Improving Management of Chronic Diseases in Rural Areas Begins with Maximizing Community Pharmacy Services


Community pharmacies are an untapped resource in rural areas but need to market their services to effect changes in public health.

Rural areas in the United States frequently lack adequate health care resources in reasonable proximity to patients. Often, patients travel long distances to the closest health care clinic, which creates difficulty in receiving quality care for chronic conditions such as diabetes or cardiovascular disease (CVD); however, community pharmacists are generally very accessible, but underutilized.

Community pharmacists boast quality interactions with patients and a plethora of knowledge about drugs and disease state management. Now, a targeted media campaign in South Dakota may improve utilization of community pharmacy services.

A group of researchers in low population density South Dakota sought to improve awareness of expanded pharmacy services in communities with limited access to adequate health care services. The researchers developed a media and print campaign called “Your Pharmacist Knows” throughout pharmacies in South Dakota. The campaign highlighted available pharmacy services, including medication therapy management (MTM), adherence help, and cost savings.

The researchers surveyed patients before and after the ad campaign using the modified theory of planned behavior (mTPB). This theory is a theoretical model that assesses individuals’ intent to use expanded pharmacy services based on the following constructs:

  • Attitude: Individual perception of benefit of using pharmacy services.
  • Perceived benefits and norms: Individual perception of pharmacy services based on other members of the community.
  • Perceived control: Individual perception of how easy or difficult accessing pharmacy services will be.

Researchers compared these mTPB constructs against age, gender, insurance status, and education level. All mTPB constructs were significant for individuals’ intention to use pharmacy services.

The results also showed a significant improvement in patients’ use of pharmacy services during the media campaign. The greatest improvement was seen in patients of female gender, with higher education, and having insurance coverage.

“Our findings prove beneficial for developing ways to better advertise pharmacy services to patients and education on the benefits of these services to promote overall public health,” the study authors wrote.

The results demonstrate that targeted media can affect perceptions of the benefits of pharmacy services or how difficult/easy accessing these services is. Using these findings, we may be able to improve care for patients with chronic conditions that are an enormous burden to the health care system and that have high mortality rates.

The right ad campaign can affect patients’ attitude, perceived norms, and benefits. Perceived control may drive people to take advantage of expanded pharmacy services. If we can affect attitude, social norms, and perceived control, then we can get them to use services.

The most significant driver of individual intent to use pharmacy services was knowledge. This emphasizes a key point: Pharmacists need to showcase pharmacy services and actively market those services to low socioeconomic patients with chronic diseases.

About the Author

Elizabeth Leander, PharmD, is the pharmacy manager at Big Y Pharmacy in Manchester, CT.


Pinto S, Kotschevar C, Hunt A, et al. Impact of a Public Health Awareness Campaign on Patients' Perceptions of Expanded Pharmacy Services in South Dakota Using the Theory of Planned Behavior. Pharmacy (Basel). 2022;10(6):178. Published 2022 Dec 19. doi:10.3390/pharmacy10060178.

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