Travel Time Thresholds, Vulnerability Index Provide Pharmacy Access Insights
Using a novel pharmacy vulnerability index, researchers identified US regions at the most risk of becoming pharmacy deserts.
Regionally adapted travel time thresholds and a vulnerability index algorithm can play significant roles in addressing the measurements of pharmacy access, according to data published in JAMA Network Open.1 Researchers suggested their findings could be used to prevent future inequities regarding access to US pharmacies.
“Access to community pharmacies is essential for ensuring medication access and promoting public health,” wrote authors of the study. “More than two-thirds of US adults use at least one medication, and over 90% of prescriptions are filled at community pharmacies.”
Experts are also continuing to conduct ongoing research into the issues causing pharmacy deserts in the US. | image credit: Dmitriy / stock.adobe.com
Aside from pharmacists’ frontward-facing position in their communities, especially when compared with other providers, they also offer a plethora of crucial health care services. Pharmacists across the country at community practices have become common administrators of vaccine, diagnostic, and medication therapy management (MTM) services.
READ MORE: Over 300 Pharmacy Closures Reported in the Last 3 Months
Experts are also continuing to conduct ongoing research into the issues causing pharmacy deserts in the US. “Pharmacy closures can lead to a rise of pharmacy deserts, meaning that there is no retail pharmacy within 1 mile (in urban areas), 2 miles (in suburban areas), or 10 miles (in rural areas) from an individual household,” wrote Cencora in its definition of pharmacy deserts.2
More specifically, this ongoing issue of the inequity in US pharmacy access has led researchers to focus on the underserved communities and populations most at risk of losing local pharmacies and direct access to medications. Calls to improve pharmacy access in low-income, minority communities in both rural and urban locales have been commonplace among industry advocates.
“If the issues contributing to pharmacy deserts are not addressed, it is likely that pharmacy deserts will continue to expand, and the situation will worsen. It is crucial that continual efforts are made to expand pharmacy services and access to pharmacy desert areas to improve outcomes and decrease health care disparities, especially in the segregated minority and low-income communities,” wrote Noelle Kwan, PharmD, BCPS, for the US Pharmacist.3
With health care policy, location, travel time (instead of distance), and more arising as factors that address pharmacy access, researchers proposed a redesign of the current and common processes to assess spatial access to pharmacies and health care infrastructure as a whole. This redesign was developed to proactively assist in the identification of pharmacy deserts using a novel pharmacy vulnerability index.1
“This population-based, cross-sectional study in the contiguous 48 states performed geographic information systems analysis of pharmacy data from the National Council for Prescription Drug Programs dataQ,” they continued. “Participants included all open-door pharmacies (community or retail pharmacies open to the general public without restrictions on who can access its services) in the US as of February 2024.”
By first identifying proper definitions and parameters for the assessment of US pharmacy deserts, researchers were then able to better identify where they existed. Further introducing new terms and perspectives regarding pharmacy deserts, researchers explored the idea of “keystone pharmacies.”
“We defined pharmacy vulnerability index as the number of pharmacies that would need to close for a census tract to be considered a desert,” wrote the authors. “A vulnerability index score of 1 designates communities relying on a single pharmacy for access. We refer to these pharmacies, which are the only source of pharmacy services in an area, such that their closure would result in a pharmacy desert, as keystone pharmacies.”
As part of the study analysis, data were collected for a total of 323.5 million patients (12.3% Black; 60.3% White). A total of 57.1 million, or 17.7% of the study population, were living in a pharmacy desert tract during the time of the study. Slightly less prominent was the prevalence of keystone pharmacies in the US as 28.9 million patients (8.9%) lived in a census tract with one.
“Notably, independently owned pharmacies were more likely than chain pharmacies to be keystone pharmacies,” they wrote.1 “The most rural settings were disproportionately reliant on keystone pharmacies for access.”
With success in their assessment of pharmacy deserts in the US, researchers identified the 2 key aspects that informed their data.
First, they found that the use of travel time was a more accurate measure of pharmacy access than that of distance. Travel time was found to be a better measurement of the nuanced approaches when it comes to traveling within either urban or rural communities. Secondly, the researchers found significantly successful results in using their vulnerability index.
“The methods used in this analysis, including regionally adapted travel time thresholds and a vulnerability index algorithm, provide a nuanced understanding of pharmacy accessibility that can be applied to the measurement of access to other critical resources. Through the identification of areas that rely on a single pharmacy for access, our research can support the implementation of targeted policy efforts to prevent further exacerbation of inequities in pharmacy access,” concluded authors of the study.1
READ MORE: How Pharmacy Deserts are Being Defined, Identified
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