City folk and country folk

rural Australia

Do rural and urban community pharmacies actually differ in the services and practice models they offer?

It’s often stated that practising as a community pharmacist in rural and regional Australia is quite different to practising in urban areas, but is this actually the case?

Australian researchers who conducted a recent systematic review have only found limited evidence of any real differences between pharmacy in rural and urban locations.

The University of Tasmania researchers, who included former PSA national president Dr Shane Jackson, found 17 publications from the English speaking world that met their criteria of comparing the services offered in these settings. Five of the studies were Australian.

Overall, the extent of any differences between rural and urban community pharmacy practice has not been thoroughly investigated or defined, they concluded.

“There was some evidence that rural pharmacists were seemingly more willing take on new roles, deliver a higher level of pharmaceutical care and services, take on more clients for opioid substitution, initiate conversations about health or non-related topics, and talk longer to their customers,” the authors said.

“However, this conclusion is based on a small number of studies, often with a limited number of
respondents from a wide variety of contexts and based on simplistic data analysis, without adequate control for potential confounding variables”.

A 2003 Australian study of 1131 pharmacies, found no statistical difference in the provision of many professional services, including for hypertension and diabetes. However this research did find that more rural and remote pharmacies offered extra services for Aboriginal people, as well as more services in herbal medicine.

Another study found South Australian rural pharmacists were more prepared to provide opioid substitution and take on drug programme clients than their urban colleagues (90% versus 48%).

Rural pharmacies in this study had a lower number of clients per pharmacy (four compared to six) but the study suggested they had a higher degree of cooperation and communication with the GP prescriber. 

This better relationship with other healthcare providers was also indicated in international studies, the review authors said.

Further high-quality research was needed to fully ascertain any differences in community pharmacy practice between these settings, the authors concluded.

The research was published in the International Journal of Pharmacy Practice.

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