Many independent pharmacies are closing across rural America, hindering patients' access to healthcare professionals and important services like in-person medication counseling, according to U.S. News & World Report.
Here are four things to know:
1. About 1,230 stores — or about 16 percent of all independent rural pharmacies in the U.S. — have closed since 2003, according to data released in July and cited by U.S. News. Most closures occurred between 2007-09, after CMS fully implemented Medicare Part D. However, pharmacies are still closing in 2018. The RUPRI Center for Rural Health Policy Analysis found 630 rural communities with at least one independent, chain or retail pharmacy in 2003 did not have any as of this March.
2. These closures mean some patients in rural areas may need to travel long distances just to pick up a prescription or rely on mail-order pharmacy arrangements, which limits valuable in-person access to pharmacists.
"If you have to drive 60 miles to pick up your drug, you're not going to get your refills on time as often as you should," Bree Watzak, PharmD, a clinical associate professor in the College of Pharmacy and the Rural and Community Health Institute at Texas A&M University in College Station, told U.S. News.
3. Pharmacists may be the only healthcare professionals stationed in a rural area due to a national shortage of primary care physicians. In addition, rural communities often contain many older Americans with chronic diseases who require more complicated medication management practices.
"The problem is, even when you lose a smaller number of pharmacies a year, you're still losing a point of access to that professional," Keith Mueller, PhD, director of the RUPRI Center, told U.S. News. "In some communities, they may be the sole source of any kind of clinical advice."
4. Pharmacists also play a key role in both medication reconciliation and patient safety, according to Dr. Watzak.
"You don't necessarily have specialists in small towns. So you may go to a big city for your cardiologist and another big city for your orthopedic surgeon," she told U.S. News. "That pharmacist in your town is the one who sees everything that's going on — not necessarily the specialist in the city where you went. … It's very important to have eyes on the different medications you're taking, to make sure they're optimized and there won't be duplications or side effects."