Assessing barriers to COVID-19 diagnostic testing in community pharmacies: Insights from Alabama

The COVID-19 pandemic stressed the critical role of diagnostic testing in controlling the spread of infectious diseases. Due to their accessibility and presence in underserved areas, community pharmacies have become vital in decentralizing COVID-19 testing. Despite their potential, pharmacies face significant barriers in integrating testing services.

This study aimed to assess the provision of COVID-19 diagnostic testing across community pharmacies in Alabama and investigate how various pharmacist and pharmacy characteristics, along with perceived barriers, influence the likelihood of offering COVID-19 testing services.

A cross-sectional study was conducted targeting 1172 community pharmacies in Alabama. Data were collected via a mixed-mode survey from February to April 2023, achieving a response rate of 20.5% (n = 240). The primary measure was the new Pharmacist Perceived COVID-19 Diagnostic Testing Barriers, a 9-item Likert scale. Bivariate and multivariable logistic regression analyses were conducted to identify factors associated with testing provision.

Out of 240 pharmacies, 28.3% provided COVID-19 testing. Providers were significantly more likely to be corporately-owned (61.8%, P < 0.001); they also had higher prescription volumes (median 300, P < 0.001) compared to independent pharmacies. Lower perceived barriers in Organizational Logistics significantly increased the likelihood of offering testing (OR = 0.55, P = 0.028). In corporately-owned pharmacies, lower perceived personal exposure risk was a significant factor (OR = 0.65, P = 0.047), whereas independent pharmacies faced challenges related to regulatory compliance (OR = 0.35, P = 0.025).

The study highlights distinct barriers faced by corporately-owned and independent pharmacies. Corporately-owned pharmacies benefited from higher operational capacities but faced notable exposure concerns. Independent pharmacies, however, struggled with regulatory compliance, which impacted their testing service provision. Addressing the unique barriers different pharmacy settings face with tailored strategies is crucial for enhancing COVID-19 testing accessibility and strengthening public health efforts and pandemic preparedness.