July 17, 2024
Written by Mary Gilbert
The UNC Eshelman School of Pharmacy’s Rural Pharmacy Health Initiative (RPHI) internship places the School’s pharmacy students in rural practice sites to advance health care accessibility for far-reaching Eastern North Carolina communities. This successful program also works to grow and sustain the rural health care workforce of the future. A major goal of this initiative is that as these pharmacy students become rooted in the rural North Carolina communities in which they are training, they will see the vast opportunities available as a health care provider and choose to one day return to build their professional careers.
Through the RPHI, the UNC Eshelman School of Pharmacy, with support from Carolina Across 100, is collaborating to improve access to health care across 18 Eastern North Carolina counties through the establishment of rural pharmacy hubs. These are thriving rural regions where medically underserved patients can access equitable care through advanced pharmacy services. The rural pharmacy internship inspires pharmacy students to play an active role in patient care through clinical experience and engaged learning about rural communities.
Meet the 2024 RPHI Summer Interns
Kashish Patel, interning in the Area L Rural Pharmacy Hub, spoke about why she was drawn to the Rural Pharmacy Health Initiative.
“The opportunity to work directly with patients in rural areas, where access to health care can be limited, resonated deeply with me.”
Patel pursued the six-week internship because it offered her the chance to gain “hands-on experience” working in rural communities. She added that the internship promised “to broaden my understanding of the social determinants of health and the role of pharmacists in improving outcomes in diverse community settings.”
The motivations of another intern, Jalisa Grissett, differed based on her personal experiences. Growing up in a rural North Carolina community, Grissett witnessed the impacts of limited access to health care resources on her community. “I just wanted to be a part of this initiative and work to improve, not only access to care, but quality of care and quality of life for these patients.”
Bridging the Resource Gap
In rural communities where the nearest hospital is an average of 10.5 miles away, pharmacists and their interns often serve as the front door to health care.
“In Duplin County specifically, there is a shortage of primary care providers, which ultimately leads to a lot of unmet health care needs,” Grissett says.
During the internship, pharmacy students support the staff at the rural health hubs in many different ways. Grissett says that pharmacists and students are working daily to offer preventative care, patient education and more to patients. Some of these services were previously unavailable unless the patient saw a primary care physician.
Another intern, Zach Vera, expressed how understanding rural communities has been a major part of their learning experience. They emphasized the importance of a pharmacist being knowledgeable about community habits, like tobacco use and farming, and how that can influence compassionate care and conversations with rural patients. Similarly, Kyle Endsley said, “The community I serve often has the desire to be healthier, but often lacks the resources to do so.”
Vera points out that perspectives about perceived importance of health generally emphasize urban populations, rather than rural ones. Endsley and Veras’ experiences speak to the growing need for better access to care in rural communities. The RPHI is working in these rural areas through community partnerships to reduce negative health outcomes and provide desperately needed services. Collaborating with local health centers, community pharmacies and county health departments, the program is actively working to bridge the gap in resources.
A unique area of learning for several of the interns was related to 340b Drug Discount Pricing. The 340b Drug Pricing Program under the Health Resources and Services Administration enables low-income patients to access medications at a more affordable price. Endsley says the 340b Program has a profound impact on how the clinic operates and sets future goals, which “generates a significant amount of savings for the clinic that can be used to improve clinic provisions.” That money can support patients through funding opportunities like expanded clinic operations or the hiring of more providers.
More Equitable Outcomes
Vera, Patel, and Grissett all mentioned that they see pharmacy practices impacting chronic disease management for patients in their rural communities. Their work, in conjunction with pharmacists and other health care professionals at these rural health hubs, aims to improve overall community health and reduce disparate health outcomes.
When asked who benefits the most from their work, the RPHI interns overwhelmingly responded “patients.” The rural health hubs work to break down existing barriers to health care access like transportation, scheduling conflicts, and medication information to improve patient quality of life.
Grissett talked about witnessing firsthand the increased health needs within medically underserved communities, more specifically, for patients who are uninsured, minority populations and children. Her experiences underscore the opportunity for impact through the RPHI program, building community collaboration to provide much-needed care for rural patients.
When asked how they think pharmacy practice will continue to impact health care in rural communities, RPHI interns were excited and hopeful. Grissett expects rural pharmacy practice to produce quick change through patient interaction and continued conversations about personalized care. Likewise, Endsley trusts that the opportunity for rural pharmacists to fill health will improve patient outcomes and grow the health and resilience of these communities. Vera believes the future of rural health is tied to data access and utilization, and Patel is eager for more telehealth services and remote patient monitoring to reach rural areas, promoting equality and improving access to care.
Looking Forward
Stephanie Kiser, BScPhm, Executive Director of the Rural Pharmacy Health Initiative and Professor of the Practice with the UNC Eshelman School of Pharmacy, is proud of the RPHI internship program and is eager to grow this collaboration. “The future of advancing pharmacy practice and serving our medically underserved communities lies in the hands of our future pharmacy graduates. We know that having the experience to be truly embedded in a community with these outstanding rural healthcare providers has broadened their understanding of the impact a pharmacist can make. These four inaugural rural pharmacy interns are a key element and model for collaborative, interprofessional workforce development in service to improving the health of our rural North Carolinians.”
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