MP02-11 IDENTIFYING TRUE BARRIERS TO MEDICATION AVAILABILITY IN RURAL AND LOW-INCOME AREAS: AN OPPORTUNITY FOR PATIENT ADVOCACY

Abstract

You have accessJournal of UrologyGeneral & Epidemiological Trends & Socioeconomics: Quality Improvement & Patient Safety I1 Apr 2018MP02-11 IDENTIFYING TRUE BARRIERS TO MEDICATION AVAILABILITY IN RURAL AND LOW-INCOME AREAS: AN OPPORTUNITY FOR PATIENT ADVOCACY Jorge Whitley, Amy Taylor, Paul Merguerian, and Kathleen Kieran Jorge WhitleyJorge Whitley More articles by this author , Amy TaylorAmy Taylor More articles by this author , Paul MerguerianPaul Merguerian More articles by this author , and Kathleen KieranKathleen Kieran More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2018.02.137AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES Obtaining medications may be difficult for patients with geographic and economic challenges, and may contribute to inadequate treatment of postoperative pain or delayed treatment of possible infections. We undertook this study to describe geographic and socioeconomic variations in the availability of medications commonly prescribed by pediatric urologists at pharmacies in our state. METHODS We queried all retail pharmacies statewide on opening hours, availability of 10 commonly prescribed pediatric medications (CPPM), compounding ability (CA), and services for limited English proficiency patients (LEPP). We stratified counties by population density (high [HPDC]: >200 people/square mile; low [LPDC]: <50 people/square mile), pharmacy density (PD), and household income (HI) to evaluate differences in medication availability. RESULTS 1057/1058 (99.9%) pharmacies took part, representing all 39 counties. Counties had a median 9 (range: 1-305) pharmacies. 760 (71.9%) pharmacies were open 7 days, and 19 (1.8%) were open 24 hours. PD and population density were strongly correlated (r2=0.98, p<0.001). More pharmacies in HPDC vs LPDC (75.6% vs 56.2%, p<0.001) and high vs low HI counties (76.9% vs 40%, p<0.001) were open 7 days. CA availability was similar in HPDC vs LPDC (100% vs 73.9%, p=0.48), and in high and low HI counties (100% vs 62.5%, p=0.30). More HPDC than LPDC had 24-hour pharmacies (62.5% vs 0%, p<0.001). No low HI counties had 24-hour pharmacies, while 62.5% of high HI counties did (p=0.30). Stock rates were similar for HPDC, LPDC, HHI, LHI counties, except for nitrofurantoin (Figure). Median time to stock a requested medication was 2 (range: 1-3) days. 65.9% of pharmacies offered services for LEPP (median 14 [range: 1-150] languages), as did all counties with foreign-born population >10%. CONCLUSIONS Limited pharmacy availability (e.g. decreased pharmacy density and reduced opening hours), rather than medication availability, may make filling prescriptions challenging for patients in rural and low HI areas. Using these data, we created a living database to help clinicians direct patients to pharmacies where prescriptions can be filled promptly. Understanding barriers to medication acquisition helps providers advocate for patients with potential challenges in care. © 2018FiguresReferencesRelatedDetails Volume 199Issue 4SApril 2018Page: e15-e16 Advertisement Copyright & Permissions© 2018MetricsAuthor Information Jorge Whitley More articles by this author Amy Taylor More articles by this author Paul Merguerian More articles by this author Kathleen Kieran More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...