Coordinated Primary Care Access in Rural and Suburban Alberta and Rural Wyoming: A Systematic Review and Narrative Synthesis of Community Pharmacist-Family Physician Care Models

Background/Objectives: Primary care access in Alberta, Canada is dictated by geography, attachment, timeliness, continuity, and local service burdening. Physician and primary care delivery in rural communities are subject to travel burden, workforce fragility, and intermittency, while suburban communities have immediate proximity to facilities, but are also challenged by delayed access, low attachment, and fragmented episodic care. These access challenges are echoed in rural and frontier contexts in the United States including the state of Wyoming. In this systematic review and narrative synthesis we investigated if and how care coordination between community pharmacists and family physicians, increases primary care access in rural and suburban Alberta, and how transferable those findings are to rural Wyoming and other similar frontier settings. Methods: We searched PubMed/MEDLINE, Embase, Scopus, CINAHL, and the Cochrane Library using controlled vocabulary and free-text terms to identify English-language peer-reviewed studies and practice-relevant evidence published from 1 January 2010 to 19 April 2026 related to primary care access, rural, suburban and frontier settings, Alberta, Wyoming, community pharmacy, pharmacist prescribing, physician-pharmacist collaboration, medication management, chronic disease care, continuity, and emergency department use. Earlier landmark primary-care, physician-pharmacist collaboration, and medication-safety studies were retained only when necessary for conceptual framing. Results: We screened 34 eligible records for inclusion in the narrative synthesis, and seven official contextual sources were included for jurisdictional interpretation. Strong evidence demonstrates that pharmacists are accessible primary care extenders where community services are coordinated with family physicians through documentation, referral pathways, red-flag protocols, and shared medication plans. The strongest evidence is specific to hypertension, cardiovascular risk reduction, and medication management and chronic disease monitoring. Direct Alberta-Wyoming comparative intervention evidence is limited. Conclusions: Physician-pharmacist coordinated care should be implemented prospectively as a geographically tailored access model, not a physician replacement model, with evaluation of access, continuity, medication safety, emergency department use and equity.