Can We Overcome Pharmacy Desert Barriers ?
by TOM JAMES , MD
We hear about it on the news . We hear the plight of children and families who do not have access to fresh foods in clean and affordable groceries . The schools have had to step up to provide healthy meals for children who live in food deserts and cannot afford to go to food stores in more affluent areas of Jefferson County . These stories pull at our heartstrings .
But a more insidious desert exists for some of our patients who do not have adequate access to obtain the medications we prescribe . Studies have demonstrated that geographic / transportation access to a neighborhood pharmacy , the type of pharmacy ( independent or chain ), plus the adequacy of pharmacists and medications stocked , are all independent variables . In socioeconomically diverse urban neighborhoods , the health outcome differences can be quite dramatic . 1 The Telepharm software organization defines a pharmacy desert as being more than 15 minutes away from the bulk of the population . They assume the person has a car . So , their map of Kentucky shows pharmacy deserts only in the rural parts of the Commonwealth ( https :// maps . telepharm . com / telepharm / maps / 116831 / state-pharmacy-desert-map #). A more common definition is that a pharmacy desert exists if there is low vehicular access within a half mile of the person ’ s residence or more than a mile if there is bus or auto access . 2
Pharmacy deserts don ’ t generate much media coverage or public attention . Food deserts get more attention because of the impact on children . Pharmacy deserts are much more likely to cause harm to older and sicker members of the community who may not have reliable access to the medically necessary medications . Recently , a 64-year-old patient , Robert *, was admitted to hospital with heart failure . He presented with shortness of breath and dependent edema typical of that condition . After four days in the hospital with diuretics and diagnostic echocardiography , Robert was deemed safe enough for discharge . It was a weekend , and the hospital did not have its weekday Meds-to-Beds program . So , he was discharged with his prescriptions for metoprolol , furosemide and potassium . He was still
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