Community Pharmacies Actively Advance Clinical Trial Access

Research keeps the pharmacy field growing and improves health outcomes. Collecting, analyzing, and interpreting data—in other words, research—is a strong suit for many pharmacists. Yet few community pharmacies participate in organized research despite their locations in areas where potential study participants live.^1,2 Research is not just an academic endeavor. It can be career enhancing, personally fulfilling, or a stepping stone to academia.³

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CLINICAL TRIALS: THE NITTY-GRITTY

Clinical studies are laborious, time-consuming, and detailed. Many studies need to be conducted in health care environments that can provide the necessary funding, personnel, resources, and training. For example, research involving intravenous (IV) oncology medications would need access to sterile compounding, monitoring equipment such as electrocardiogram machinery and laboratories, and individuals trained in the art and science of providing IV oncology medications. In community pharmacies, other areas are more adaptable and often relate to pharmacy practice.^4,5 Diabetes, cardiovascular risk, infectious disease, and similar diagnoses seen often in the community are areas ripe for research.⁴

Pharmacists assist with research in many ways, as Table 1^2,6 indicates.

Pharmacists may need training because the research process is strictly structured and heavily regulated. Ultimately, the key concern is patient consent and safety. To date, community pharmacists are often more involved in the mandatory tasks associated with research, such as dispensing and recordkeeping.

With more emphasis on practicing at the top of their licenses, pharmacists may find a foray into research inviting. For decades, experts have urged pharmacists to be more involved in the study of OTC medications.⁷ With more products available for self-treatment than ever, data are needed concerning use patterns, effectiveness, and safety. To produce reliable data, pharmacists will need to address confidentiality and informed consent, randomization if the research compares groups, blinding if appropriate, and adherence to ethics.^6,7

Adherence support is also a critical research function.⁸ Analysis estimates that medication nonadherence rates in clinical trials range from 22% to 41% despite considerable support from study staff. Nonadherence in clinical trials lengthens studies, increases expenses, complicates study results, and muddies statistical analysis. Involving pharmacy staff who can promote, encourage, and monitor adherence has been shown to help.⁸

One area in which community pharmacy involvement in clinical trials is tremendously beneficial is increasing participant diversity.^1,9 Many clinical trials lack ethnically diverse populations, which creates limitations to the applicability of the study findings. In the United Kingdom, researchers identified pharmacies as a key recruitment tool during the COVID-19 pandemic. Participating pharmacies, many of which were located in areas home to many racial and ethnic minority groups, displayed promotional materials, and pharmacists discussed clinical trial opportunities with patients. Indeed, pharmacy involvement increased diversity.^4,10 Researchers involved in this endeavor are pushing for more pilot studies, additional funding, and increased collaboration with primary care providers for community pharmacies.⁴

Patient reluctance to participate is a related challenge that slows trial accrual.⁹ Patients have many questions about research and may be more reluctant if random assignment to placebo is possible.⁹ Pharmacists need excellent communication skills to assuage patients’ apprehension and emphasize the altruistic value of participation.

Certain barriers may prevent community pharmacists from engaging in research or expanding their participation.³ Time constraints are one problem, as the detail-oriented work associated with research requires unfettered concentration.^3,5,9 Remuneration is another; pharmacists, like all health care professionals, want and need to be paid for their work. Infrastructure development is also a concern. Pharmacists need training, space, and a process to find appropriate trials or develop their own.^3,5 In the latter case, community pharmacists can benefit by contacting pharmacy schools and collaborating with faculty. Access to an institutional review board, which is essential for studies involving human participants, is also a problem for some sites. Interestingly, some pharmacists worry about maintaining their motivation and interest; running a research project is the opposite of filling a simple prescription. It can take months or even years to complete, and often, failure is a reality.⁵

GETTING INVOLVED

Many research opportunities are available in community pharmacy, but interested parties may need to look for them.¹¹ Table 2 lists some avenues to become involved.

CONCLUSION

Community pharmacists are proven assets in the community in many ways, and increasing involvement in clinical trials can elevate their profile and benefit medicine as well. Their proximity to and relationships with patients can help develop reliable real-world data.

REFERENCES

1. Wilkinson E. Ethnicity research gap: is pharmacy the key to making trials more representative? Pharm J. 2023;311(7975). doi:10.1211/PJ.2023.1.189935

2. Atanasov V. Study of the role and participation of the pharmacist in clinical trials of medicinal products. Presented at: Sofia University St Kliment Ohridski; 2022; Sofia, Bulgaria.

3. Crilly P, Patel N, Ogunrinde A, Berko D, Kayyali R. Community pharmacists’ involvement in research in the United Kingdom. Pharmacy (Basel).2017;5(3):48. doi:10.3390/pharmacy5030048

4. PRINCIPLE Trial. Accessed March 17, 2025. https://www.principletrial.org/

5. De Vera MA, Campbell NKJ, Chhina H, Galo JS, Marra C. Practical strategies and perceptions from community pharmacists following their experiences with conducting pharmacy practice research: a qualitative content analysis. Int J Pharm Pract. 2018;26(4):302-309. doi:10.1111/ijpp.12409

6. Chaplin S, Blenkinsopp A. Clinical trials in community pharmacies. BMJ. 1992;304(6819):63-64. doi:10.1136/bmj.304.6819.63

7. Masheter HC, Brown EG. Clinical trials in community pharmacies. BMJ. 1992;304(6823):385. doi:10.1136/bmj.304.6823.385

8. Robiner WN. Enhancing adherence in clinical research. Contemp Clin Trials. 2005;26(1):59-77. doi:10.1016/j.cct.2004.11.015

9. Abdel Shaheed C, Maher CG, Williams KA, McLachlan AJ. Participation of pharmacists in clinical trial recruitment for low back pain. Int J Clin Pharm. 2014;36(5):986-994. doi:10.1007/s11096-014-9985-y

10. PANORAMIC. Accessed March 17, 2025. https://www.panoramictrial.org/

11. Martinez J, Laswell E, Cailor S, Ballentine J. Frequency and impact of pharmacist interventions in clinical trial patients with diabetes. Clin Ther. 2017;39(4):714-722. doi:10.1016/j.clinthera.2017.02.006