(1032) An Implementation Science Focused Practice Based Research Network for Rural Community Pharmacies: RURAL-CP

Objectives: Practice-based research networks (PBRNs) support the translation and evaluation of evidence-based practices and interventions on a large scale and are most common in primary care settings. Few pharmacy PBRNs exist. Our objective is to describe the composition and characteristics of the Rural Research Alliance of Community Pharmacies (RURAL-CP), which is the first PBRN exclusively for rural community pharmacies.

Methods: Pharmacy recruitment began in late 2019 and is ongoing. Each RURAL-CP state (Alabama, Arkansas, Georgia, Mississippi, North Carolina, South Carolina, Tennessee) is represented by a state liaison who is employed by a college of pharmacy in that state. State liaisons generated lists of rural pharmacies in their states and contacted those pharmacies to notify them of RURAL-CP and solicit their interest in learning more about the network. Pharmacies were purposively selected to provide geographical distribution across each state. State liaisons then engaged in site visits with interested pharmacies. Pharmacies were considered rural if they had a Rural-Urban Commuting Area (RUCA) code of four or higher. For each enrolled pharmacy, a pharmacist liaison completed a survey that assessed the pharmacy’s operational characteristics, including business operations, human resource management, division of clinical responsibilities, technology and enhanced services, organizational context, and research priorities. Additionally, up to five other pharmacy staff members completed a brief survey on organizational context. Descriptive statistics were calculated.

Results: As of May 2023, 126 pharmacies were enrolled in RURAL-CP. Most pharmacies (91%) were independent pharmacies and operated six days per week (82%). On average, pharmacies employed 10 staff members (median=9 employees) and most trained student pharmacists (62%). Pharmacies offered valuable services in their community, including immunizations (91%), medication synchronization (75%), medication delivery (79%), and naloxone dispensing (71%). Blood glucose testing was the most common point-of-care (POC) test offered (37%), and most pharmacies were interested in expanding POC offerings, particularly A1c testing (72%) and cholesterol screening (68%). RURAL-CP pharmacies have, on average, relatively strong organizational contexts and readiness for change, and were rated highly on promoting an enjoyable work environment and supporting pharmacy change efforts. Pharmacists’ top research priorities were expansion of clinical services, reimbursement, patient adherence, and addressing diabetes and hypertension.

Conclusions: RURAL-CP pharmacies are geographically disbursed across the Southeast, offer a variety of important services in their communities, and are keen to expand their service offerings, especially immunizations and diabetes-related services. As rural pharmacies continue to close, efforts to support their financial viability are critical to prevent the number of pharmacy deserts from increasing. RURAL-CP provides the infrastructure necessary to study the impact of rural pharmacies on their communities. Together with state liaisons consisting of implementation scientists and clinicians, patient care services and practice models can be tested and effectively translated to a rural context. Individuals interested in joining RURAL-CP or recruiting RURAL-CP pharmacies for implementation science studies should visit the study website at https://ruralcp.web.unc.edu/.