State Telepharmacy Policies and Pharmacy Deserts
Pharmacy deserts have increased, potentially affecting patient access and care. Historically, telepharmacies have been used to reduce pharmacy deserts to restore access, but states frequently restrict their operation. To analyze whether telepharmacy policy is associated with pharmacy deserts and acc...
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| Veröffentlicht in: | JAMA network open 2023-08, Vol.6 (8), p.e2328810-e2328810 |
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| description | Pharmacy deserts have increased, potentially affecting patient access and care. Historically, telepharmacies have been used to reduce pharmacy deserts to restore access, but states frequently restrict their operation.
To analyze whether telepharmacy policy is associated with pharmacy deserts and access to pharmacy services.
This cohort study analyzed pharmacy location and census data from 2016 through 2019 for US states with new telepharmacy policies. Nearby control states were used for comparison in a pretest-posttest nonequivalent group design. Statistical analysis was performed from January 2022 to July 2023.
Intervention states were selected if a change in telepharmacy policy was adopted in 2017 or 2018.
Pharmacy deserts were defined as any geographic area located at least 10 miles from the nearest pharmacy. Primary outcomes included the change in number of telepharmacies, pharmacy deserts, and population in pharmacy deserts. Secondary outcomes included the percentage of telepharmacies located in medically underserved areas or populations (MUA/Ps), and the association between a telepharmacy opening nearby and the transition of a pharmacy desert into a nonpharmacy desert.
Twelve US states were included in the study (8 intervention states, 4 control states). Intervention states experienced an increase in the mean number of telepharmacies to 7.25 with a range of 4 (Arizona, Indiana) to 14 (Iowa), but control states remained at a mean of 0.25 telepharmacies with a range of 0 to 1 (Kansas). Compared with controls, intervention states experienced a 4.5% (95% CI, 1.6% to 7.4%) decrease in the percentage of places defined as pharmacy deserts (P = .001) and an 11.1% (95% CI, 2.4% to 22.6%) decrease in the population in a pharmacy desert (P = .03). Telepharmacies were more likely to be located in a MUA/P than traditional pharmacies (preperiod in MUA/P: 63.2% of telepharmacies [12 of 19] vs 33.9% of traditional pharmacies [5984 of 17 511]; P = .01; postperiod in MUA/P: 62.7% of telepharmacies [37 of 59] vs 33.7% of traditional pharmacies [5998 of 17 800]; P |
| doi_str_mv | 10.1001/jamanetworkopen.2023.28810 |
| format | Article |
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To analyze whether telepharmacy policy is associated with pharmacy deserts and access to pharmacy services.
This cohort study analyzed pharmacy location and census data from 2016 through 2019 for US states with new telepharmacy policies. Nearby control states were used for comparison in a pretest-posttest nonequivalent group design. Statistical analysis was performed from January 2022 to July 2023.
Intervention states were selected if a change in telepharmacy policy was adopted in 2017 or 2018.
Pharmacy deserts were defined as any geographic area located at least 10 miles from the nearest pharmacy. Primary outcomes included the change in number of telepharmacies, pharmacy deserts, and population in pharmacy deserts. Secondary outcomes included the percentage of telepharmacies located in medically underserved areas or populations (MUA/Ps), and the association between a telepharmacy opening nearby and the transition of a pharmacy desert into a nonpharmacy desert.
