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Equitable Access to Chronic Therapies in Hospital Pharmacy Settings: A Conceptual Framework for Continuity of Care

Cindy Serwaa Asiedu, Alice Adwubi Asiedu

Abstract

Patients with chronic conditions depend on uninterrupted access to long-term therapies, yet hospital pharmacy settings in resource-constrained environments face recurring obstacles to delivering that continuity equitably. This article synthesizes the literature on chronic-therapy access in hospital pharmacy settings and proposes a conceptual framework for diagnosing and strengthening continuity of care. Drawing on pharmacy practice, health-services, and equity research, it identifies the principal points at which access to chronic therapies is interrupted or unequally distributed, including formulary availability, stock continuity, dispensing workflow, affordability and payment barriers, and the management of patients requiring sustained treatment. The framework groups these into dispensing-level and system-level determinants and specifies the relationships through which they shape the continuity and equity of access for chronic patients. It then maps a set of practice-level interventions to each determinant, such as structured stock management for chronic medications, patient-level continuity tracking, and affordability navigation, and states the conditions under which each is expected to improve access. Rather than reporting case data, the article contributes a model that reframes equitable chronic-therapy access as a manageable function of identifiable, modifiable determinants. Propositions connecting specific determinants to continuity outcomes are offered, and the article concludes with a research agenda for testing the framework across comparable hospital pharmacy contexts.

Keywords

chronic therapy; continuity of care; hospital pharmacy; access to medicines; equity; noncommunicable diseases; stockouts; affordability.

References

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