Community pharmacies are the ideal location to screen the public for social needs that impact health, according to a recent UB-led study that examined the implementation of two social determinants of health screening models at 10 pharmacies.
The study, published earlier this year in the Journal of the American Pharmacists Association, found that 65% of the 76 patients screened through the programs experienced social challenges, the most prevalent of which were affordability of daily needs and difficulties navigating the health care system. The findings will help the researchers develop a toolkit that guides pharmacies through implementing the services.
Social determinants of health are increasingly recognized as major drivers of individual health and well-being, as exposure to social disadvantages result in disparities in care, poor health outcomes and billions of dollars in medical costs, says co-principal investigator David Jacobs, assistant professor of pharmacy practice, School of Pharmacy and Pharmaceutical Sciences.
“Addressing health disparities and social inequity is the pharmacy profession’s next challenge,” says Jacobs. “Pharmacies play a central role in their communities, have strong relationships with their patients and local organizations, and are transforming into patient-care service centers. Given these strengths, community pharmacies are an ideal location for social-needs screening and referral programs.”
“There is a growing movement to integrate social determinants of health screenings within primary care,” says co-principal investigator Christopher Daly, clinical assistant professor of pharmacy practice. “Pharmacies serve as a point of contact in most communities, with patients visiting their local pharmacies twice as frequently as their primary care providers.”
Amanda Foster, postdoctoral associate in the pharmacy school, is first author.
Many community pharmacies already work with patients to alleviate social-related barriers to care, such as by offering home delivery to address transportation challenges or by recommending cost-effective medications to improve medication affordability. Developing formal screening and referral programs, however, could standardize these types of services and improve patient care, says Daly.
The study examined 10 pharmacies over a three-month period: nine in New York and one in Missouri. The pharmacies in New York employed a social-determinants-of-health-specialist model, in which a staff member was trained to provide screenings and refer patients to an independent practice association that later connected patients to local resources. The pharmacy in Missouri used a community health worker model, in which both screenings and referrals to resources were completed by pharmacy staff.
Both models were developed in collaboration with the Community Pharmacy Enhanced Services Network. Under each, pharmacy staff members were trained to recognize verbal cues and observe signs that a patient may be experiencing social challenges and to recommend them for screening.
Social needs assessments examine a wide range of complex personal, social and environmental factors. While more than 90% of pharmacy staff were comfortable helping patients navigate the health care system and find a primary care provider, only a third reported comfort in addressing issues related to mental health or unsafe housing conditions, such as issues involving domestic abuse.
The toolkit, as well as additional training in addressing patients’ physical and mental health concerns, may improve staff comfort with implementing screening programs, says Jacobs. The development of a reimbursement model is also necessary to ensure the sustainability of the programs, he adds.