Pharmacy residents increase access to health care!

It is always an honor and privilege to bring to you another Residency Special Issue. This issue is the sixth special issue, which highlights the important research conducted by residents to advance pharmacy practice. During this year, pharmacies were greatly affected by coronavirus disease 2019 (COVID-19), and yet, amid enormous stress and upheaval, preceptors and their residents continued to conduct research projects promoting and strengthening pharmacy practice.

As of March 3, 2022, a total of 233.4 million doses of COVID-19 vaccinations have been administered by community pharmacies through the Federal Retail Pharmacy Program, a collaboration between the federal government, states and territories, and 21 national pharmacy partners and independent pharmacy networks. Including long-term care pharmacies, more than 41,000 locations provided vaccinations. This represents enormous reach into our many communities throughout the United States, from urban to rural and most areas in between. The magnitude of this program showcases the important ways in which pharmacy provides access to health care. Improving access to health care and reducing barriers to care are key to improving the health of all Americans. Pharmacists improve access by identifying barriers to care and addressing those barriers and by creating new services that meet the needs of patients.

Several of the residency research projects increased access to care. Greene et al. contacted 17 uninsured patients after discharge from inpatient care and found that more than one-third of patients did not know how to apply for a free prescription medication service, even though they were eligible. Pharmacists can work with these patients to provide education about the program and increase access to needed medications. Also working with a vulnerable population, Amundson et al. measured the perceptions of underserved, underinsured Hispanic adults and found that there was a high correlation between their perceived trust in their provider and the perceived effectiveness of vaccines. Messaging from pharmacists could counter vaccine hesitancy and was found to be key to patients’ willingness to receive the vaccine, leading to improved access to vaccinations.

Although access to care has been a long-standing problem, this issue worsened during the pandemic with reduced availability of physician visits. Mascari et al. implemented a long-acting injectable (LAI) antipsychotic medication administration service at a community pharmacy, which increased access to medication for patients with mental illness. More than 80% of patients felt comfortable receiving their LAI at the pharmacy, and 71% of patients said that the service was convenient. Coffman et al. showed that a computer system prompt for the pharmacist may increase pharmacists’ offer to provide naloxone to at-risk patients; the pharmacist improved access to a critically important medication to reduce overdose deaths.

The many services that pharmacists provide, many of which improve access, need to be documented. Provision of enhanced pharmacy services is increasing but efficient means of documentation are necessary, and there may be limited time and staffing resources or lack of payment to facilitate the documentation process. Baggett et al. identified barriers and best practices related to electronic care (ECare) plans, which uses health information technology to submit the encounter.

Pharmacists, historically working behind the scenes or in basements, became a visible health care provider to all patients through vaccination administration and COVID-19 testing. Pharmacists can do much to improve access to medications as evidenced by the residency projects, and therefore, improve the health of all Americans. As I write this, the federal government just released a “Test to Treat” initiative for COVID-19 antivirals. Pharmacists are uniquely poised to increase access to both the testing and the immediate follow-up treatment that is required in a timely manner for the medications to be most effective. Pharmacists have proved that they truly are the most accessible health care provider and can increase access to life-saving medications.

The Journal of the American Pharmacists Association (JAPhA) would like to acknowledge the dedication of the preceptors and the sites where the residents work. A successful residency program requires a strong support system, especially during challenging times. However, even given these historic challenges, the residents and preceptors continue to advance practice. These residents were also mentored by members of the JAPhA Editorial Advisory Board. JAPhA would like to thank Chris Gillette, Juan Hincapie-Castillo, Adriane Irwin, Elaine Nguyen, Jennifer Panich, Dima Qato, Laura Rhodes, and Ben Urick for their dedication to the journal.

As COVID-19 case counts fall, and the summer looks brighter, the world now faces another humanitarian crisis as war escalates in Ukraine. Just as pharmacists stepped up and provided care during the pandemic, I am sure that all pharmacists around the world will support the suffering people in Ukraine. Together, let us continue to increase access to care for all people, here in the United States, and globally.