Defining Pharmacy Access: A Review of Pharmacy-Level Research in the United States.

BACKGROUND

Access to pharmacy services is a critical determinant of health care equity, as it directly impacts medication adherence, chronic disease management, and overall health outcomes. Despite the important role of community pharmacies in the United States, disparities in access persist, particularly among rural, minority, and low-income populations. However, there is no consensus on how pharmacy access should be defined or measured, and how these definitions relate to health outcomes.

OBJECTIVE

This review evaluates how pharmacy access is defined and measured in US-based studies and examines its implications on health outcomes, quality of care, and health care costs.

METHODS

We conducted a scoping review of US-based studies published over the past 20 years, identifying patterns in definitions and measurements of pharmacy access, as well as associated health outcomes. The review followed Arksey and O'Malley's framework and PRISMA-ScR guidelines.

RESULTS

Sixteen studies met the inclusion criteria, most of which used cross-sectional designs. Definitions of pharmacy access varied, with metrics including distance to the nearest pharmacy, pharmacy density, and the concept of pharmacy deserts. Limited pharmacy access was associated with lower medication adherence, poorer chronic disease management, increased health care costs, and higher hospitalization rates.

CONCLUSIONS

Efforts to improve pharmacy access should focus on standardizing measurement approaches and implementing targeted interventions to sustain pharmacies in underserved areas. These strategies have the potential to enhance medication adherence, reduce health care costs, and address health disparities across vulnerable communities.