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Expanded practice in rural community pharmacy: a macro-, meso and micro-level perspective.

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  • 1Mt Isa Centre for Rural and Remote Health, James Cook University, Mount Isa, Qld 4825, Australia selina.taylor@jcu.edu.au.

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Expanding pharmacy services in rural Australia can improve healthcare access. Key themes for success include government support, interprofessional collaboration, pharmacist readiness, and community engagement to enhance rural health outcomes.

Keywords:
extended practicemodels of carepharmaciespharmacy practicescope of practiceAustralia

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Area of Science:

  • Health Services Research
  • Rural Health
  • Pharmacy Practice

Background:

  • Expanding community pharmacists' scope of practice can improve healthcare access in rural and remote areas.
  • Internationally, a lack of support from other health professionals (HPs) has hindered the adoption of expanded pharmacy models.
  • Rural allied health workers, including pharmacists, often operate with extended scopes to meet community needs.

Purpose of the Study:

  • To explore Australian rural and remote doctor, nurse, and allied health professional perspectives on expanded pharmacy services.
  • To identify barriers and facilitators for the uptake of expanded pharmacy models in non-metropolitan settings.

Main Methods:

  • A descriptive qualitative study using an ethnographic lens of rural culture.
  • Semi-structured, in-depth interviews were conducted with 23 rural and remote health professionals (doctors, nurses, allied health).
  • Thematic analysis was guided by a multi-level framework (macro, meso, micro) aligned with the WHO framework for integrated people-centred health services.

Main Results:

  • Key themes included the need for supportive government policies and funding (macro).
  • Collaboration with other health providers, pharmacists' capacity (knowledge, skills, time, space), and quality assurance were identified as crucial (meso).
  • Empowering and engaging consumers through rural community pharmacies was highlighted (micro).

Conclusions:

  • This study provides the first evidence for Australian rural pharmacists developing expanded practice models.
  • Addressing challenges and leveraging motivators for expanded pharmacy practice is essential.
  • Engagement from government and rural health providers is critical for successful implementation and improved rural health outcomes.