Factors contributing to the recruitment and retention of rural pharmacist workforce: a systematic review

Background: Recruiting and retaining medical, nursing, and allied health professionals in rural and remote areas isa worldwide challenge, compromising continuity of care and population health outcomes in these locations.Specifically, pharmacists play an essential and accessible frontline healthcare role, and are often the first point ofcontact for health concerns. Despite several incentives, there remains a maldistribution and undersupply ofpharmacists in rural and remote areas across many parts of the world. Although current systematic reviews havefocussed on factors affecting pharmacists’ retention generally, literature specifically focused on rural pharmacistworkforce in a global context remains limited. The aim of this systematic review is to identify factors associatedwith recruitment and retention of the pharmacist workforce in rural and remote settings. Better understanding ofthese contributors will inform more effective interventional strategies to resolve pharmacist workforce shortages.Methods: A systematic search of primary studies was conducted in online databases, including Medline, Embase,CINAHL, Scopus, Web of Science and PsycINFO, and by hand-searching of reference lists. Eligible studies wereidentified based on predefined inclusion/exclusion criteria and methodological quality criteria, utilising the CriticalAppraisal Skills Programme (CASP) and Good Reporting of A Mixed Methods Study (GRAMMS) checklists.Results: The final review included 13 studies, with quantitative, qualitative, or mixed methods research design.Study-specific factors associated with recruitment and retention of pharmacists in rural practice were identified andgrouped into five main themes: geographic and family-related, economic and resources, scope of practice or skillsdevelopment, the practice environment, and community and practice support factors.Conclusions: The results provide critical insights into the complexities of rural recruitment and retention ofpharmacists and confirms the need for flexible yet multifaceted responses to overcoming rural pharmacistworkforce challenges. Overall, the results provide an opportunity for rural communities and health services to betteridentify key strengths and challenges unique to the rural and remote pharmacist workforce that may beaugmented to guide more focussed recruitment and retention endeavours