Using Pharmacists to Provide Care in Rural Areas

Rural communities tend to have older and sicker residents as compared to urban and suburban communities. The increased need for medical care and prescription drugs, coupled with scarcity of primary care physicians in rural areas, exacerbates many barriers to accessing necessary health care. Maximizing the utilization of pharmacists as part of the health care delivery system is among several state strategies to meet the unique health care needs of rural and underserved communities.

Nearly 9 in 10 Americans live within five miles of a community pharmacy, making pharmacists some of the most accessible healthcare professionals. Pharmacists are trained to test, treat and immunize for many infectious diseases, including influenza, and by practicing their full scope of practice within their training and license, could alleviate pressure on the healthcare system exacerbated created by the COVID-19 pandemic. Along with dispensing prescription medications and offering expertise in the safe use of prescriptions to patients, pharmacists play an important role in enhancing public health and increasing access to care in rural and underserved areas in coordination with other health care providers.

As of May 2019, there are more than 311,000 licensed pharmacists working in in drug, general merchandise and grocery stores as well as hospitals and other health care facilities across the United States. In order to practice, pharmacists must hold, at minimum, a bachelor’s degree, though most states require a Doctor of Pharmacy (PharmD) degree and pass the appropriate licensure exams. Each state has a board of pharmacy which regulates pharmacists, pharmacy interns and pharmacies within their state, as well as licensing applications, renewals and transfers.

Pharmacists are often the first line of contact for patients in rural communities and provide important advice on the safe use of prescription and over-the-counter medications to remedy symptoms until patients can schedule an appointment with their physician.  In recent years, some states expanded pharmacists’ scope of practice to include prescribing certain medications (e.g., hormonal contraceptives, tobacco cessation aids) and modifying prescriptions under specific circumstances, either independently or in collaboration with the original prescriber. This can allow patients to receive medications in a timelier manner.

Ten states allow pharmacists to prescribe hormonal contraceptives while 12 states allow pharmacists to prescribe tobacco cessation aids. In West Virginia, pharmacists are allowed to dispense self-administered hormonal contraceptives to patients 18 years or older if they have completed a board-approved training program and have notified the patient’s primary care provider. Iowa allows pharmacists to prescribe nicotine replacement tobacco cessation products. 

Three states allow pharmacists to modify original prescriptions written by a physician. For example, Idaho allows a pharmacist to modify a prescription quantity, dosage form or complete missing information.

As health workforce shortages continue to grow, states will look for ways to increase access to health care, especially in areas facing primary care provider shortages like rural communities. Utilizing pharmacists to help patients manage medications and address chronic illness is one strategy states may examine. Please visit the pharmacist overview page for more information.