Twelve US states were included in the study (8 intervention states, 4 control states). Intervention states experienced an increase in the mean number of telepharmacies to 7.25 with a range of 4 (Arizona, Indiana) to 14 (Iowa), but control states remained at a mean of 0.25 telepharmacies with a range of 0 to 1 (Kansas). Compared with controls, intervention states experienced a 4.5% (95% CI, 1.6% to 7.4%) decrease in the percentage of places defined as pharmacy deserts (P = .001) and an 11.1% (95% CI, 2.4% to 22.6%) decrease in the population in a pharmacy desert (P = .03). Telepharmacies were more likely to be located in a MUA/P than traditional pharmacies (preperiod in MUA/P: 63.2% of telepharmacies [12 of 19] vs 33.9% of traditional pharmacies [5984 of 17 511]; P = .01; postperiod in MUA/P: 62.7% of telepharmacies [37 of 59] vs 33.7% of traditional pharmacies [5998 of 17 800]; P < .001). When a telepharmacy was established in pharmacy deserts, 37.5% (30 of 80) no longer met the study's definition of a pharmacy desert the following year. In contrast, only 1.8% of places (68 of 3892) where a nearby telepharmacy did not open experienced this change (χ21=416.4; P < .001).
In this cohort study, intervention states experienced a reduced population in pharmacy deserts, suggesting an association with new telepharmacy openings. States aiming to improve pharmacy access might consider less restrictive telepharmacy policies to potentially elicit greater patient outcomes.</description><identifier>ISSN: 2574-3805</identifier><identifier>EISSN: 2574-3805</identifier><identifier>DOI: 10.1001/jamanetworkopen.2023.28810</identifier><identifier>PMID: 37578793</identifier><language>eng</language><publisher>United States: American Medical Association</publisher><subject>Cohort analysis ; Deserts ; Drug stores ; Health Policy ; Online Only ; Original Investigation ; Pharmacy</subject><ispartof>JAMA network open, 2023-08, Vol.6 (8), p.e2328810-e2328810</ispartof><rights>2023. This work is published under https://creativecommons.org/licenses/by-nc-nd/4.0/ (the “License”). Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License.</rights><rights>Copyright 2023 Urick BY et al. .</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-a474t-8fa6181aaaf2a37d4d4adf5ac1be30469abc03624506e2bcc2cf1f9c9a5374433</citedby><cites>FETCH-LOGICAL-a474t-8fa6181aaaf2a37d4d4adf5ac1be30469abc03624506e2bcc2cf1f9c9a5374433</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>230,314,776,780,860,881,27903,27904</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/37578793$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Urick, Benjamin Y</creatorcontrib><creatorcontrib>Adams, Jessica K</creatorcontrib><creatorcontrib>Bruce, Maimuna R</creatorcontrib><title>State Telepharmacy Policies and Pharmacy Deserts</title><title>JAMA network open</title><addtitle>JAMA Netw Open</addtitle><description>Pharmacy deserts have increased, potentially affecting patient access and care. Historically, telepharmacies have been used to reduce pharmacy deserts to restore access, but states frequently restrict their operation.
To analyze whether telepharmacy policy is associated with pharmacy deserts and access to pharmacy services.
This cohort study analyzed pharmacy location and census data from 2016 through 2019 for US states with new telepharmacy policies. Nearby control states were used for comparison in a pretest-posttest nonequivalent group design. Statistical analysis was performed from January 2022 to July 2023.
Intervention states were selected if a change in telepharmacy policy was adopted in 2017 or 2018.
Pharmacy deserts were defined as any geographic area located at least 10 miles from the nearest pharmacy. Primary outcomes included the change in number of telepharmacies, pharmacy deserts, and population in pharmacy deserts. Secondary outcomes included the percentage of telepharmacies located in medically underserved areas or populations (MUA/Ps), and the association between a telepharmacy opening nearby and the transition of a pharmacy desert into a nonpharmacy desert.
Twelve US states were included in the study (8 intervention states, 4 control states). Intervention states experienced an increase in the mean number of telepharmacies to 7.25 with a range of 4 (Arizona, Indiana) to 14 (Iowa), but control states remained at a mean of 0.25 telepharmacies with a range of 0 to 1 (Kansas). Compared with controls, intervention states experienced a 4.5% (95% CI, 1.6% to 7.4%) decrease in the percentage of places defined as pharmacy deserts (P = .001) and an 11.1% (95% CI, 2.4% to 22.6%) decrease in the population in a pharmacy desert (P = .03). Telepharmacies were more likely to be located in a MUA/P than traditional pharmacies (preperiod in MUA/P: 63.2% of telepharmacies [12 of 19] vs 33.9% of traditional pharmacies [5984 of 17 511]; P = .01; postperiod in MUA/P: 62.7% of telepharmacies [37 of 59] vs 33.7% of traditional pharmacies [5998 of 17 800]; P < .001). When a telepharmacy was established in pharmacy deserts, 37.5% (30 of 80) no longer met the study's definition of a pharmacy desert the following year. In contrast, only 1.8% of places (68 of 3892) where a nearby telepharmacy did not open experienced this change (χ21=416.4; P < .001).
