Journal of the American Pharmacists Association : JAPhA · 2025
Implementation and outcomes of a pharmacist-led social determinants of health screening and intervention program in an integrated health system specialty pharmacy model.
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Lakada Irfana, Stutsky Martha, Huynh Carolkim, Periyasamy Shreevidya, Idusuyi Andrea
Аннотация
BACKGROUND: Social determinants of health (SDOH) are nonmedical factors that impact health outcomes. Pharmacists within integrated health system specialty pharmacies (HSSPs) are positioned to identify and address SDOH barriers.
OBJECTIVE: The objective was to implement and evaluate a pharmacist-led SDOH program for HSSP patients.
PRACTICE DESCRIPTION: The practice innovation was implemented within 4 health systems in Michigan and Massachusetts with associated HSSPs and a standard specialty pharmacy clinical management model incorporating initial patient counseling and periodic reassessments.
PRACTICE INNOVATION: A SDOH screening and intervention program was developed and piloted at 4 health systems with associated HSSPs. Patients with HIV, rheumatoid arthritis (RA), and hyperlipidemia meeting pre-defined inclusion criteria were enrolled in the program from September 2023 through September 2024. After screening patients for SDOH barriers, pharmacists offered targeted interventions and structured follow-ups to ensure resolution of challenges.
EVALUATION METHODS: Patients enrolled in the program were analyzed using data extracted from the electronic medical record and patient management platform. The primary outcome was intervention acceptance rate; secondary outcomes included intervention categories, patient-perceived value of interventions, ongoing support needs, pharmacist time spent, and clinical outcomes.
RESULTS: Of the 50 patients (HIV: n = 6; RA: n = 27; hyperlipidemia: n = 17) enrolled, 56% completed screening and 79% of those accepted interventions. Of the 19 patients who received follow-up, 63% found the interventions beneficial, and 4 required ongoing support. The most frequent interventions included food security/nutrition (46%) and physical activity (25%). The average time per intervention was 60 min (range: 15-180 min). Patients with interventions demonstrated clinical outcomes improvements, including a mean Routine Assessment of Patient Index Data 3 score reduction of 3 points (range: 1.3-27.3) and mean low-density lipoprotein reduction of 29.8 mg/dL (range: 44-137) for RA and hyperlipidemia, respectively.
CONCLUSIONS: These pilot results suggest that a pharmacist-led SDOH program may be effective in addressing patient barriers, demonstrated by high acceptance rate and perceived benefit of interventions and improved clinical outcomes.
OBJECTIVE: The objective was to implement and evaluate a pharmacist-led SDOH program for HSSP patients.
PRACTICE DESCRIPTION: The practice innovation was implemented within 4 health systems in Michigan and Massachusetts with associated HSSPs and a standard specialty pharmacy clinical management model incorporating initial patient counseling and periodic reassessments.
PRACTICE INNOVATION: A SDOH screening and intervention program was developed and piloted at 4 health systems with associated HSSPs. Patients with HIV, rheumatoid arthritis (RA), and hyperlipidemia meeting pre-defined inclusion criteria were enrolled in the program from September 2023 through September 2024. After screening patients for SDOH barriers, pharmacists offered targeted interventions and structured follow-ups to ensure resolution of challenges.
EVALUATION METHODS: Patients enrolled in the program were analyzed using data extracted from the electronic medical record and patient management platform. The primary outcome was intervention acceptance rate; secondary outcomes included intervention categories, patient-perceived value of interventions, ongoing support needs, pharmacist time spent, and clinical outcomes.
RESULTS: Of the 50 patients (HIV: n = 6; RA: n = 27; hyperlipidemia: n = 17) enrolled, 56% completed screening and 79% of those accepted interventions. Of the 19 patients who received follow-up, 63% found the interventions beneficial, and 4 required ongoing support. The most frequent interventions included food security/nutrition (46%) and physical activity (25%). The average time per intervention was 60 min (range: 15-180 min). Patients with interventions demonstrated clinical outcomes improvements, including a mean Routine Assessment of Patient Index Data 3 score reduction of 3 points (range: 1.3-27.3) and mean low-density lipoprotein reduction of 29.8 mg/dL (range: 44-137) for RA and hyperlipidemia, respectively.
CONCLUSIONS: These pilot results suggest that a pharmacist-led SDOH program may be effective in addressing patient barriers, demonstrated by high acceptance rate and perceived benefit of interventions and improved clinical outcomes.