College furthers research on pharmacy access gaps

Following a partnership with the Minnesota Department of Health (MDH) that mapped pharmacy access gaps across the state, the University of Minnesota College of Pharmacy is digging deeper to understand the reason behind closures and impacts on community health. 

The first rendition of the map identified Minnesotan communities that were geographically distant from a pharmacy, deemed “low-access” areas, as well as communities served by a single or “keystone” pharmacy, which were labeled as “limited-access” or “at-risk.” Fellows then analyzed the populations living in those low- and limited-access areas to factor in socioeconomic determinants like income and vehicle access. The current phase of the project aims to supplement the map qualitatively through interviewing stakeholders and closed pharmacies as well as measuring community response.   

“It's one thing to look at the data and realize that more pharmacies are closing. It's another thing to hear the stories and the personal experiences of those involved in it,” said Dr. Elise Moore, a post-doctoral fellow in the Department of Pharmaceutical Care & Health Systems (PCHS). “A theme emerging from a lot of these conversations is there’s a big struggle between pharmacies being a business and pharmacies being a community resource, especially some of these independent pharmacies.”

Continuing to map pharmacy access (or lack thereof) allows for consistently tracking trends, which helps the team understand any impact on the health outcomes of the populations affected, said Dr. Olihe Okoro, co-director of community engagement and associate professor in the Department of Pharmacy Practice and Pharmaceutical Sciences (PPPS). The team plans to partner with the University’s Center for Transportation Studies to expand geomapping efforts, allowing them to study community access to food, trauma centers, education, and more. Understanding the basic resources available across different communities helps draw correlations between different populations and health care components, Moore explained. 

Okoro said information gleaned from interviews with closed pharmacies— owners, managers, and other stakeholders— is critical to understanding what keystone pharmacies may need to stay open. Moore said further down the line the team hopes to also obtain interviews with keystone pharmacies. 

Another branch of the project conducts media analysis concerning pharmacy closures, looking at local newspaper and media articles, editorials, and commentaries to gauge communities’ responses to pharmacy closures. All of this information can ideally help inform legislative advocacy and policy.

During stakeholder interviews, Moore observed a struggle with pharmacies that want to be community advocates, particularly independent pharmacies, but current policy and reimbursement rates make it difficult for them to maintain that boundary. In addition to her fellowship with PCHS, Moore works at Cub Pharmacy in North Minneapolis. If that location closed, the area would become a pharmacy desert. Moore said working there adds perspective to the mapping research, providing insight into the resources a keystone pharmacy has access to as well as any extra burden they may carry day-to-day as the only pharmacy in the area. 

“We've talked to larger organizations, we've talked to independent pharmacies— there's a lot of commonality in why places closed, a lot to do with reimbursement rates,” Moore said. “But there's uniqueness in the experiences of having the backing of a [larger] organization where they can transfer records versus an independent pharmacy really operating in their community to serve it.”