{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,18]],"date-time":"2026-03-18T10:02:37Z","timestamp":1773828157174,"version":"3.50.1"},"reference-count":50,"publisher":"Wiley","issue":"4","license":[{"start":{"date-parts":[[2017,10,10]],"date-time":"2017-10-10T00:00:00Z","timestamp":1507593600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["The Journal of Rural Health"],"published-print":{"date-parts":[[2018,9]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Purpose<\/jats:title><jats:p>To examine the relationship between area population density and community pharmacy\u2010based Alzheimer's Disease (AD)\u2010related services: pharmacists\u2019 medication knowledge and counseling, immunizations, and in\u2010stock cognitive enhancers in 3 predominantly rural regions of the United States.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>A standardized interview was administered by telephone to a 100% sample of community pharmacies in 3 areas: Northern California\/Southern Oregon (n = 206), North and South Dakota (n = 278), and West Virginia (n = 420). Key study outcomes included: pharmacists\u2019 medication knowledge, availability of immunization services, and cognitive enhancers in stock. Respondents were classified by population density (persons\/mi<jats:sup>2<\/jats:sup>) by pharmacy location to evaluate the relationship between rurality and AD\u2010related pharmacy services. Chi\u2010squared and logistic regression analyses were performed using Stata 10.1.<\/jats:p><\/jats:sec><jats:sec><jats:title>Findings<\/jats:title><jats:p>Pharmacies in more rural areas (50.1\u2010100.0, 25.1\u201050.0, and \u226425.0 persons\/mi<jats:sup>2<\/jats:sup>) were about 50% less likely to offer immunizations (95% CI: 0.32\u20100.91; 0.32\u20100.76; 0.28\u20100.80, respectively) compared to the least rural areas (&gt;100.0 persons\/mi<jats:sup>2<\/jats:sup>). Compared to the least rural areas, pharmacists in the most rural areas (\u226425.0 persons\/mi<jats:sup>2<\/jats:sup>) were less likely to name \u22652 gastrointestinal adverse effects of donepezil (OR = 0.50, 95% CI: 0.31\u20100.82) or have memantine XR 28 mg (OR = 0.61, 95% CI: 0.41\u20100.89) and other surveyed medications (OR = 0.57, 95% CI: 0.39\u20100.82) in stock.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>We found disparities in AD\u2010related services in community pharmacies located in more rural counties, wherein individuals with AD and their caregivers may face barriers to obtaining quality pharmaceutical care. There is a need to strengthen pharmacists\u2019 knowledge and improve pharmacy services to reduce disparities.<\/jats:p><\/jats:sec>","DOI":"10.1111\/jrh.12279","type":"journal-article","created":{"date-parts":[[2017,10,11]],"date-time":"2017-10-11T02:42:40Z","timestamp":1507689760000},"page":"347-358","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":14,"title":["Rural Disparities in Alzheimer's Disease\u2010Related Community Pharmacy Care in the United States"],"prefix":"10.1111","volume":"34","author":[{"given":"Paul Jacob","family":"Henkel","sequence":"first","affiliation":[{"name":"Department of Geographical and Historical Studies University of Eastern Finland  Joensuu Finland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4998-8921","authenticated-orcid":false,"given":"Marketa","family":"Marvanova","sequence":"additional","affiliation":[{"name":"School of Pharmacy, College of Health Professions North Dakota State University  Fargo North Dakota"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2017,10,10]]},"reference":[{"key":"e_1_2_6_2_1","unstructured":"USDA.Farm Income and Wealth Statistics. 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