Patients and Pharmacists Tackle SDOH, with Surprising Information

What is the business case for social determinants of health (SDH) and what would motivate payers to support these initiatives?

At the 2022 Annual Meeting of the Pharmacy Quality Alliance (PQA) on Wednesday, attendees heard about some unexpected insights stemming from a workshop held just before the start of the conference between patients and pharmacists who worked together to create a patient-centered, SDOH-focused outcomes research program within the community pharmacy setting.

During the session, 2 PQA staff members – DeBran Tarver, PhD, MPH, Qualitative Research Analyst, and Megha Parikh, PhD, MS, Principal Investigator – described the overall structure and goals of the project, which is funded by a patient. -Centered Outcomes Research Institute (PCORI) Eugene Washington PCORI Engagement Award. Announced in November 2021, the project is managed by PQA and the Patient Advocate Foundation (PAF).

The project brings together 6 patients and 3 pharmacists in a planning committee to create a patient-centered research program. They were guided by a gap analysis, which identified 5 key areas of SSD that impact patients in community pharmacies: transportation, housing, health literacy, food insecurity, and drug cost.

Additionally, the gap analysis identified patient preferences and experiences with DSS in the pharmaceutical setting and identified resource issues relevant to the pharmacy perspective, Parikh said.

Last month, the group met on Zoom to narrow down their search list and share stories about what each party has been through, Parikh said. For example, patients explained that they could not afford medicine or that they did not understand certain things about side effects.

“It was helpful for patients and pharmacy stakeholders to understand each other’s perspectives,” Parikh said.

They conducted surveys among themselves to decide the most important issues to work on in order to implement the SDOH initiatives, and in the working groups there was a lot of discussion about patient-pharmacist communication, appropriate screening tools and pharmacy infrastructure. There was additional prioritization of research topics ahead of the in-person meeting held this week just prior to the start of the PQA conference in Baltimore, Maryland.

Then she said, “They got a little rogue and added a topic that wasn’t on our list.”

For the group, their top priority turned out to be making a business case for SDOH and understanding their value and clarifying reimbursement issues.

Other important issues that emerged from the in-person session included better training for pharmacists and pharmacy staff, including technicians and clerks, on topics such as implicit bias, empathy and discussion. sensitive topics.

There also needs to be a better way to identify and connect patients to resources, the group decided.

Patients also had other ideas, such as pointing out that they see a pharmacist more often than they see their primary care provider and that they would like pharmacies to be “more accessible and inviting,” Parikh said.

From the perspective of pharmacists, the main takeaway is that “they don’t believe in the system as it is now; [it] doesn’t fit their current workflow or goals.”

“You can have as many tools and checklists as you want, but if you don’t have pharmacist engagement, or reimbursement, realistically screening and large-scale SDOH initiatives won’t happen. will not produce,” Parikh summed up.

The group will meet again in June for a final workshop.