"The crux of the community": A qualitative focus group study of the impact of community pharmacy closures in Colorado and Utah.

BACKGROUND

Community pharmacies are critical access points for health care in the United States, especially for underserved populations. However, a substantial number of recent pharmacy closures have been widely documented. Pharmacies at greater risk of closure are typically found in urban areas, are independently-owned businesses, and disproportionately serve low-income populations. While prior research has quantitatively assessed the impact of pharmacy closures on medication adherence and geographic access, less is known about the broader impacts of pharmacy closures on communities, pharmacy operations, pharmacy staff, and patients.

OBJECTIVE

To qualitatively describe the impacts of community pharmacy closures in Colorado and Utah on communities, pharmacy operations, pharmacy staff, and patients from the perspective of pharmacists and technicians.

METHODS

We conducted three semistructured focus groups in September and October 2024 with 13 participants who had experienced a community pharmacy closure in Colorado or Utah within the previous 6 years. Focus group transcripts were analyzed using a mixed deductive-inductive approach to identify major themes.

RESULTS

Closures negatively impacted communities by creating pharmacy deserts, harming local economies, and complicating workforce recruitment beyond the pharmacy industry. Increased prescription volume, staffing challenges, and operational stress at remaining pharmacies disrupted pharmacy operations. Staff described emotional and psychological tolls, including stress, burnout, and regret over career choices, as well as job loss and increased competition for available positions. Closures also impacted patients by increasing wait times, disrupting continuity of care, and disproportionately affecting vulnerable populations such as those without transportation, older adults, and individuals requiring controlled substances.

CONCLUSION

Pharmacy closures have far-reaching consequences that extend beyond access to medications, affecting the social and economic fabric of communities and the overall well-being of both pharmacy staff and patients. These findings can inform future research and policy efforts aimed at mitigating the negative impacts of closures and promoting equitable access to pharmacy services.