Community Pharmacy: Long-Term Condition Care Barriers

Access to pharmacies, a cornerstone of healthcare, is becoming increasingly challenging for millions of Americans. The emergence of “pharmacy deserts”—areas where residents must travel excessive distances, often 10 miles or more, to reach the nearest pharmacy—is raising concerns about equitable access to essential medications and care. This issue isn’t limited to rural communities; it’s also impacting underserved urban neighborhoods.

The problem is escalating. Between 2010 and 2021, over 29% of pharmacies across the United States closed, according to recent data, exacerbating the formation of these deserts, particularly in low-income areas and communities of color.

The consequences of limited pharmacy access are significant. Delays in obtaining necessary medications can lead to the worsening of chronic conditions, increased hospitalizations and poorer overall health outcomes. For individuals managing conditions like diabetes, heart disease, or asthma, consistent access to medication is critical, and disruptions in that access can be life-threatening.

While the closure of pharmacies is a major driver of this issue, several factors contribute to the creation and expansion of pharmacy deserts. Economic pressures on independent pharmacies, coupled with changing reimbursement models, can make it difficult for them to remain viable. Rural communities, already facing limited healthcare resources, are particularly vulnerable when a local pharmacy closes, as it often represents a significant loss of healthcare access.

The role of long-term care (LTC) pharmacies is gaining recognition as a potential solution, particularly for individuals receiving long-term services and supports (LTSS). These pharmacies specialize in providing medication management and education to patients with complex care needs, often delivering services directly to patients’ homes. A recent report highlighted the unique contributions of LTC pharmacies in improving patient safety and health outcomes, especially for those receiving care in home- and community-based settings.

However, LTC pharmacies also face challenges, including policy and operational barriers that hinder their ability to fully serve patients. Removing these barriers could allow them to expand their reach and improve care for seniors and individuals with disabilities.

Community pharmacists are uniquely positioned to bridge gaps in primary care, but they face their own set of obstacles. A recent study identified several barriers to community pharmacists’ readiness to implement deprescribing of inappropriate medications for older adults. These included a lack of access to patient records, ineffective collaboration with physicians, and insufficient time due to heavy workloads.

Other barriers identified in research include cost concerns for patients—high copays and lack of insurance can prevent individuals from seeking necessary care—and geographic challenges, particularly in rural areas. These factors create a complex web of obstacles that limit access to essential pharmacy services.

Addressing the crisis of pharmacy deserts requires a multifaceted approach. Potential solutions include incentivizing pharmacies to locate in underserved areas, expanding the role of mobile pharmacies, and leveraging technology to improve access to medication and pharmacist-led care. Improving collaboration between pharmacists and other healthcare providers is also crucial, as is addressing the policy and operational barriers that hinder LTC pharmacies.

enhancing access to patient records and streamlining communication between pharmacists and physicians could significantly improve medication management and reduce the risk of adverse drug events. Investing in community pharmacy infrastructure and supporting pharmacists’ ability to provide comprehensive care services are essential steps toward ensuring equitable access to healthcare for all Americans.

The growing number of pharmacy deserts represents a significant public health challenge. Without concerted efforts to address this issue, vulnerable populations will continue to face barriers to accessing the medications and care they need to maintain their health and well-being.