Building a more sustainable community pharmacy in rural Ohio


January 25, 2021

Lahrman photo
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Even on Christmas Eve, Shrivers Pharmacy and Wellness in Athens, Ohio, was serving its patients with at-home delivery of their medication needs. It’s this distinctive offering that allows the team at Shrivers to get to know their patients better, serve their needs more holistically and have an expanded role in the community due to a lack of other resources in rural Ohio.

“Shrivers provides a level of service that I don’t think you would see at any other pharmacy,” said Rebecca Lahrman, PharmD, MS, BCACP, a clinical pharmacist at Shivers and assistant professor-clinical at The Ohio State University College of Pharmacy. “We are able to build that trust and relationship with our patients.”

It’s that level of care and dedication to patients that Dr. Lahrman said makes community pharmacy so important. “I have a deep passion for community pharmacy and showing not only the value we add to the health care system but the services we can offer in sustainable ways."

Dr. Lahrman is in a unique position—rather, several positions at once—to be able to impact both pharmacy practice in her community and budding pharmacists and doctors working on their degrees.

In 2019, Dr. Lahrman was hired to a three-prong position created by Shivers owner Ben Holter, PharmD, RPh, MBA, and Sarah Adkins, PharmD, BCACP, a clinical pharmacist in the Division of Pharmacy Practice and Science at the Ohio State College of Pharmacy.

Lahrman at Shivers for flu shots
Dr. Lahrman provides flu vaccinations in the parking lot of Shivers during the pandemic.

Dr. Lahrman spends half of her workweek at Shivers as an on-staff pharmacist and in clinical services development. The other half is divided between teaching undergraduate and professional pharmacy students at Ohio State, teaching medical students at the Ohio University Heritage College of Osteopathic Medicine, assisting Ohio State pharmacy residents with community research and in various community service roles.

“My role collided with everyone needing these bits and pieces of help, and that need created a full position,” she said.

Dr. Adkins, who has held close ties with Ohio University and the Athens community, worked with Dr. Holter and Jennifer Rodis, PharmD, BCPS, FAPhA, associate dean for outreach and engagement at the Ohio State College of Pharmacy, to assemble the full-time position that met the needs at Ohio State, Ohio University and Shivers – and, importantly, to meet the needs of the Athens community.

Like many pockets of Ohio, the Appalachian region of the state where Athens is located is underserved in a variety of ways. Dr. Lahrman cites reliable transportation and medication affordability as just a few of the challenges that residents in her community face.

“One of the things that we often gloss over is that rural communities and inner-city communities actually have some of the same barriers to accessing health care, they just play a slightly different narrative,” she said.

Dr. Lahrman works closely with the local health department to serve patients with needs that may go beyond pharmaceutical. She sits on a care coordination committee within the department that includes representatives from local libraries, senior centers and other institutions, to focus on local health-related issues and promote programs created to solve them.

Ohio Rep. Edwards's visit to Shivers
Dr. Lahrman and PharmD student Kyle Zanath host Ohio state Rep. Jay Edwards in early 2020 for Zanath's advocacy APPE.

“She has immersed herself in the community,” Dr. Adkins said. “She is passionate about the patients, clinical outcomes and community pharmacy. She loves what she does and is an excellent coworker and pharmacist.”

Through her teaching, Dr. Lahrman can impart that passion on students from Ohio State and Ohio University.

Fourth-year Ohio State pharmacy students who do their Advanced Pharmacy Practice Experience (APPE) rotation at Shivers have the opportunity to learn how a rural independent pharmacy can meet the needs of its patients. Dr. Lahrman teaches them about sustainable practices both on the care side and the business side, stressing the importance of transparency to patients about the pharmacy’s payment structure. “If you see value in creating the service, there should be someone else seeing value in that as well,” she said.

For Ohio University medical students who do their rotation at Shivers, Dr. Lahrman demonstrates the relationship between pharmacists and medical practitioners. She said that she teaches from the standpoint of, “You’re a diagnostician, and that’s excellent, but I’m a pharmacy expert and I’m a drug expert and this is how I can help you to make your life easier and our practice better.”

Dr. Lahrman knows the value of experiential learning and mentorship. She received her PharmD and master’s degree at the University of Cincinnati, where she met many mentors who helped her find her passions within the field of pharmacy. Through her research and residencies, Dr. Lahrman kept an open mind about her career, which she said led her to her current role at Ohio State.

Lahrman on run
Dr. Lahrman enjoys running in beautiful southeast Ohio.

“Only Ohio State would partner with an independent pharmacy and a different university to bring together the really unique position I have in Athens,” she said. “I still don’t really know all of the opportunities I will have at Ohio State, but I know that they are endless and I am encouraged to pursue them. That is an opportunity in and of itself.”

The challenges brought on by the COVID-19 pandemic have allowed Dr. Lahrman to make changes to her pharmacy practice that not only make sense for the pandemic environment but are sustainable in a post-pandemic environment as well, such as serving more patients through the drive-thru and home deliveries.

Dr. Lahrman said she hopes that community pharmacies will continue to meet the needs of their patients by implementing unique methods and keeping their relationship with patients strong. “For me, it’s really those continuous patient interactions and having long-term relationships with patients, and community pharmacy is able to offer that.”