Bridging health disparities: a national survey of ambulatory care pharmacists in underserved areas
Background: There is a shortage of primary care medical providers, particularly in rural communities and communities of racial and ethnic minority groups. Clinical pharmacists can help fill gaps in care among these vulnerable populations.
Objective: To identify characteristics of ambulatory care pharmacists that pursue and maintain employment within underserved areas.
Methods: An original survey was distributed nationwide to ambulatory care clinical pharmacists in underserved settings. Respondent characteristics were analyzed using descriptive statistics.
Results: Of the 111 completed surveys, a majority of respondents were White, non-Hispanic, female, with English as their only spoken language. A majority of pharmacists completed a clinical experience or specialized training focused on underserved care prior to their position. The top three motivators for pharmacists accepting their clinical position as well as staying at their job were passion for caring for underserved populations, the presence of a faculty appointment, or the freedom and flexibility of advanced clinical roles.
Conclusions: With a large majority of our respondents identifying as White and unilingual, there remains a large opportunity to increase diversity in the clinical pharmacy ambulatory care workforce caring for underserved populations. There is an observed correlation between early experiential or specialized training in underserved care and pharmacists pursuing employment in these areas. Thus, one potential long-term strategy to diversify and grow the ambulatory care clinical pharmacist workforce in underserved settings is for clinical practice sites to partner with colleges of pharmacy to recruit and maintain quality individuals who can meet the needs of diverse patient populations as well as expand student and resident training opportunities in underserved settings.
US Department of Health and Human Services. Healthy People 2030: Social determinants of health literature summaries. https://health.gov/healthypeople/objectives-and-data/social-determinants-health/literature-summaries (accessed Nov 30, 2020).
Bureau of Health Workforce, Health Resources and Services Administration, U.S. Department of Health & Human Services. Designated health professional shortage areas (HPSA) statistics: designated HPSA quarterly summary. https://data.hrsa.gov/topics/health-workforce/shortage-areas (accessed Nov 30, 2020).
US Department of Health and Human Services National Health Service Corps. Loan repayment program FAQs. http://nhsc.hrsa.gov/currentmembers/loanrepaymentrecipients/faqs/index.html (accessed Nov 30, 2020).
Agency for Healthcare Research and Quality. 2019 National healthcare quality and disparities report. https://www.ahrq.gov/sites/default/files/wysiwyg/research/findings/nhqrdr/2019qdr-final-es.pdf (accessed Feb 24, 2021).
Chavez B, Kosirog E, Brunner JM. Impact of a Bilingual Pharmacy Diabetes Service in a Federally Qualified Health Center. Ann Pharmacother. 2018;52(12):1218-1223. https://doi.org/10.1177/1060028018781852
Fagan EB, Gibbons C, Finnegan SC, et al. Family medicine graduate proximity to their site of training: policy options for improving the distribution of primary care access. Fam Med. 2015;47(2):124-130.
Payne MH, Tuchscherer RM, Billups SJ, et al. Changes in pharmacy students' perceptions of underserved populations after a six-week clinical rotation in a federally qualified health center clinic. Curr Pharm Teach Learn. 2018;10(8):1149-1153. https://doi.org/10.1016/j.cptl.2018.05.017
Odom Walker K, Ryan G, Ramey R, et al. Recruiting and retaining primary care physicians in urban underserved communities: the importance of having a mission to serve. Am J Public Health. 2010;100(11):2168-2175. https://doi.org/10.2105/ajph.2009.181669
American College of Clinical Pharmacy. The definition of clinical pharmacy. Pharmacotherapy. 2008;28(6):816-817. https://doi.org/10.1592/phco.28.6.816
American Association of Colleges of Pharmacy. Resources, pharmacy workforce center, national pharmacist workforce studies, 2019 national pharmacist workforce study. https://www.aacp.org/article/2019-national-pharmacist-workforce-study (accessed Nov 19, 2020).
Quiñones AR, Botoseneanu A, Markwardt S, et al. Racial/ethnic differences in multimorbidity development and chronic disease accumulation for middle-aged adults. PLoS One. 2019;14(6):e0218462. https://doi.org/10.1371/journal.pone.0218462
Ma A, Sanchez A, Ma M. The Impact of Patient-Provider Race/Ethnicity Concordance on Provider Visits: Updated Evidence from the Medical Expenditure Panel Survey. J Racial Ethn Health Disparities. 2019;6(5):1011-1020. https://doi.org/10.1007/s40615-019-00602-y
Traylor AH, Schmittdiel JA, Uratsu CS, Mangione CM, Subramanian U. Adherence to cardiovascular disease medications: does patient-provider race/ethnicity and language concordance matter?. J Gen Intern Med. 2010;25(11):1172-1177. https://doi.org/10.1007/s11606-010-1424-8
Shavers VL, Fagan P, Jones D, et al. The state of research on racial/ethnic discrimination in the receipt of health care. Am J Public Health. 2012;102(5):953-966. https://doi.org/10.2105/ajph.2012.300773
Bott AM, Collins J, Daniels-Costa S, et al. Clinical Pharmacists Improve Patient Outcomes and Expand Access to Care. Fed Pract. 2019;36(10):471-475.
Zhang X, Lin D, Pforsich H, Lin VW. Physician workforce in the United States of America: forecasting nationwide shortages. Hum Resour Health. 2020;18(1):8. https://doi.org/10.1186/s12960-020-0448-3
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