Rural Health
Jen Hand
A network developed solely for rural community pharmacies has paired with schools of pharmacy to address questions related to pharmacy practice and medication use.
The Rural Research Alliance of Community Pharmacies (RURAL-CP) started in 2019 at the University of North Carolina and is the first and only multistate practice-based research network in the United States dedicated to rural community pharmacies.
“We seek to give rural pharmacies a collective voice,” said Delesha Carpenter, PhD, RURAL-CP program director.
She and the RURAL-CP team manage a network that now has 164 member pharmacies spanning the seven contiguous southeastern states of Alabama, Arkansas, Georgia, Mississippi, North Carolina, South Carolina, and Tennessee.
Tennessee’s RURAL-CP liaison, Tyler Melton, PharmD, said the program has been well received there.
“Insights from Tennessee pharmacies are shared with the larger RURAL-CP group to guide project discussions and planning,” said Melton, an assistant professor at the University of Tennessee Health Science Center’s College of Pharmacy. “I am grateful for the continued participation of our community pharmacies in strengthening this network.”
Each state has a liaison associated with a college of pharmacy who is responsible for recruitment and staying in touch with the pharmacies.
The issues
Carpenter, who is also a professor in the Division of Pharmaceutical Outcomes and Policy at the Eshelman School of Pharmacy at UNC, said that financial threats are an issue at all pharmacies but especially at rural ones.
A June 2025 JAPhA article presented results of a survey from several RURAL-CP member pharmacies. The findings revealed insufficient reimbursement to cover the cost of dispensing medications as a major issue for rural pharmacies.
Also troubling, according to Carpenter, are what she calls predatory health insurance representatives who may call or come to the homes of older adults selling insurance with lower premiums. Carpenter said patients do not realize until it is too late that they are locked out of their local pharmacy or have unwittingly signed up for mail-order prescriptions.
RURAL-CP also helps assist its member pharmacies solve staffing issues by tracking down “floater” pharmacists and pharmacy technicians to fill in scheduling gaps or help to develop new reimbursable services.
Carpenter said they seek to help rural pharmacies stay afloat until other policy initiatives are put in place. “Like being able to get provider status to bill for Medicaid for certain things,” she said.
The mission
Across its network, RURAL-CP pairs student pharmacists with professors on funded research studies. The mission of RURAL-CP is to reduce rural health disparities by supporting high-quality implementation research with rural community pharmacies.
According to UNC’s website, student pharmacists may look at survey data or assist with data collection for ongoing studies, and they sometimes formulate their own research studies that they can put into practice through the network.
Student pharmacists who are on rotation at RURAL-CP pharmacies may counsel patients, dispense medications, and help start new pharmacy services, such as drug takeback programs or naloxone dispensing. Student pharmacists may help with recruitment feedback, too. Carpenter said their members love to speak with student pharmacists.
She also said there is an undergrad public health student from the Gillings School of Global Public Health at UNC researching where the keystone pharmacies are in the RURAL-CP network. The student is using Rural-Urban Commuting Area (RUCA) codes to locate potential pharmacy deserts. RURAL-CP considers a pharmacy to be rural if it has a RUCA code of 4 to 10, with some exceptions.
By bringing together pharmacists facing similar issues, RURAL-CP documents how rural pharmacies continue to provide needed services during difficult financial times and helps pharmacists address communication around sensitive topics, including opioid overdose, vaccines, and suicide. ■