Pharmacy characteristics correlating to performance in a community pharmacy network

Area of Science:

• Pharmacy Practice
• Health Services Research
• Pharmacoeconomics

Background:

• Community pharmacy networks are increasingly utilized to enhance patient care and outcomes.
• Understanding the relationship between pharmacy operational characteristics and performance is crucial for network optimization.
• Existing research has not comprehensively evaluated how diverse pharmacy attributes influence a wide array of performance metrics.

Purpose of the Study:

• To investigate the correlation between specific pharmacy characteristics and a comprehensive set of performance measures within a community pharmacy network.
• To identify which structural and operational factors in pharmacies are associated with better or worse performance outcomes.
• To inform the development of criteria for high-performing community pharmacy networks.

Main Methods:

• A cross-sectional survey collected baseline data on demographics, services, technology, and staffing from 123 pharmacies in the North Carolina community pharmacy enhanced services network.
• Performance data, including adherence, hospitalization, emergency department visits, medical costs, and a composite score, were collected and calculated for each pharmacy.
• Multivariable statistical models using generalized estimating equations (GEE) were employed to assess the associations between pharmacy characteristics and performance measures.

Main Results:

• Of the 115 pharmacies analyzed, five pharmacy characteristics demonstrated significant associations with at least three performance measures.
• Pharmacists in non-dispensing roles, home visits, and smoking cessation programs were positively linked to improved adherence and overall scores.
• Free home delivery showed mixed results (positive for diabetes adherence, negative for total medical spending and ED visits), while dispensing automation was negatively associated with adherence to certain medication classes.

Conclusions:

• No single pharmacy characteristic was found to be associated with a majority of the performance measures evaluated.
• The study highlights the complex interplay between pharmacy operations and performance outcomes.
• Further investigation is required to identify robust structural variables that can serve as minimum criteria for selecting high-performing pharmacies within networks.