Journal article
Rural access to clinical pharmacy services
Journal of the American Pharmacists Association, Vol.54(5), pp.518-525
09/2014
DOI: 10.1331/JAPhA.2014.13248
PMID: 25216881
Abstract
To examine the impact of rural residence and primary care site on use of clinical pharmacy services (CPS) and to describe the use of clinical telepharmacy within the Veterans Health Administration (VHA) health care system.
Using 2011 national VHA data, the frequency of patients with CPS encounters was compared across patient residence (urban or rural) and principal site of primary care (medical center, urban clinic, or rural clinic). The likelihood of CPS utilization was estimated with random effects logistic regression. Individual service types (e.g., anticoagulation clinics) and delivery modes (e.g., telehealth) were also examined.
Of 3,040,635 patients, 711,348 (23.4%) received CPS. Service use varied by patient residence (urban: 24.9%; rural: 19.7%) and principal site of primary care (medical center: 25.9%; urban clinic: 22.5%; rural clinic: 17.6%). However, in adjusted analyses, urban-rural differences were explained primarily by primary care site and less so by patient residence. Similar findings were observed for individual CPS types. Telehealth encounters were common, accounting for nearly one-half of patients receiving CPS. Video telehealth was infrequent (<0.2%), but more common among patients of rural clinics than those receiving CPS at medical centers (odds ratio [OR] = 9.7; 95% CI 9.0-10.5).
We identified a potential disparity between rural and urban patients' access to CPS, which was largely explained by greater reliance on community clinics for primary care than on medical centers. Future research is needed to determine if this disparity will be alleviated by emerging organizational changes, including expanding telehealth capacity and integrating pharmacists into primary care teams, and whether lessons learned at VHA translate to other settings.
Details
- Title: Subtitle
- Rural access to clinical pharmacy services
- Creators
- Brandon J PattersonPeter J KaboliTraviss TubbsBruce AlexanderBrian C Lund
- Resource Type
- Journal article
- Publication Details
- Journal of the American Pharmacists Association, Vol.54(5), pp.518-525
- DOI
- 10.1331/JAPhA.2014.13248
- PMID
- 25216881
- ISSN
- 1544-3191
- eISSN
- 1544-3450
- Language
- English
- Date published
- 09/2014
- Academic Unit
- Pharmacy; Psychiatry; Epidemiology; Pharmacy Practice and Science; Internal Medicine
- Record Identifier
- 9984094368102771
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