Spotlighting Community Pharmacies

Illustrated Map of the United States including Puerto Rico in various shades of blue.

The 50 Stories from 50 States Challenge, an initiative from the ACT Pharmacy Collaborative, amplifies the vital patient care services that community pharmacies are providing nationwide.

By Joseph A. Cantlupe

The COVID-19 pandemic magnified the value of pharmacists, especially those in community pharmacies who are highly accessible to the public. The doors of community pharmacies stayed open as they always do—and during a time when most other medical practices had limited in-person appointments. Pharmacists found people seeking not only vaccines but medical advice in a manner that many had not previously considered as they stayed closer to home, postponed checkups and preventive screenings or had lengthy waits for doctors’ appointments. Indeed, community pharmacies are increasingly becoming the go-to places to help patients monitor their health conditions, particularly those with chronic conditions like diabetes or hypertension. This has been a long-standing vision of community pharmacy that is now becoming a reality in communities across the United States.

A key partnership involving the University of Pittsburgh, AACP, the Community Pharmacy Foundation and CPESN USA, a network of independent pharmacies across the country, is highlighting the importance of the evolving pharmacy workplace. They formed a group known as the ACT (Academia-CPESN Transformation) Pharmacy Collaborative. It is a national collaborative bringing together faculty from colleges of pharmacy “to unite, mobilize and amplify community pharmacy transformation efforts.” CPESN USA is a clinically integrated nationwide organization of pharmacy networks, including more than 3,500 pharmacies, working to advance community-based pharmacy practice in America.

The collaboration is spearheaded by a team from the University of Pittsburgh School of Pharmacy and a Task Force including AACP faculty representatives, CPESN USA leaders and key staff from AACP, NCPA, ACCP and APhA. The ACT Pharmacy Collaborative includes 94 colleges of pharmacy, with each dean stating their school’s commitment to the priority of community pharmacy practice transformation to patient-centered care in our neighborhoods nationwide. One of their latest ventures is the 50 Stories from 50 States Challenge, an initiative designed to accent the positive impacts of pharmacies in communities.

Community pharmacy is transforming at a rapid rate, and the ACT Pharmacy Collaborative wants to help equip pharmacy faculty members to keep up with what is happening out there in practice. A big part of this is uniting all the right stakeholders to support the transformation of community-based pharmacy practice.

Dr. Miranda Steinkopf

Stories Across the Nation

The 50 Stories from 50 States Challenge will deliver stories of pharmacists and their teams caring for patients in community pharmacies. The intent is for the stories to inspire and educate students as well as professionals about the importance of pharmacies, including relationships with the medical community, community organizations and academia, said Dr. Melissa Somma McGivney, a professor and associate dean for community partnerships at the University of Pittsburgh School of Pharmacy.

The project also is intended to send a message to state and federal lawmakers about the value of community pharmacy as a point of healthcare access and care nationwide. Current laws limit the ability of the pharmacist to be recognized as a provider of healthcare services at state and federal levels.

“From my perspective, community pharmacy practice is evolving quickly,” McGivney said. “The 50 Stories from 50 States Challenge represents all the change that is happening. We need all the schools to be sharing and encouraging students to learn about what is being done in community pharmacies. It’s not the same as it historically has been.”

“Together we want to amplify all the positive, impactful patient care that is happening nationwide,” McGivney added. “And so this 50 Stories from 50 States Challenge meets these criteria. We’re uniting together to tell a story, to amplify what is occurring around the country.” As for the regulatory message, she pointed out that “pharmacists are providers of patient care. With drug reimbursement at an all-time low, the business of community pharmacy is changing.”

While about 80 percent of chronic disease treatment is through drug therapy, “chronic care is often disjointed and complex,” she said. “There are a lot of forces coming together. Pharmacists can help meet these needs.” Among the many issues: People needing access to care, such as in rural areas, where there is a shortage of primary care practitioners. In the meantime, healthcare payers, the insurers, are demanding quality metrics with uneven funding.

Dr. Miranda Steinkopf, an Academic Leadership and Education Fellow at AACP who has been instrumental in working on the project, echoed the idea that pharmacy practice is experiencing unrelenting changes and the importance of initiatives like the 50 Stories from 50 States Challenge. “Community pharmacy is transforming at a rapid rate, and the ACT Pharmacy Collaborative wants to help equip pharmacy faculty members to keep up with what is happening out there in practice,” Steinkopf said. “A big part of this is uniting all the right stakeholders to support the transformation of community-based pharmacy practice.”