In this cohort study, intervention states experienced a reduced population in pharmacy deserts, suggesting an association with new telepharmacy openings. States aiming to improve pharmacy access might consider less restrictive telepharmacy policies to potentially elicit greater patient outcomes.</description><subject>Cohort analysis</subject><subject>Deserts</subject><subject>Drug stores</subject><subject>Health Policy</subject><subject>Online Only</subject><subject>Original Investigation</subject><subject>Pharmacy</subject><issn>2574-3805</issn><issn>2574-3805</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2023</creationdate><recordtype>article</recordtype><sourceid>ABUWG</sourceid><sourceid>AFKRA</sourceid><sourceid>AZQEC</sourceid><sourceid>BENPR</sourceid><sourceid>CCPQU</sourceid><sourceid>DWQXO</sourceid><recordid>eNpdkV1LwzAUhoMoOtS_IEVvvOk8-Wpab0TmJwgO1Otwmqba2TYz6ZT9ezt1Y45cJCTPeTknDyHHFIYUgJ5NsMHWdl_Ov7upbYcMGB-yNKWwRQZMKhHzFOT22nmPHIYwAQAGlGeJ3CV7XEmVqowPCDx12Nno2dZ2-oa-QTOPxq6uTGVDhG0RjZe3VzZY34UDslNiHezh375PXm6un0d38cPj7f3o8iFGoUQXpyUmNKWIWDLkqhCFwKKUaGhuOYgkw9wAT5iQkFiWG8NMScvMZCi5EoLzfXLxmzud5Y0tjG07j7We-qpBP9cOK_3_pa3e9Kv71BQEkylL-oTTvwTvPmY2dLqpgrF13f-fmwXNUgmq7zFRPXqygU7czLf9fAtqsbiCnjr_pYx3IXhbrrqhoBdy9IYcvZCjf-T0xUfr86xKlyr4N92BkEo</recordid><startdate>20230801</startdate><enddate>20230801</enddate><creator>Urick, Benjamin Y</creator><creator>Adams, Jessica K</creator><creator>Bruce, Maimuna R</creator><general>American Medical Association</general><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>3V.</scope><scope>7X7</scope><scope>7XB</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>AZQEC</scope><scope>BENPR</scope><scope>CCPQU</scope><scope>DWQXO</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>K9.</scope><scope>M0S</scope><scope>PIMPY</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>7X8</scope><scope>5PM</scope></search><sort><creationdate>20230801</creationdate><title>State Telepharmacy Policies and Pharmacy Deserts</title><author>Urick, Benjamin Y ; Adams, Jessica K ; Bruce, Maimuna R</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-a474t-8fa6181aaaf2a37d4d4adf5ac1be30469abc03624506e2bcc2cf1f9c9a5374433</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2023</creationdate><topic>Cohort analysis</topic><topic>Deserts</topic><topic>Drug stores</topic><topic>Health Policy</topic><topic>Online Only</topic><topic>Original Investigation</topic><topic>Pharmacy</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Urick, Benjamin Y</creatorcontrib><creatorcontrib>Adams, Jessica K</creatorcontrib><creatorcontrib>Bruce, Maimuna R</creatorcontrib><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Central (Corporate)</collection><collection>Health & Medical Collection</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>ProQuest Central (Alumni Edition)</collection><collection>ProQuest Central UK/Ireland</collection><collection>ProQuest Central Essentials</collection><collection>ProQuest Central</collection><collection>ProQuest One Community College</collection><collection>ProQuest Central Korea</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Health & Medical Collection (Alumni Edition)</collection><collection>Publicly Available Content Database</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>MEDLINE - Academic</collection><collection>PubMed Central (Full Participant titles)</collection><jtitle>JAMA network open</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Urick, Benjamin Y</au><au>Adams, Jessica K</au><au>Bruce, Maimuna R</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>State Telepharmacy Policies and Pharmacy Deserts</atitle><jtitle>JAMA network open</jtitle><addtitle>JAMA Netw Open</addtitle><date>2023-08-01</date><risdate>2023</risdate><volume>6</volume><issue>8</issue><spage>e2328810</spage><epage>e2328810</epage><pages>e2328810-e2328810</pages><issn>2574-3805</issn><eissn>2574-3805</eissn><abstract>Pharmacy deserts have increased, potentially affecting patient access and care. Historically, telepharmacies have been used to reduce pharmacy deserts to restore access, but states frequently restrict their operation.
