Q&A: Pharmacy Programs Can Help Make Care More Accessible for Patients | APhA 2025

In the vast, often underserved rural landscapes of Idaho, pharmacists are transforming health care delivery by breaking down traditional barriers to medication access and patient care. With numerous pharmacy closures and limited primary care options, health care systems are implementing innovative strategies that expand the role of pharmacists beyond traditional dispensing, creating novel solutions that directly address patient needs.

Darcy Aslett, PharmD, residency program director for PGY-1 community-based residency at St. Luke's Health System, discusses approaches including medication lockers strategically placed in remote areas, home delivery services, and expanded prescribing capabilities for pharmacists. By collaborating closely with physicians and advanced practice providers, pharmacists are now able to prescribe medications for conditions like urinary tract infections, provide critical medications such as EpiPens and inhalers, and offer personalized medication counseling. This patient-centered model not only improves health care access but also enhances patient understanding and satisfaction, particularly in regions where health care resources are scarce.

Pharmacists are transforming health care delivery by breaking down traditional barriers to medication access and patient care. | Image Credit: auremar | stock.adobe.com

Drug Topics: What are some clinical pharmacy services that could be particularly valuable in addressing current patient needs?

Darcy Aslett, PharmD: I think for clinical pharmacy services that are going to be useful in addressing current patient needs, you first have to really identify what our current patient needs. So I think, especially for patients in the state of Idaho or in rural areas, we're looking at different types of barriers that can be actually physically getting your medication because we've had a lot of pharmacy closures, that can be affording the medication, that can be just information and access to knowledge, or even information or access to primary care provider, and I feel like pharmacy can really address a lot of these issues. With regards to access to medications, coming up with some novel approaches to accessing medications. Our system has been awesome about trying some of these novel approaches with great success. So some of our medication lockers—that's what I'll be presenting on—as well as our in-clinic pharmacies, which can provide Part D vaccinations within a clinic. So those are some things that we just kind of need to start thinking outside the box, and how can we get what patients need right to them?

Drug Topics: What are some clinical services that are well suited for rural pharmacy practice?

Aslett: So if you take a look at rural pharmacy practice, I mean, just patients in rural settings just have probably more barriers, I would say. One of those barriers is access to a pharmacy. So a couple of things that our system has been implementing are the medication locker, so these are locker boxes that can be placed in a more remote area, and you can access your medications that way. We also have home delivery, which would be another way that patients can access medications. I also think that patients in rural areas just have issues with access to a provider, and so pharmacists can provide some of these services through prescribing services, as long as they're done in a collaborative manner with our physician and APP [advanced prescribing providers] partners. So we can do things like prescribing for UTI; we can do things like prescribing an EpiPen or an inhaler, and so we need to really enable our pharmacist to do this. I think the other thing is ensuring that our partners in the pharmacy, our technicians, are practicing on a higher clinical level as well, and I really like the fact that Idaho allows us to do that. So those would be some other things I would say can help patients in rural populations.

Drug Topics: How can pharmacists contribute to care services, such as health screenings, smoking cessation, and weight management?

Aslett: I mean, really, you're just looking at all those that you've mentioned are going to be more prescribing services, and I think that as we start to roll out those prescribing services, it's really important to make sure that we're partnering with our physician and APP partners, so you need, and truthfully, anytime we've rolled out anything, there's been a lot of excitement around pharmacy services from physicians and from APPs; they're excited to partner with pharmacy. Things that we're already doing are refill authorizations, therapeutic substitution, and we're also doing some prescribing services, but anytime we roll those out, we need to make sure that we're talking with our physician and APP partners and developing best practices around those, and they're just very eager.

Drug Topics: What are some common challenges in implementing clinical services, and how can pharmacists overcome these?

Aslett: Challenges are kind of multifaceted. I think one of the main challenges is making sure that we have, at least from the perspective of the health system, that you have leadership excited and wanting to support the projects that you want to push forward. So it's important also to ensure that you have physician representation in those projects as well physician and APP representation. So I think just building relationships is a huge component of what needs to be done, and again, I talked about collaboration with those groups, and I really just haven't had major barriers there. I think a lot of times they're eager and excited to partner with us. I think also, just from like the boots-on-the-ground level, you need a pharmacist that's willing to engage in those types of activities and kind of take the lead on those activities, so making sure that the education is there, making sure that the training is there, and that also goes for our pharmacy technicians, as we talk about ensuring that they're doing more clinical work as well. They can be practicing at a higher level as well. So, just making sure all the pieces are together as you start to roll out these services.

Drug Topics: How can pharmacists collaborate with community organizations to expand access to clinical services?

Aslett: I think for, specifically outside of my organization, we have seen some successful collaboration with community organizations. So, I'm thinking about like the Idaho Department of Health and Welfare. We've collaborated with them on free naloxone and distribution of that through the system. Also, there are certain opioid removal programs that we've been able to collaborate with some of our state partners on. I think the important thing is, at our organization, we do have residents, and we were able to utilize them, and they've been instrumental in kind of helping to explore some of these options outside of our organization, and what they can do is kind of dig in and do that work. There might be something like a grant that needs to be written or data that needs to be collected and reported back, and so they're able to do that work, build those relationships, and then we can kind of initiate those programs as well.

Drug Topics: What are some strategies for ensuring the financial sustainability of clinical pharmacy services?

Aslett: Financial sustainability is super important. Obviously, you can't have these programs running otherwise, but I think from a health system perspective, again, just taking a look at patient satisfaction and patient outcomes. So, a lot of the programs that we have, for example, are meds-to-beds and transitions of care programs are so robust, and they produce such a better outcome for the patient, even though there's a lot of labor involved with that. There's such good work that goes that goes on with that. We have medication reconciliation, the direct patient counseling that is occurring in the patient room with the patient caregiver, and I think just that personal interaction, that personal touches, is just a huge patient satisfier. I also think if you can get the medication to the patient, the right medication, the right counseling, that's going to significantly reduce your errors upon discharge, and patients are just going to go home understanding a lot more than if it was a rush out of a hospital. So, I think you have to invest in these things, and the patient outcomes, at least from the health system perspective, are what make it appealing, I think, to leadership and to our patients.

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