ACT Pharmacy Collaborative logo

Under the 50 Stories from 50 States Challenge, pharmacy trainees (e.g., students, residents, fellows), practicing community pharmacists and pharmacy professors from each state collaborate on stories that reflect the importance of community pharmacies. Each story submission includes a written narrative, a video recording and pictures describing the community pharmacy, its services, the population it serves and a specific story about providing care to an individual or group of patients. Officials are still gathering the stories (with more than 50 submissions so far), hoping to get all 50 states as well as Washington, D.C. and Puerto Rico involved. The documents and recordings will be available for use as early as this summer in a multimedia library on the ACT Pharmacy Collaborative website and promoted on partner sites with open access for practicing pharmacists, pharmacy organizations, students and others.

“Pharmacists in community pharmacies have demonstrated their ability to directly care for patients through vaccinations, testing and expanded services such as comprehensive medication management using the appointment based-model, disease-specific monitoring services such as hypertension and diabetes care, to name a few,” McGivney said. “We have witnessed pharmacists going out of the pharmacy to take care of the population, instead of the community always going to them. The pharmacist is one of the only healthcare professionals who tend to be mobile; we tend to take the show on the road—especially for vaccines.”

Many people in the general population “don’t know the totality of what a pharmacist is capable of doing,” McGivney said. “We are trying to make these stories accessible in everyday language. In general, people have an understanding that pharmacists can dispense medication, but many people don’t know we can play a huge role for chronic disease management, measuring a patient’s progress and checking them, working with doctors in collaborative practice agreements to make adjustments in medications that ultimately benefit patients.”

The ACT Pharmacy Collaborative has featured previous challenges including a national day of service, a legislative day challenge and a patient case challenge, which resulted in a workbook available at www.actforpharmacy.com, said McGivney. CPESN had approached University of Pittsburgh officials knowing the school was active in the community pharmacy practice space and asked them to help launch a nationwide program. Community pharmacists became involved, and various faculty and pharmacist leaders from 14 states designed the ACT Pharmacy Collaborative, she said.

“They asked, how can we take this same concept and encourage it in other parts of the country?” McGivney recalled. The university spoke to other groups and attended various meetings involving pharmacy faculty and clinicians. “We heard from faculty members that they often felt isolated from other faculty members because they weren’t practicing in the same environment,” she added. Eventually, the 50 Stories from 50 States Challenge was launched.

“We recognize the power of stories to form connections and better understanding,” Steinkopf said. “We felt the 50 Stories from 50 States Challenge could be so powerful in education and advocacy because the stories allow for a deeper look at the amazingly impactful work occurring in community pharmacies and share this in a way that numbers or statistics never could.”

We are trying to make these stories accessible in everyday language. In general, people have an understanding that pharmacists can dispense medication, but many people don’t know we can play a huge role for chronic disease management, measuring a patient’s progress and checking them, working with doctors in collaborative practice agreements to make adjustments in medications that ultimately benefit patients.

Dr. Melissa Somma McGivney

Highlighting How Pharmacies Help Communities

Generally, the stories showcase the role pharmacies play in helping people who may be impacted by chronic conditions or receiving vaccinations, said Dr. Sophia Herbert, an assistant professor of pharmacy and therapeutics at the University of Pittsburgh School of Pharmacy. Herbert mentioned a story involving a five-year-old and her father who were in a pharmacy and tested positive for strep throat. Since their illness was detected on a holiday, the pharmacy was allowed under state law to both test and treat the patient with the appropriate medication under protocol, without the need of an additional appointment.

A story submitted by Puerto Rico focused on how community pharmacists responded to various public health emergencies that impacted the island over the last few years, including Hurricane Maria, earthquakes and COVID-19. As they evaluate the states’ story submissions, students and faculty will examine research, evaluate the writing and review clinical work with experts, Herbert explained. “It’s definitely a team effort. The students helping to review stories are getting a lot out of it, through information gathering and learning about pharmacy practices and patient care. It can be an eye opener, especially for a student who doesn’t know the full breadth of patient care and what’s happening in community pharmacies.”

The stories are likely to reflect “what pharmacy teams are bringing into the communities, which is ready access to a trained healthcare professional in our rapidly changing healthcare system,” Steinkopf said. “Pharmacists are providing care to communities not only when other access points are shut down but all the time.” In addition, pharmacies are playing a crucial role in communities where people have disproportionately fewer resources and higher disease burden, she said.

In areas of chronic disease management, pharmacists have been found to be “uniquely positioned help patients deal with chronic diseases, because people often go to their pharmacy much more frequently than they go to their doctors’ offices,” Steinkopf pointed out. She noted that often regulators who dictate legislation related to pharmacy “don’t know all that the pharmacists are doing, and they are not paid or reimbursed accordingly.”

“We are trying to highlight through these stories all of the great work that community pharmacists are doing to care for patients across the country in many different ways,” Steinkopf said. In that way, too, faculty, student pharmacists and legislators continually learn how the profession is evolving and what they can do to help support this evolution.

Joseph A. Cantlupe is a freelance writer based in Washington, D.C.