To analyze whether telepharmacy policy is associated with pharmacy deserts and access to pharmacy services.
This cohort study analyzed pharmacy location and census data from 2016 through 2019 for US states with new telepharmacy policies. Nearby control states were used for comparison in a pretest-posttest nonequivalent group design. Statistical analysis was performed from January 2022 to July 2023.
Intervention states were selected if a change in telepharmacy policy was adopted in 2017 or 2018.
Pharmacy deserts were defined as any geographic area located at least 10 miles from the nearest pharmacy. Primary outcomes included the change in number of telepharmacies, pharmacy deserts, and population in pharmacy deserts. Secondary outcomes included the percentage of telepharmacies located in medically underserved areas or populations (MUA/Ps), and the association between a telepharmacy opening nearby and the transition of a pharmacy desert into a nonpharmacy desert.
Twelve US states were included in the study (8 intervention states, 4 control states). Intervention states experienced an increase in the mean number of telepharmacies to 7.25 with a range of 4 (Arizona, Indiana) to 14 (Iowa), but control states remained at a mean of 0.25 telepharmacies with a range of 0 to 1 (Kansas). Compared with controls, intervention states experienced a 4.5% (95% CI, 1.6% to 7.4%) decrease in the percentage of places defined as pharmacy deserts (P = .001) and an 11.1% (95% CI, 2.4% to 22.6%) decrease in the population in a pharmacy desert (P = .03). Telepharmacies were more likely to be located in a MUA/P than traditional pharmacies (preperiod in MUA/P: 63.2% of telepharmacies [12 of 19] vs 33.9% of traditional pharmacies [5984 of 17 511]; P = .01; postperiod in MUA/P: 62.7% of telepharmacies [37 of 59] vs 33.7% of traditional pharmacies [5998 of 17 800]; P < .001). When a telepharmacy was established in pharmacy deserts, 37.5% (30 of 80) no longer met the study's definition of a pharmacy desert the following year. In contrast, only 1.8% of places (68 of 3892) where a nearby telepharmacy did not open experienced this change (χ21=416.4; P < .001).
In this cohort study, intervention states experienced a reduced population in pharmacy deserts, suggesting an association with new telepharmacy openings. States aiming to improve pharmacy access might consider less restrictive telepharmacy policies to potentially elicit greater patient outcomes.</abstract><cop>United States</cop><pub>American Medical Association</pub><pmid>37578793</pmid><doi>10.1001/jamanetworkopen.2023.28810</doi><oa>free_for_read</oa></addata></record> |
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| source | DOAJ Directory of Open Access Journals; EZB-FREE-00999 freely available EZB journals; Alma/SFX Local Collection |
| subjects | Cohort analysis Deserts Drug stores Health Policy Online Only Original Investigation Pharmacy |
| title | State Telepharmacy Policies and Pharmacy Deserts |
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