Lukas Berenbroek Photo: Amy Obizinski
While many Americans face challenges accessing health care, most have easy access to a pharmacy.
That’s the central premise driving the research of Lucas Berenbrock (PHARM ’13G, MED ’17), an associate professor of pharmacy and therapeutics at the University of Pittsburgh School of Pharmacy, who is interested in how pharmacies can become entry points or delivery centers for certain aspects of health care.
During the COVID-19 lockdown in 2020, Berenbroek launched a project to map the locations of around 62,000 pharmacies across the country to understand how they were filling gaps in people's medical needs.
This effort to visualize pharmacy access has become an especially valuable tool over the past year as many independent pharmacies and national chains like Rite Aid, CVS and Walgreens have closed stores, raising concerns about what have been called “pharmacy deserts.” The Associated Press used the map this spring as part of a national project on pharmacy closures.
Berenbroek also hosted the inaugural Over-the-Counter Hearing Aids and Hearing Self-Care Symposium, held at Pitt on June 7. The event brought together thought leaders from the fields of pharmacy, audiology and public health to discuss how modern over-the-counter (OTC) hearing aids are improving patients' access to hearing health care in the United States.
“What connects the two projects is access,” Berenbroek says. “Pharmacies are in every neighborhood and they're open at night, on weekends and holidays when other medical facilities are not, so people rely on them as a place to get medical care and help maintain their overall health.”
We spoke with Berenbroek about his work; the interview has been edited for length and clarity.
Pitt Magazine: What first sparked your interest in becoming a pharmacist?
Lucas Berenbrock: I loved the chemistry part, I loved the science behind it, and I loved the idea of being able to help people in a very tangible way. I grew up in Beaver County and my first job was at Giant Eagle restocking shelves and preparing carts. My favorite part of the job was standing at the end of the conveyor belt bagging groceries because I got to talk to people. It made me feel like I was part of the community. That's why I'm drawn to community pharmacy, because I like being the focal point and the face of the community.
When I was in pharmacy school at the University of Pittsburgh, I was researching ways that community pharmacists could not only dispense medications, but also provide immunizations and comprehensive medication reviews. In 2012, I went to the American Pharmacists Association annual meeting and represented the University of Pittsburgh in the patient counseling competition at the national competition. I placed in the top 10 at that meeting. It gave me the confidence to say, “I'm good at talking to patients and doing what community pharmacists do best.”
How did your mapping project begin?
I wanted to prove this point. It's often said that 90% of Americans live within 5 miles of a pharmacy, but it's hard to find where that statistic came from. We thought there was a gap in the literature, so I got together with mapping experts from the Department of Geology and Environmental Sciences here at the University of Pittsburgh and my colleagues from the School of Pharmacy. We wrote a white paper at the time that assumed that the COVID-19 vaccine would be administered at a local pharmacy, projecting where pharmacies would be, when the vaccine would be available, and how pharmacies would be the sites of vaccine distribution and administration. That paper was published a couple of days before the emergency use authorization of Pfizer's COVID-19 vaccine was granted. It was very exciting to see that analysis published and people relying on it for their vaccine planning efforts.
Since then, we've been applying mapping to different things that can be done in community pharmacies. We have some projects with students looking at OTC contraception, which just launched in the first quarter of 2024, and we have another group looking at OTC hearing aids. We're able to apply the map to show where products are available and that people can have easier access to them if they're available in a community pharmacy.
What first got you interested in hearing aids?
In 2017, I brought first-year pharmacy students to senior community centers to do what we call “brown bag reviews.” Seniors brought their medications in brown paper bags, and the students reviewed the medications with faculty, answering any questions they might have and explaining safety and effectiveness.
As I was thinking about other things that older adults need help with, hearing came to mind. That's how I connected with the audiology folks at the School of Health and Rehabilitation Sciences (SHRS). My longtime collaborator, Elaine Mohmer, professor of audiology and vice chair of clinical education in communication sciences and disorders at the University of Pittsburgh, came in with her students to get their hearing tested. She looked at me and said, “Hey, you know, a law just passed that's creating a new category of hearing aid that's going to be available over the counter.”
“Nobody was talking about this in pharmacy yet, but everybody was talking about it in audiology. And now we've developed a program to educate pharmacists about hearing health care and over-the-counter hearing aids. We're doing more research to find practice models and getting pharmacists to work with audiologists so there's team collaboration.”
What about pharmacy closures? Are you seeing any patterns?
Going forward, we're going to start doing some analysis looking at trends in closure rates. We also want to analyze that against opening rates because closures are only one side of the coin. If pharmacies are opening in places where pharmacies are closing, is it really a problem? Some have suggested that pharmacies are closing in socio-economically disadvantaged areas and opening in more affluent areas, but we haven't done that analysis yet. We plan to do that in the second half of 2024.
When you first got into this field, did you imagine that cartography would be such a big part of your work?
One of the things that Pittsburgh College of Pharmacy has been talking about, especially to prospective students, about the PharmD is how versatile this degree is. Not everyone who graduates from pharmacy school becomes a clinician. Some go into managed care, consulting, the pharmaceutical industry. So we love this buzz because it opens up a much bigger world of opportunity for our graduates. Whenever we work on projects with students, we kind of highlight the fact that by doing this research, we're advocating for what pharmacists can do. We're advocating for patients by expanding access. I think that's the fun part of research, because we're always looking for new ways that pharmacists can provide or bring value to the health system and to health care.
What do you wish more people knew about the role of a pharmacist?
Pharmacists are an untapped resource and profession. We are well trained. We are the people with the most education about medicines. So part of our professional identity as pharmacists is medicine experts, but we are also health care providers and clinicians. When you think about pharmacists in this traditional dispensing role, that's a very narrow view of what pharmacists currently do.
Our profession has received a lot of attention since COVID-19. Now is our opportunity to use this attention to ensure that we are seen as clinicians and health care providers and people who can contribute to public health. I think our students are starting to realize that, too. That's part of why they're attracted to pharmacy.
