack of access to specialist care [14-19]. Indeed, in the US, rural areas contain 19% of the population but only 11% of the physician workforce [15], and the ratio of specialists per population consistently declines as locations become smaller and more remote [15,17].…”

Section: Introductionmentioning

confidence: 99%

Cardiovascular medication utilization and adherence among adults living in rural and urban areas: a systematic review and meta-analysis

et al. 2014

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BackgroundRural residents face numerous barriers to healthcare access and studies suggest poorer health outcomes for rural patients. Therefore we undertook a systematic review to determine if cardiovascular medication utilization and adherence patterns differ for rural versus urban patients.MethodsA comprehensive search of major electronic datasets was undertaken for controlled clinical trials and observational studies comparing utilization or adherence to cardiovascular medications in rural versus urban adults with cardiovascular disease or diabetes. Two reviewers independently identified citations, extracted data, and evaluated quality using the STROBE checklist. Risk estimates were abstracted and pooled where appropriate using random effects models. Methods and reporting were in accordance with MOOSE guidelines.ResultsFifty-one studies were included of fair to good quality (median STROBE score 17.5). Although pooled unadjusted analyses suggested that patients in rural areas were less likely to receive evidence-based cardiovascular medications (23 studies, OR 0.88, 95% CI 0.79, 0.98), pooled data from 21 studies adjusted for potential confounders indicated no rural–urban differences (adjusted OR 1.02, 95% CI 0.91, 1.13). The high heterogeneity observed (I2 = 97%) was partially explained by treatment setting (hospital, ambulatory care, or community-based sample), age, and disease. Adherence did not differ between urban versus rural patients (3 studies, OR 0.94, 95% CI 0.39, 2.27, I2 = 91%).ConclusionsWe found no consistent differences in rates of cardiovascular medication utilization or adherence among adults with cardiovascular disease or diabetes living in rural versus urban settings. Higher quality evidence is needed to determine if differences truly exist between urban and rural patients in the use of, and adherence to, evidence-based medications.

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Trends in Community Pharmacy Counts and Closures Before and After the Implementation of Medicare Part D

Abstract: Unintended consequences of Medicare Part D may serve to reduce patient access to pharmacy services in opposition to the stated goals of the program.

Cited by 12 publications

References 7 publications

The availability of pharmacies in the United States: 2007–2015

The availability of pharmacies in the United States: 2007–2015

Identifying Barriers and Facilitators at Affect Community Pharmacists' Ability to Engage Children in Medication Counseling: A Pilot Study

Cardiovascular medication utilization and adherence among adults living in rural and urban areas: a systematic review and meta-analysis

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