The study, by a team from Durham University, is the first to show that most people in England, particularly in more deprived areas, live within walking distance of a community pharmacy.
The findings suggest that access to pharmacy services does not follow the "inverse care law" often quoted in respect of medical care - whereby the best medical care is most available to those who least need it. Instead, it follows its own "positive pharmacy care law," note the authors.
Lead author Dr. Adam Todd, of Durham's School of Medicine, Pharmacy and Health, says the role of the local pharmacist has changed considerably in the last few years. Community pharmacies are increasingly more concerned with promoting healthier living and helping people change their health-related behavior.
Community pharmacies well placed to deliver public health services
The new study calls on the government to help local pharmacies provide more services to tackle public health concerns.
He adds that their study shows England's local pharmacists are well placed "in the community to deliver public health services. This is particularly important for the poorest areas where more people die from conditions such as smoking, alcohol misuse and obesity compared to people from more affluent areas."
He and his team urge the government to help community pharmacies bolster their role and provide more services to tackle major public health concerns.
For the study, the team analyzed pharmacy location and local population data for all community pharmacies in England. Each pharmacy's postcode was assigned to a population lookup table, and matched to a deprivation index as well as to the type of area, such as urban, town and fringe, hamlet or isolated dwelling, as a measure of the number of households in the vicinity.
The main outcome measure was whether or not the households in an area - as defined by postcodes - had access to a community pharmacy within a 20-minute walk. A person walks about 1.6 km in 20 minutes, so the team placed 1.6 km "buffers" around each pharmacy to represent a 20- minute walk and then clipped the population postcodes to the pharmacy buffers.
They admit that one of the study's limitations is they had to represent the 20-minute walking distance as a straight line, which is not necessarily the case in real life.
89% of households in England within 20-minute walk of their community pharmacy
They found that overall, 89% of England's households are situated within a 20-minute walk of their community pharmacy. In areas of high deprivation, the percentage is even higher, reaching nearly 100% for some postcodes.
Dr. David Branford, chair of the English Pharmacy Board, suggests pharmacists are well placed to understand and deliver solutions for individual patients, and:
"The less formal approach and sheer convenience provided by a high street presence means they are a beacon of wellbeing and advice to many who would simply never engage with other healthcare settings. This study confirms their accessibility and the huge potential they have for delivery of quality healthcare to those who need it most."
As an example of what they mean, the Durham team points to Dixon and Hall, a group of four community pharmacies located in North East England.
As well as the customary clinical services such as flu jabs, treatments for minor ailments and emergency contraception, all four branches offer a range of health promotion services, including help with giving up smoking, plus health checks and advice on body mass index, cholesterol, alcohol and diet.
Dixon and Hall's managing director and pharmacist Louise Lydon says:
"Community pharmacies are an accessible option for patients, with a health professional available to discuss any issues without needing to book an appointment, which is a real opportunity for community pharmacies."
'Every contact is a health opportunity'
She says they follow an ethos of "every contact is a health opportunity," and openly ask patients about their smoking habits, as well as conduct brief alcohol interventions and carry out health checks on an ad hoc basis:
"This is an excellent way to engage with patients as we find appointment systems are often too formal and have high non-attendance for health promotion type interventions," she explains.
Meanwhile, another study published recently as part of the Pennsylvania Project in the US, found community pharmacist intervention boosts drug adherence and reduces health care costs.
Written by Catharine Paddock PhD