Primary Care

Loren Bonner

We hear so much about pharmacists being one of the most accessible health care providers, but how often do patients actually see their community pharmacist?

“We felt that a number supported by robust data in a peer-reviewed journal could advance the profession of pharmacy in ways that stories alone could not,” said Lucas Berenbrok, PharmD, BCACP, assistant professor at the University of Pittsburgh School of Pharmacy, and lead author of a new study published in JAMA Network Open.

In their research, Berenbrok and colleagues from the University of Pittsburgh School of Pharmacy found that among over 680,000 active Medicare beneficiaries, visits to a community pharmacy greatly outnumbered encounters with primary care physicians. Patients visited community pharmacies approximately twice as frequently as they visited primary care offices. The difference in number of visits and encounters was largest in nonmetropolitan, rural areas.

The study is likely the first to quantify and compare the occurrence of visits between community pharmacists and primary care physicians through a nationally representative sample (see map).

“The frequency of visits estimated by our analysis suggests that community pharmacists have frequent opportunities to deliver patient-centered services in community-based locations,” the authors noted. “As value-based health care increasingly places emphasis on preventive care and chronic disease management, the community pharmacist is a highly accessible clinician who can provide many of these services.”

Strengths and weaknesses of the study

According to Berenbrok, the ultimate goal of the research was to highlight how often patients see their community pharmacist and to acknowledge the important roles pharmacists play in keeping patients healthy. Berenbrok said they were also careful about interpreting their findings within the context of interprofessional care.

“Our goal was to highlight how pharmacists can contribute to multidisciplinary primary care teams due to their unique accessibility,” he said.

The study was strengthened by the number of beneficiaries and claims in the data set. “We were pleased that a study like this could represent a large portion of patients who visit pharmacies and those who would benefit from additional touchpoints for preventive care and chronic disease state management,” said Berenbrok.

The study did have limitations, however. Lack of entry to point-of-sale data at the community pharmacy could be viewed as one barrier.

“Because we only had access to Part D prescription drug claims data, our data can only provide an estimate of the number of visits and may underestimate the true number,” said Berenbrok. “Pharmacy visits when the patient paid with cash, picked up an over-the-counter item, received an immunization other than herpes zoster, and received medication therapy management were not captured in our analysis.”

The analysis excluded Medicare beneficiaries using mail-order pharmacies as well.

The power of data

“We hope that our study will help others appreciate community pharmacists as health care providers who keep patients healthy by contributing to preventive care and chronic disease state management through collaborative medication management,” said Berenbrok.

Berenbrok added that he hopes the data will be used in advocacy efforts to formally recognize pharmacists as health care providers deserving of reimbursement for patient care services.

“We would like to encourage others to explore how important robust data sets can be when advocating for the recognition of pharmacists as health care providers. When combined with meaningful stories, data can be powerful enough to transform the way pharmacists take care of patients,” said Berenbrok.