Academic Exchange Quarterly     ISSN 1096-1453    Volume 22, Issue 3    Fall 2018

Community Engaged Culturally Sensitive Pharmacy Design
Our article, “Community Engaged Culturally Sensitive Pharmacy Design,” (Fall 2018 issue) presents lessons learned
from a collaborative community-engaged project in a pharmacy, which is focused on patient-centered care. The goal
of the project was to provide interior-design students a service-learning experience aimed at bridging the gap between
theory and practice in an authentic setting. Interior design students gained disciplinary and cross-cultural experiences
while problem solving for the pharmacy, which mainly serves Hmong and Karen cultures. Students reported about
learning about the community, gaining a better understanding of pharmacy needs and cultural aspects as major benefits
of this experience. We hope our findings help stimulate discussion and research about pharmacy design, client-care
outcomes, and how our approach could be a model for educators to use with students interested in culturally-sensitive,
client-sensitive pharmacy design.

The article speaks well to our approach and provides details about the project. We’ll take this editorial opportunity to
offer more about client care, pharmacy interior design, and a future research direction.

Pharmacies and the profession of pharmacy, which provides licensed practitioners to those pharmacies, have evolved like any
other business wishing to survive, including other health care enterprises. In the U.S., people needing prescription medications
go mainly to brick-and-mortar pharmacies. Last year, just over 4 billion prescriptions were filled in retail U.S. pharmacies. (1)

However, more than $500 billion in health care spending results from so-called “drug-related problems.” These problems
include patients simply not taking their medications as prescribed. According to research recently published (2, 3), only half
of medications prescribed for treating acute and chronic conditions are taken as originally recommended.

Some patients elect not to fill a prescription, they confront impediments to filling a prescription, or use only a few doses
without finishing the course of treatment, which can lead to poor outcomes or hospital readmission, adding to health-care costs.
Nevertheless, the most frequent drug-related problem occurs when a person has a chronic condition that could be remedied but
who, for a range of reasons, does not initiate treatment.

The conditions may be quite mild or sporadic, not rising to the level of concern that might prompt a person to seek medical care.
Alternatively, people may not seek medical attention because of a lack of primary-care clinicians, high out-of-pocket costs,
access or medication-use issues, or having insufficient or a lack of insurance.

Pharmacists, the nation’s third largest health profession, frequently have direct contact with patients, physicians, and other
prescription-writing providers in most locations. Pharmacists are well situated to intervene on patients’ behalf.

Now, what about the places where most pharmacists work? Could a more inviting, culturally-sensitive design help patient-client
groups feel more comfortable when choosing to come to a pharmacy for assistance or have prescriptions filled? What are
these pharmacies like? Are pharmacies designed for efficiency for its employees, to satisfy legal requirements, or to be inviting
for patrons? What do patrons think about going to a pharmacy and how it looks?

Take a look; what do you see in your neighborhood? Over the last few decades independent, sole-owner pharmacies have
decreased dramatically. The number of conglomerate, corporate pharmacies has risen. The shift in ownership is a debate for
another day. Let’s focus on the physical appearance, the design, of the majority of corporate U.S. pharmacies serving a walk-in,
ambulatory trade.

Corporate pharmacies look similar. The architecture and design reinforce a corporate brand. A brick-and-mortar location in an
urban area or within a supermarket or big-box store has the same look and feel as a rural location, even if the square footage
varies. The brand may be reinforced, but what do the clientele, the patients using medications, think about an environment when
they consider seeking a pharmacy for medication information, an empathic approach, a place to discuss a sensitive subject, a
reinforcing word, privacy, or information on general health topics? How do patients respond to design changes that a large
enterprise introduces corporate-wide? (4)

Without a doubt, designing a pharmacy to be culturally inviting for its patrons is a socially good thing. We submit that it is time
to go further and ask how a pharmacy’s interior design influences medication-related outcomes of its clientele, its patients, current
and future, which wish to use a pharmacy. In other words, would a cultural or client-sensitive designed pharmacy contribute to a
reduction in “drug-related problems” among its patients? We believe this would be an excellent collaborative opportunity and a future
area for research.

(1) Number of Retail Prescription Drugs Filled at Pharmacies by Payer [Accessed July 2, 2018]

(2) Cost of not Taking your Medicine [Accessed July 9, 2018]

(3) Viswanathan M, Golin CE, Jones CD et al. Interventions to improve adherence to self-administered medications for
        chronic diseases in the United States: a systematic review. Ann Intern Med. 2012 Dec 4; 157 (11): 785-95.

(4) Walgreens Unveils Rebranding Effort as Pharmacy Wars Escalate [Accessed July 9, 2018]

        Abimbola O. Asojo, University of Minnesota
        Paul L. Ranelli, University of Minnesota
        Alina Cernasev, University of Minnesota
        Justine Pliska, University of Minnesota

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